Major Depressive Disorder (DSM-V) – Unmet Need – Detailed, Expanded Analysis: Treatment-Resistant Depression (US/EU)

Major depressive disorder is a chronic drug-treated condition, and treatment of it is ingrained with generic therapies. However, many of these therapies suffer from shortcomings in efficacy and/or safety and tolerability, resulting in treatment-resistant depression (TRD) and creating opportunity for improved therapies. Although branded agents such as Lundbeck / Takeda’s Trintellix / Brintellix (vortioxetine) and Janssen’s Spravato (esketamine) have expanded the armamentarium of therapeutic options, opportunity remains for new therapies. This report provides quantitative insight into psychiatrists’ perceptions of key treatment drivers and goals and assesses the current level of unmet need and opportunity in the treatment of TRD.


  • What are the treatment drivers and goals for TRD?
  • What are surveyed psychiatrists’ opinions of the relative performance of select therapies, including Trintellix / Brintellix, Spravato, Rexulti, aripiprazole, duloxetine, and off-label ketamine on key efficacy, safety / tolerability, and convenience of administration attributes in TRD patients?
  • What drug attributes are key influencers, which have limited impact, and which are hidden opportunities in the treatment of TRD?
  • What trade-offs across different clinical attributes and prices are acceptable to U.S. and European psychiatrists for a hypothetical new drug to treat TRD?


Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. One market scenario is profiled in detail by Clarivate experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

Markets covered: United States, United Kingdom, France, Germany.

Primary research: Survey of 62 U.S. and 30 European psychiatrists fielded in April 2022.

Key companies: Lundbeck, Takeda, Janssen, COMPASS Pathways.

Key drugs: Aripiprazole, Rexulti, bupropion SR, duloxetine, Trintellix / Brintellix, Spravato, ketamine (intravenous).

Content highlights

  • Target Product Profile (TPP) simulator based on conjoint analysis methodology.
  • Stated versus derived importance of product attributes on prescribing behavior.
  • Assessment of current drug performance against treatment drivers and goals.
  • Physician perceptions of unmet needs in the indication and related indications.
  • Analysis of remaining drug development opportunities.

Table of contents

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