Neuromodulation for major depressive disorder: innovative measures to capture efficacy and outcomes. (December 2020)

• Record Type: Journal Article
• Authors: Rabin, Jennifer S; Davidson, Benjamin; Giacobbe, Peter; Hamani, Clement; Cohn, Melanie; Illes, Judy; Lipsman, Nir
• Is Part Of: Lancet. Volume 7:Number 12(2020)
• Page Start: 1075
• Page End: 1080
• Publication Date: 2020-12
• Subjects: Psychiatry -- Periodicals; 616.89
• DOI: 10.1016/S2215-0366(20)30187-5
• Languages: English
• ISSNs: 2215-0366

Abstract

Summary: Major depressive disorder is a common and debilitating disorder. Although most patients with this disorder benefit from established treatments, a subset of patients have symptoms that remain treatment resistant. Novel treatment approaches, such as deep brain stimulation, are urgently needed for patients with treatment-resistant major depressive disorder. These novel treatments are currently being tested in clinical trials in which success hinges on how accurately and comprehensively the primary outcome measure captures the treatment effect. In this Personal View, we argue that current measures used to assess outcomes in neurosurgical trials of major depressive disorder might be missing clinically important treatment effects. A crucial problem of continuing to use suboptimal outcome measures is that true signals of efficacy might be missed, thereby disqualifying potentially effective treatments. We argue that a re-evaluation of how outcomes are measured in these trials is much overdue and describe several novel approaches that attempt to better capture meaningful change.