escitalopram + mirtazapine + duloxetine + venlafaxine

This entry refers to a sequential pharmacological treatment regimen used in a clinical trial conducted by the Medical University of Vienna for patients with major depressive disorder (MDD). The protocol involves initial treatment with the selective serotonin reuptake inhibitor (SSRI) escitalopram. In cases of non-response after six weeks, patients are switched to alternative antidepressants, including the noradrenergic and specific serotonergic antidepressant (NaSSA) mirtazapine, or the serotonin-norepinephrine reuptake inhibitors (SNRIs) duloxetine or venlafaxine. The trial utilizes hybrid PET/MR imaging with a [11C]DASB radiotracer and an acute citalopram challenge to identify biomarkers for predicting individual treatment response by monitoring serotonin transporter (5-HTT) occupancy and regional brain activation changes.