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Treatment-Resistant Depression Treatment Market Size, Share & COVID-19 Impact Analysis, By Drug Type (NMDA, Antidepressants, Antipsychotics, and Others), By Distribution Channel (Hospital Pharmacies, Drug Stores & Retail Pharmacies, and Online Pharmacies), and Regional Forecasts, 2022-2029

Region : Global | Format: PDF | Report ID: FBI102820



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The global treatment-resistant depression treatment market size was valued at USD 1.52 billion in 2021 and is projected to grow from USD 1.55 billion in 2022 to USD 2.83 billion by 2029, at a CAGR of 9.0% during the forecast period. The global COVID-19 pandemic has been unprecedented and staggering, with treatment-resistant depression treatment experiencing higher-than-anticipated demand across all regions compared to pre-pandemic levels. Based on our analysis, the global market exhibited a higher growth of 20.2% in 2020 as compared to 2019.

Treatment-Resistant Depression (TRD) is a type of Major Depressive Disorder (MDD), which occurs after inadequate response of at least two antidepressants during the treatment process. Several factors such as abnormal neural activity, melancholic clinical features, inflammatory system activation, bipolarity, neurotransmitter dysfunction, and a higher traumatic load are associated with this disorder. There are various treatment approaches for this mood disorder, such as monotherapy (antidepressants) and polytherapy. In polytherapy, a combination of various drugs and drug classes is given for the treatment of this mood disorder, such as the combination of two different antidepressants and the combination of antidepressants with antipsychotics, among others.

The treatment-resistant depression treatment market growth is accredited to the prompt upsurge in the prevalence of this mood disorder and the necessity to defend the life of the individual from suicide. Furthermore, many key players are emphasizing on the research and development activities to develop inventive drugs to treat this mood disorder, which is predicted to thrust the demand for its treatment during the forecast period.


COVID-19 Affirmatively Affected Market Revenue due to Growing Incidence of Depression 

The coronavirus pandemic has resulted in a remarkable demand for healthcare. The occurrence of COVID-19 cases has created global worries related to multiple psychiatric problems. A substantial rise in treatment-resistant depression treatment has been observed during these days, which is attributable to the rising incidence of this disorder during the lockdown and the high risks of suicides among patients. Furthermore, the pandemic has also elevated awareness and reduced the stigma surrounding mental health treatment, which increased the demand for its treatment.

For instance, according to the study published by Elsevier Inc. in October 2021, rates of depression climbed by around 28.0% in 2020 due to the effect of the COVID-19 pandemic. Such an increased rate of this disorder led to a rise in the incidence of this disorder during the pandemic.

Various market players and government-funded research institutes initiated drug development projects for this disorder through research grants to exploit the potential candidates under development, leading to the introduction of novel products for treatment during the forecast period.

Furthermore, the market players witnessed an increase in the revenue of drugs generated during 2020. For instance, H. Lundbeck A/S's Lexapro registered a growth of 9.7% in 2020 from 2019 due to increased engagement of healthcare professionals to treat a broad range of psychiatric diseases.


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Transition from Oral to Other Route of Administration to Spur Market

The rising occurrence of TRD has generated consciousness regarding its treatment. Various market players are developing advanced drugs that can be administered through nasal and intravenous routes rather than the traditional oral route of administration.

The traditional antidepressants used for this disorder treatment require at least 4-6 weeks to produce an effect with a risk of incomplete or poor outcomes through the oral route of administration, whereas the intranasal has been found to produce better results within hours of administration.

  • For instance, according to an article published by Pharmacopsychiatry in January 2022, the novel pipeline antidepressant MIJ821 of Novartis Pharmaceuticals demonstrated a more significant reduction in depressive episodes within 24 hours of administration via infusion weekly among patients. 

The overall findings displayed that treatment with intranasal esketamine in amalgamation with a novel oral antidepressant was more efficient than a placebo plus an oral administration. The intranasal esketamine showcased a prompt drop of depressive symptoms and postponed its relapse time.

