George I. Papakostas

TL;DR: Clinical studies investigating the predictors of resistance following the failure of 2 or more antidepressant trials should be pursued, and further controlled clinical trials are essential to identify the most effective treatment strategies.

TL;DR: Atypical antipsychotics are effective augmentation agents in major depressive disorder but are associated with an increased risk of discontinuation due to adverse events.

TL;DR: A greater probability of receiving placebo, greater baseline severity and an earlier year of publication predicted greater antidepressant-placebo "efficacy separation", and fixed versus flexible dose design, trial duration and population age did not influence clinical trial outcome.

TL;DR: Current evidence supports adjunctive use of SAMe, methylfolate, omega-3, and vitamin D with antidepressants to reduce depressive symptoms.

TL;DR: A number of studies report poorer quality of life in MDD patients compared to controls, and trials comparing the role of newer psychopharmacologic agents in the acute phase of treatment, and the roleof newer psychotherapies in the continuation and maintenance phases of treatment are lacking, to help translate clinical response into restoration of psychosocial function and to thus further improve the standard of care.