Individualizing Treatment of Major Depressive Disorder: Balancing Efficacy with Tolerability

Summary: Major depressive disorder (MDD) is an illness of great morbidity that affects many people across the world. The current goal for treatment of MDD is to achieve remission. However, despite scientific advances in the treatment for MDD, antidepressants as first-line agents yield only modest remission rates. Not achieving remission from depressive symptoms increases the risk of a more chronic and debilitating course of illness with frequent relapses. Although a number of reasons contribute to these modest outcomes, the presence of residual symptoms is a major problem. In addition, side effects and nonadherence should be kept in mind throughout treatment. Only 25% to 50% of patients with MDD adhere to their antidepressant regimen for the length of time recommended by depression guidelines, and nearly 50% of depressed patients referred from primary care to specialty care treatment fail to complete the referral. 0.5 CME Credits