Such increasing research & development for advanced drugs through other routes of administration is expected to surge the demand for drugs, thereby boosting the overall treatment-resistant depression treatment market growth.


Growing Prevalence of TRD Worldwide to Drive Market Growth

The surge in the prevalence of this mood disorder is one of the most critical drivers that positively impact the market's growth. TRD occurs when an individual hasn't responded to doses of two different antidepressants taken for an adequate time, usually six weeks. The increase in the prevalence of this medical condition has increased the demand for the treatment-resistant depression treatment.

  • According to Springer's research article published in August 2021, major depression disorders affect over 300 million people worldwide, and approximately one-third of patients with MDD have treatment-resistant depression.

The prevalence is also associated with disproportionate healthcare costs that have significant direct and indirect cost implications, which places considerable strain on healthcare and social resources.

The variability in the type of healthcare setting and accessibility to quality healthcare across the countries to assess unmet needs and treatment failure increases the demand for effective therapeutic measures.

Such a rising prevalence of this disorder and disproportionate healthcare costs, which varies across the globe, are anticipated to surge the demand for an effective treatment thereby, fostering the overall treatment growth.

Increasing Drug Development Projects for TRD to Boost Market Growth

The surge in the prevalence of TRD and the presence of few treatment options has stimulated the market players to initiate full-fledged research and development activities. Various major market players are focusing on developing new and innovative therapies in the market, citing the clinical benefits and a significant unmet need in treating the disorder globally. 

  • For instance, in August 2022, it is reported that GH Research invested USD 4.2 million in the Q2 of 2022 compared to USD 2.0 million for Q2 of 2021. The increase was due to increased activities related to clinical trials and employee expenses to support these activities. The company's lead pipeline candidate, GH001, completed Phase 1 and Phase 1/2 clinical trials in patients with TRD.

It is the leading cause of worldwide disability as conventional therapies are ineffective in a large patient pool, and novel therapies are needed to cater to this growing demand. Various pharmaceutical and life science companies are actively investing in clinical trials of potential pipeline candidates to introduce novel products for treatment.

  • In February 2022, Denova Biopharma secured U.S. FDA approval to initiate a Phase 2b clinical trial to analyze the efficacy and safety of DB104 (liafensine) in patients with treatment-resistant mood disorder.

Such active participation from the public and private players in developing potential candidates under investigational studies to accelerate the demand for treatment worldwide.


Poor Management of Disorders to Limit Market Growth

Despite increasing investment from market players in the TRD project for developing an effective therapeutic measure, there is poor management of this mood disorder, resulting in significant variations in how patients are being managed in real-world practice.

Furthermore, the lack of clarity in diagnosing patients is a significant challenge for its treatment. Patients drop out or discontinue treatment due to poor or no positive outcomes. Moreover, a cultural and social stigma toward reporting non-responsiveness to treatment, lack of therapeutic options, and inadequate guidelines for managing patients are cumulatively responsible for limiting market growth.

  • For instance, according to a December 2020 study published by NIH, for management of TRD, 41.0% of physicians reported treatment discontinuation and loss to follow-up as the top challenge, while 15.0% indicated a lack of therapeutic options as their biggest challenge. Another 14.0% and 13.0% were related to a lack of standardized TRD definition and specific guidelines, respectively.

Lack of clarity in guidelines for diagnosis and management of this mood disorder patients coupled with limited therapeutic measures is anticipated to hamper market growth during the forecast period.


By Drug Type Analysis

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NMDA to Expand at Highest CAGR due to Launches of Pipeline Drugs during the Forecast Period

Based on drug type, the treatment-resistant depression treatment market is segregated into NMDA, antidepressants, antipsychotics, and others.

