Evidence map›Paper›PMID 38406088›Full record

ArticleCureus2024

Personalized Approach in the Management of Difficult-to-Treat and Treatment-Resistant Depression With Second-Generation Antipsychotics: A Delphi Statement.

Hansal Bhachech, Kamal Nath, Roop Sidana, Nilesh Shah, Rajesh Nagpal, R Sathianathan, Ashutosh Kakkad, Krishnaprasad Korukonda

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Hansal BhachechDepartment of Psychiatry, Santvan Clinic, Ahmedabad, IND.
Kamal NathDepartment of Psychiatry, Silchar Medical College and Hospital, Silchar, IND.
Roop SidanaDepartment of Psychiatry, Tekchand Sidana Memorial Psychiatric Hospital and Deaddiction Centre, Sriganganagar, IND.
Nilesh ShahDepartment of Psychiatry, Lokmanya Tilak Medical College, Sion, Mumbai, IND.
Rajesh NagpalDepartment of Psychiatry, Manobal Clinic, New Delhi, IND.
R SathianathanDepartment of Psychiatry, Madras Memory Clinic, Chennai, IND.
Ashutosh KakkadMedical Services, Torrent Pharmaceuticals Limited, Ahmedabad, IND.
Krishnaprasad KorukondaMedical Services, Torrent Pharmaceuticals Limited, Ahmedabad, IND.
Indus University · INMinistry of Defence · INLokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College · INSilchar Medical College and Hospital · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Major depressive disorder (MDD) has many facets including mixed or atypical depression that requires personalized care to improve treatment-related outcomes. Second-generation antipsychotics (SGAs) offer complementary mechanisms for clinical roles in difficult-to-treat depression and treatment-resistant depression cases. Aim/objective To further delineate a consensus on the clinical positioning of SGAs for MDD, mixed, or atypical depression, a Knowledge Attitude Perception (KAP)-mediated Delphi Statement was planned. Material/methods A literature review for the definition, diagnosis, and management of MDD, mixed, and atypical depression as treatment-resistant depression (TRD) or difficult-to-treat depression (DTD) was conducted by a steering committee of academic and clinical experts (n=6) while developing a validated KAP questionnaire. Scientific statements as clinical recommendations were evolved using the Delphi methodology before building a clinical expert consensus with an online survey (n=24). Results Twenty-four psychiatrists highlighted DTD to offer a multidimensional approach to assess treatment strategies involving selective serotonin reuptake inhibitors (SSRIs) or SGAs, while ensuring symptom, functional, and quality of life (QoL) domain improvement for improved outcomes and remission rates. MDD cases with anxiety, anhedonia, comorbidities, and risk traits require personalized care with early induction of SGAs for severe cases or symptom persisters with functional impairment. Early augmentation with SGAs including aripiprazole or cariprazine can provide a favorable risk-benefit profile for clinical cases of MDD with or without the antecedent of mixed depression or personality disorder.  Conclusion The literature review and KAP responses emphasize the importance of early identification for personalized care strategies with SGAs for DTD. Large-scale real-world evidence needs to evolve with due recognition of different phenotypes as TRD or DTD with partial or functional impairment to understand the impact of appropriate treatment pathways with SGAs.

Indexed as

aripiprazolecariprazinedelphidifficult to treat depressionhealth knowledge attitudes practicemdd (major depressive disorder)personalized carequetiapinesecond generation antipsychoticstreatment-resistant depression

Identifiers

PMID38406088
PMCPMC10890970
OpenAlexW4391188173

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.