(210) Adjunctive treatments for depression: Delineating real-world treatment patterns

Background: Current guidelines rarely address the use of adjunctive treatments for depression. However, previous studies indicate that adjunctive treatments are frequently employed for patients with severe symptoms or inadequate responses to initial treatments.

Objectives: This study aims to assess the real-world treatment patterns for adjunctive depression treatments. Specifically, it investigates the timing and types of adjunctive treatments added during the treatment course.

Methods: We identified first-time users of adjunctive treatment between 2015 and 2021 in the adult Danish population using Danish register data on hospital contacts, hospital-administered medicines, and redeemed pharmacy prescriptions. The initial depression-related hospital or pharmacy contact was defined as the index, and a six-month follow-up period was employed. Upon indexing, we excluded individuals with a history of severe mental health disorders, depression, and dementia. For this project, adjunctive treatment encompasses anti-psychotics and mood stabilizers prescribed with an indication for depression.

Results: 153,737 individuals were registered with a depression-related hospital (n=22,229) or pharmacy contact (n=131,508). At treatment initiation, the most common AD classes were SSRIs (64 %), NaSSAs (29 %), and SNRIs (11 %). As 8 % of the study population received Quetiapine six months after the index date, Quetiapine was the most used adjunctive, followed by Lamotrigine (2 %) and Olanzapine (1.5 %). Moreover, the prevalence of adjunctive treatment was markedly higher among individuals with a depression-related hospital contact compared to those with a pharmacy contact.

Conclusions: The widespread use of adjunctive treatments within six months of the initial depression-related hospital or pharmacy contact highlights the need for clear guidelines on their effective use in depression treatment.