Expert Discusses Novel Antidepressant That Can Be Effective with Only 1 to 2 Annual Treatments

Pharmacy Times continues our discussion with Colville Brown, MD, vice president of Global Medical Affairs Depression Franchise and Alliance at Sage Therapeutics, who highlights a new type of antidepressant that is working faster and with far fewer side effects.

PT Staff: What are the adverse events (AEs) of treatment targeting γ-Aminobutyric acid type A (GABA-A) receptors?

Colville Brown, MD: That's also a really good question. Selective serotonin reuptake inhibitors (SSRIs) and SNRIs (serotonin and norepinephrine reuptake inhibitors (SNRIs) often take weeks to month to work. And even then, patients may not fully respond to treatments and may not go back to their baselines right—really go back to their lives. In addition, oftentimes the AEs, as soon associated with these medications, lead patients to come off the drug. So, it's not only because they're not responding, but AEs like sexual dysfunction, weight gain, high rates of nausea, gastrointestinal dysfunction, and diarrhea, all these AEs can lead a patient to not stay on a drug. So, they're looking for new treatment options that don't have the same side effect profile (both patients and physicians).

PT Staff:Does treatment with GABA drive patient adherence?

Colville Brown, MD: What we're seeing with zuranolone (SAGE-217/BIIB125; Biogen and Sage Therapeutics) is that it can work rapidly. And in 80% of those who respond, they only need 1 or 2 treatments throughout the course of the year. We're also seeing that the AE profile is different. We're not seeing the common side effects that are associated with current medications. We're not seeing sexual dysfunction, and we're not seeing weight gain. We believe that it has the potential to be an option for patients and, in talking with practitioners that are working every day, they see the value of zuranolone. They see that being able to bring patients back to their lives quickly is going to be beneficial and they understand that a treatment that the majority of patients may only need for 2 weeks could also be a potential game changer for that.

PT Staff: Has there been skepticism from psychiatrists and pharmacists?

Colville Brown, MD: Zuranolone is a novel rapid-acting therapy that, following 2 weeks of treatment as I mentioned, 80% of those who respond only need 1 or 2 treatments throughout the course of the year. What we're hearing from folks that are practicing pharmacists and psychiatrists in the field is that there is a need for novel treatment options that can lead to that rapid improvement in symptoms. And they see the value of new treatment options. New treatment options come into the space to address the gaps that they've had for years. They just haven't had treatment options for them.

PT Staff:Closing thoughts?

Colville Brown, MD: Depression is a substantial unmet need. It's a serious critical mental illness and patients are struggling—they want options. What we're hearing from clinicians that are practicing every day is that they're looking for new options and they want to help their patients. They are looking for novel therapies, and the field is evolving. Zuranolone is part of a third wave of antidepressant treatments that are going to revolutionize the space and clinicians are interested in, and looking forward to, that. I think it is an important milestone for the field. Depression is such a serious unmet need and is often overlooked and physicians/people don't recognize how serious it is and how managing and treating depression can improve lives.

Supplimentary Study:

• Impact of major depressive disorder on comorbidities: A systematic literature review; Arnaud AM, Brister TS, Duckworth K, et al. J Clin Psychiatry. 2022;83(6):21r14328.