Childhood maltreatment history for guiding personalized antidepressant choice in major depressive disorder: Preliminary results from a systematic review

Childhood maltreatment history for guiding personalized antidepressant<br> choice in major depressive disorder: Preliminary results from a<br> systematic review Childhood maltreatment (CM) is a predictor of poor outcome across treatments for major depressive disorder<br> (MDD), while its potential role as a predictor of differential responses to specific antidepressants has received<br> little attention. The present systematic review examined pharmacological studies (published up to June 30th,<br> 2020) that included head-to-head comparisons of antidepressant treatments among adult MDD patients with a<br> reported history of CM or no history to evaluate if CM may help clinicians choose antidepressants with greatest<br> likelihood of successful outcome. Only three studies were included, providing limited and provisional results.<br> These preliminary findings suggest that sustained-release bupropion (alone or in combination) or aripiprazoleaugmentation<br> as next-step intervention did not demonstrate differential outcome among MDD patients with or<br> without a history of childhood adversity. Further, sertraline and the group of antidepressants with low affinity for<br> the serotonin transporter may be less suitable for MDD patients with childhood abuse history than escitalopram,<br> venlafaxine-XR, or antidepressants with high affinity for the serotonin transporter. The critical question of the<br> most potentially efficacious treatment regimens for adult MDD with CM history requires further large-sample<br> studies involving a greater number of medications, specifically designed to analyse the moderating effects of<br> different types of CM, and possibly including objective biomarkers.