The Journal of clinical psychiatry
Adjunctive Atypical Antipsychotics in Major Depressive Disorder: A Network Meta-Analysis Perspective and Consensus Panel Discussion
By Cutler AJ, Correll CU, Goldberg JF and 2 others.
Abstract
Objective
The goal of this consensus panel was to generate expert perspectives on the comparative efficacy, safety, tolerability, and clinical relevance of FDA-approved adjunctive atypical antipsychotics for adults with major depressive disorder (MDD) and inadequate response to antidepressant therapy.
Participants
Five academic and clinical experts in psychiatry and psychopharmacology participated as panelists: Roger S. McIntyre, Andrew J. Cutler, Christoph U. Correll, Joseph F. Goldberg, and Stephen M. Stahl. The discussion was conducted as a closed expert panel. Evidence: The panel primarily discussed research findings from two recent network meta-analyses (NMAs) evaluating approved adjunctive atypical antipsychotics in MDD, supplemented by relevant published literature and panel expertise. The NMAs differed in study inclusion, treatment-node definitions, and analytical approaches to examine efficacy, acceptability, and safety. Panel discussion was used to contextualize the findings and address their clinical applicability and limitations. Consensus Process: The panel reviewed and discussed the NMA methodology, comparative efficacy and safety outcomes, effect modifiers, and implications for shared decision-making. The consensus manuscript was developed from the panel discussion and evidence review, with subsequent expert review and incorporation of relevant comments and revisions.