Original Research J Clin Psychiatry August 2023

Cariprazine for the Adjunctive Treatment of Major Depressive Disorder in Patients With Inadequate Response to Antidepressant Therapy: Results of a Randomized, Double-Blind, Placebo-Controlled Study

JCP 2023;84(5):10.4088/JCP.22m14643

Full Article Read the complete peer-reviewed article in J Clin Psychiatry. Clinical Summary Many patients with major depressive disorder remain symptomatic despite an adequate antidepressant trial, leaving clinicians to decide whether adjunctive antipsychotic treatment is worth the tradeoff in benefit versus tolerability. This trial tests that real-world question for adjunctive cariprazine in an inadequate-response population and shows how a generally tolerable option can still fail to separate from placebo on depressive symptoms. FAQ Did adjunctive cariprazine improve depressive symptoms in adults with major depressive disorder who had an inadequate response to antidepressants?

Key Takeaways This phase 3 trial enrolled a moderately to severely ill inadequate-response population, with baseline MADRS total scores of 32.0–33.0, CGI-S scores of 4.6–4.7, and a current major depressive episode lasting 6 to 7 months, so the negative result applies to a clearly symptomatic adjunctive-treatment population rather than mildly ill patients. Clinical Guide How should clinicians select and start adjunctive cariprazine for adults with major depressive disorder who have had an inadequate response to antidepressant therapy?