The antidepressants segment is anticipated to extend at a moderate growth rate during the forecast period. The large share of the segment is due to the growing occurrence of this mood disorder which is projected to rise the demand for antidepressant drugs, such as serotonin and norepinephrine reuptake inhibitors (SNRIs) and Selective serotonin reuptake inhibitors (SSRIs) across the world. Furthermore, the research and development of antidepressants used in its treatment by the market players are predicted to propel segmental growth in the long run.

  • For instance, in June 2018, Navitor Pharmaceuticals, Inc. announced the initiation of Phase 1 clinical study with its NV-5138 for TRD. Such clinical studies of antidepressants are expected to boost segment growth during the forecast period.

The NMDA segment is predicted to expand at the highest CAGR during the forecast period, 2022-2029. The growth is due to the increasing research studies for developing NMDA drugs to improve treatment outcomes. Furthermore, the larger patient population suffering from this disorder and FDA approval of NMDA drugs developed by the key market are expected to fuel the segmental growth in the coming years.

  • For instance, in March 2021, Janssen Global Services, LLC announced U.S. FDA approval of SPRAVATO (esketamine) Nasal Spray for Adults with Treatment-Resistant Depression. Such approvals are expected to stimulate other market players for the R&D of NMDA drugs, thereby spurring segmental growth during the forecast timeframe.

By Distribution Channel Analysis

Hospital Pharmacies to Continue Its Dominance Owing to Increased Patient-visit to Hospitals 

Based on distribution channel, the treatment-resistant depression treatment market is categorized into hospital pharmacies, drug stores & retail pharmacies, and online pharmacies.

In 2021, the hospital pharmacies segment held the largest market share and is projected to expand at a significant CAGR during the forecast period, 2022-2029. In the treatment of this mood disorder, a prescription for drugs from a medical professional is needed, this is a crucial reason attributable to the segment's growth. Furthermore, the expansion of hospital pharmacies owing to increasing investment by the public sector in the healthcare infrastructure in emerging countries is predicted to propel the segmental growth during the forecast period.

The drug stores & retail pharmacies segment is expected to expand at a moderate CAGR during the forecast period, 2022-2029. The growth is due to increasing patient demand, an increase in the number of drug stores & retail pharmacies, and augmented capitalization by governments and other establishments to improve retail pharmacies.

The online pharmacies segment is anticipated to expand at the highest CAGR during the forecast timeframe. The segment's growth is due to the surging launch of online pharmacies. Furthermore, the growing investment in online pharmacies is expected to propel the segmental growth in the forecast timeframe.


North America Treatment-Resistant Depression Treatment Market Size, 2021 (USD Billion)

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North America led the treatment-resistant depression treatment market with a revenue of USD 0.79 billion in 2021 and is anticipated to remain dominant during the forecast timeframe. The growth is attributed to the increasing patient population suffering from treatment-resistant depressive disorder. Furthermore, the rising number of guidelines and approval of drugs for the treatment in the region is projected to drive market growth across North America.

Europe held the second-highest market share in 2021 and is anticipated to expand at a substantial CAGR during the forecast period. The significant R&D investment and increasing focus of market players to introduce drugs in the region are anticipated to increase the demand for treatment-resistant depression treatment during the forecast timeframe.

The market across Asia Pacific is predicted to expand at a moderate CAGR during the forecast period. The CAGR of the region is attributed to the rising awareness related to the treatment of this mood disorder coupled with its increasing prevalence.

  • For instance, according to a study published in the Indian Journal of Private Psychiatry in 2019, the estimated treatment-resistant depression occurs in 10–30% of patients with MDD.

The rest of the world is estimated to develop at a relatively decreased CAGR during the forecast period. The growth is due to the surging healthcare expenditures and rising incidence of mood disorders.


Diversified Antidepressants Drug Offerings by Chief Players to Spur Market Growth

Eli Lilly and Company, Pfizer Inc., and GlaxoSmithKline plc are some of the top players in the market with a strong brand existence combined with drug offerings in diversified segments, including antipsychotics and antidepressants for treatment. The companies are emphasizing on investments in research and development activities to launch effective and highly advanced drug classes for the treatment of this disorder. Furthermore, a strong focus on tactical mergers with other companies & several research organizations to develop effective treatment options is expected to support the expansion of these companies in the future.

