Journal Club: Comparing FDA-Approved Adjunctive Antipsychotics in Major Depressive Disorder R619

Course Summary

Most adults with major depressive disorder do not achieve remission with initial antidepressant therapy. For patients with an inadequate response, augmentation with an atypical antipsychotic is a well-established treatment option. Five agents currently hold FDA approval for adjunctive treatment of MDD, yet no head-to-head trials have directly compared them. A 2026 network meta-analysis addresses this gap and indicates that response and treatment acceptability follow differing hierarchies across agents. This course reviews the study’s design, findings, limitations, and clinical implications for selecting adjunctive therapy in practice.

Course Format

Homestudy

Course Syllabus

• Introduction
• Diagnostic Criteria and the Inadequate Response Spectrum
• Treatment Approach
• Outcomes of Nonremission
• Journal Club: Efficacy vs. Acceptability – Comparing FDA-Approved Adjunctive Antipsychotics in MDD
  • Background
  • Methods
  • Results
  • Secondary Outcomes
  • Exploratory Outcomes and a Notable Discordance
  • Dose-Stratified Findings
  • Placebo Response Heterogeneity
  • Discussion
• Summary

Authors

Richard Daniels, PharmD, BCPS

Richard “Cole” Daniels earned his Doctor of Pharmacy(PharmD) from the Skaggs School of Pharmacy at the University of Montana in 2018. Throughout pharmacy school he completed a 3-year internship at Community Medical Center in Missoula, Montana in which he gained valuable experience in an acute care setting. Cole currently serves as a psychiatric clinical staff pharmacist at the Montana State Hospital. He has over 11 years of pharmacy experience having worked in several settings including retail, acute care, and inpatient psychiatric care. Cole has a diverse set of interests. However, acute care medicine, infectious disease, pain management, and asthma/COPD are a primary focus of his at the Montana State Hospital. He obtained board certification as a certified pharmacotherapy specialist in the Spring of 2022.

Summer Courtney, PharmD Candidate 2027

Summer Courtney is a PharmD candidate at the University of Montana Skaggs School of Pharmacy, with an anticipated graduation date of 2027. She is committed to advancing the profession of pharmacy through patient-centered care, advocacy, and the expansion of pharmacists’ roles within the healthcare system. Her professional interests include community pharmacy practice, rural health, and the development of innovative pharmacy services that can improve healthcare access and patient outcomes. Upon graduation, she plans to practice in a community pharmacy in Montana, where she hopes to address healthcare disparities and help enhance the delivery of care in rural and underserved communities.