CNS Volume 15 supplement 7 Cover and Front matter
Bibliographic record
Abstract
Despite the availability of a large number of antidepressants, treatment nonresponse in major depressive disorder (MDD) persists.As highlighted by findings from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, the first few months of treatment may be the most critical for treatment success.When the first antidepressant is not effective, a common dilemma is whether to use an adjunctive treatment or to switch medications completely.A substantial proportion of patients with MDD do not achieve remission from sequential courses of treatment with currently available strategies.Many who do improve are left with significant residual symptoms.Adjunctive treatments in MDD have the capacity to reduce relapse rates during the process of switching medication, provide neurotransmitter effects, or cause intended therapeutic side effects.However, they can also cause pharmacokinetic interactions, additive side effects, regimen complexity, and poorer compliance.Second-generation antipsychotics (SGAs) have a much larger evidence base than other adjunctive strategies for MDD, although they are associated with extrapyramidal side effects.While antidepressant monotherapy is the standard first-line treatment, psychotherapy still represents an important treatment pathway.Cognitive-behavioral therapy, interpersonal therapy, and several more basic forms of behavior therapy have been shown to have antidepressant efficacy comparable to antidepressant medication.In this Expert Review Supplement, Michael E. Thase, MD, provides an overview of unmet needs in the management of MDD.Highlighting findings from STAR*D, Dr. Thase discusses expected first-line treatment outcomes, augmentation/switch strategies, and the role of psychotherapy.Next, Michael Gitlin, MD, provides an overview of several first-line adjunctive treatments, focusing on lithium, triiodothyronine, and stimulants.Finally, J. Craig Nelson, MD, reviews the role of adjunctive SGAs in treatment-resistant depression.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.605 | 0.392 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".