The following is a summary of “Effects of adjunctive brexpiprazole on patient life engagement in major depressive disorder: Post-hoc analysis of Inventory of Depressive Symptomatology Self-Report data” published in the June 2023 issue of Psychiatric Research by McIntyre, et al.
In major depressive disorder (MDD), patient-reported outcomes can capture meaningful domains, such as life engagement, which reflects life fulfillment, well-being, and participation in valued and meaningful activities. Using the 10-item Inventory of Depressive Symptomatology Self-Report (IDS-SR10) Life Engagement subscale, this study investigated the effects of brexpiprazole adjunct to antidepressant therapy (ADT) on patient life engagement over the short and long term. Three 6-week, randomized, double-blind studies of ADT + brexpiprazole 2–3 mg/day versus ADT + placebo in adult outpatients with MDD (DSM-IV-TR criteria) and inadequate response to ADTs were aggregated to generate short-term data.
A 26–52-week, open-label extension study of ADT + brexpiprazole 0.5–3 mg/day yielded long-term data. ADT + brexpiprazole (n = 579) demonstrated a greater improvement in the IDS-SR10 Life Engagement subscale score than ADT + placebo (n = 583), with a least squares mean difference of -1.19 (95% confidence limits: -1.78, -0.59; P=0.0001; Cohen’s d effect size: 0.23) over 6 weeks. On eight life engagement measures, ADT plus brexpiprazole was associated with greater improvement than ADT plus placebo (P<0.05), with effect sizes ranging from 0.12 to 0.24.
In the long-term study, the IDS-SR10 Life Engagement subscale score changed by -2.4 (4.9) points to Week 26 (n = 2047) and -3.7 (5.3) points to Week 52 (n = 768), with improvements on all ten items on average. Beyond its efficacy on depressive symptoms, adjunctive brexpiprazole may enhance patient life engagement, thereby facilitating personally meaningful functional outcomes in patients with MDD.