Special Topics | Comorbidities in Major Depressive Disorder | US

Disorders such as anxiety, substance use disorder, and insomnia frequently coexist with major depressive disorder (MDD) and present treatment challenges to psychiatrists and primary care physicians (PCPs). Although multiple pharmacotherapies are available to manage MDD, none are FDA-approved specifically to treat MDD patients with a comorbid disorder. Additionally, a weak late-phase clinical pipeline for MDD and any comorbid disorder represents potential opportunities for drug development and areas of clinical differentiation from existing agents.


  • Which comorbid disorders are most common in MDD patients? How do physicians treat MDD patients with comorbid anxiety, substance use disorder, or insomnia?
  • What factors most influence physicians’ choice of current therapies for MDD patients with comorbid anxiety, substance use disorder, or insomnia?
  • How do branded drugs such as Otsuka / Lundbeck’s Rexulti, Janssen’s Spravato, and Takeda / Lundbeck’s Trintellix fit into physicians’ treatment of patients with MDD and a comorbid anxiety disorder?
  • How do physicians anticipate prescribing therapies in development for MDD comorbid with insomnia (i.e., Janssen’s seltorexant [JNJ-42847922] and Sage Therapeutics’ zuranolone [SAGE-217]) when they become available?


Clarivate’s Special Topics reports assess key trends in dynamic disease areas. This report on comorbidities of MDD will help drug marketers and developers gain needed insight on physician-reported treatment dynamics, prescribing behavior, key challenges managing MDD patients with comorbidities such as anxiety disorder, substance use disorder, and insomnia, most important attributes for emerging therapies for these comorbid disorders, and physician perceptions of select emerging therapies for MDD and comorbid insomnia.


Geographies: United States.

Primary research: Survey of 100 U.S. psychiatrists and PCPs. Interviews with three U.S. psychiatrists.

Key drugs covered: SSRIs, SNRIs, mixed serotonin modulators, atypical antipsychotics, NMDA receptor antagonists, mood stabilizers, opioid receptor antagonist, opioid receptor agonists, benzodiazepines, nonbenzodiazepine sedative-hypnotics, melatonin receptor agonists, dual orexin receptor antagonist, seltorexant, and zuranolone.

Key insights provided:

  • Patient characteristics.
  • Physician treatment practices and physician insight on medical practice.
  • Most important attributes for emerging therapies.
  • Anticipated use of emerging therapies.
  • Physician perception of unmet need.
  • Impact of COVID-19 on physician management.
  • Physician recommendation of digital therapeutics.
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