Dimensional effect profiles in treatment-resistant depression: A naturalistic, prospective head-to-head comparison of arTMS, esketamine nasal spray, and oral brexpiprazole

2026-07-28

PRE

Giacomo d’Andrea

Ottavia Susini

Federica Marsico

Giovanna Mammarella

Gianfranco Tamagnini

Antonio Inserra

Gianluca Mancusi

Giorgio Di Lorenzo

Francesca Pacitti

Mauro Pettorruso

Giovanni Martinotti

DOI：10.1016/j.jad.2026.122333

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• Real-world comparison of esketamine, accelerated rTMS, and brexpiprazole in patients with treatment-resistant depression. • All treatments were associated with clinically meaningful improvement in depressive symptoms over one month. • Esketamine showed greater effects on anhedonia, brexpiprazole on rumination, and arTMS on anxiety symptoms. • Symptom-specific responses highlight relevant differences among available TRD treatments in routine practice. • Results may help clinicians tailor treatment choices based on predominant symptom profiles.

Dimensional effect profiles in treatment-resistant depression: A naturalistic, prospective head-to-head comparison of arTMS, esketamine nasal spray, and oral brexpiprazole

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