Other players involved of treatment-resistant depression treatment include Janssen Global Services, LLC, AbbVie Inc., Sandoz International GmbH (Novartis AG), H. Lundbeck A/S, Par Pharmaceutical (Endo International plc), Otsuka Pharmaceutical Co., Ltd., AstraZeneca, among others. These companies emphasize on business expansion through strategic acquisition and collaborations with market players to upscale their R&D activities.


  • Eli Lilly and Company (U.S.)

  • GlaxoSmithKline (U.K.)

  • Pfizer Inc. (U.S.)

  • Janssen Global Services, LLC (Johnson & Johnson Services, Inc.) (Belgium)

  • AbbVie Inc. (U.S.)

  • AstraZeneca (U.K.)

  • H. Lundbeck A/S (Denmark)

  • Sandoz International GmbH (Novartis AG) (Germany)

  • Par Pharmaceutical (Endo International plc) (India)

  • Otsuka Pharmaceutical Co., Ltd. (Otsuka Holdings Co., Ltd.) (Japan)


  • August 2022 - Merck Sharp & Dohme LLC initiated Phase IIa clinical trial to evaluate the safety and efficacy of MK-1942 among treatment-resistant depression patients.

  • July 2022 - Novartis Pharmaceuticals announced that it would initiate a Phase 2 clinical trial of MIJ821 (ketamine) for treatment-resistant depressive disorders in September 2022.

  • May 2022 - COMPASS Pathways presented positive data for Phase IIb study of COMP360 psilocybin therapy for treatment-resistant depression treatment at the American Psychiatric Association annual meeting in New Orleans.

  • December 2021 - GH Research announced successful outcomes of the Phase 1/2b clinical trial of GH001, an inhalable 5-MeO-DMT product candidate, for the treatment-resistant depression treatment.

  • September 2021 - Perception Neuroscience initiated Phase IIa clinical study to evaluate the safety and efficacy of PCN-101 (R-ketamine) for treatment-resistant depression treatment.


An Infographic Representation of Treatment-Resistant Depression Treatment Market

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The global treatment-resistant depression treatment market analysis includes a detailed competitive landscape, market trends, and market drivers. It focuses on key aspects such as the prevalence of TRD, regulatory scenarios by key countries/regions, and an overview of current advances in R&D for drugs in the market. Furthermore, the report provides information on key industry developments and detailed pipeline analysis. In addition, the report includes insights related to the impact of COVID-19 on the market.

Report Scope & Segmentation 



Study Period


Base Year


Estimated Year


Forecast Period


Historical Period



Value (USD billion)


By Drug Type, Distribution Channel, and Region

By Drug Type

  • NMDA

  • Antidepressants

  • Antipsychotics

  • Others

By Distribution Channel


  • Hospital Pharmacies

  • Drug Stores & Retail Pharmacies

  • Online Pharmacies

By Geography

  • North America (U.S. and Canada)

  • Europe (Germany, U.K., France, Italy, Spain, and the Rest of Europe)

  • Asia Pacific (China, India, Japan, Australia, and the Rest of Asia Pacific)

  • Rest of the World

Frequently Asked Questions

Fortune Business Insights says that the global market stood at USD 1.52 billion in 2021 and is projected to reach USD 2.83 billion by 2029.

The market is expected to exhibit a CAGR of 9.0% during the forecast period (2022-2029).

Antidepressant segment is projected to lead the market by drug type.

Key factors such as the growing prevalence of treatment-resistant depression and the growing research and development by market players for product launches are expected to drive the market growth.

Pfizer Inc., Eli Lilly and Company, GlaxoSmithKline plc, and AbbVie Inc. are the top players in the market.

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