Figure 3.

Treatment trajectory and resistance evolvement among incident patients with depression (N= 5,834)^a

^a 5,834 out of the 8,223 patients in the 2014 incident depression cohort were eligible for inclusion in this diagram as they had antidepressant monotherapy of adequate duration as their first treatment after incident diagnosis. The size of the colored nodes represents the number of patients taking different treatment regimens at each treatment step while the connecting grey bars represent the patient flow between the steps. ‘Stopped first/second-line treatment’ represents those with prescriptions from the previous step that ended before death or the study end date. ‘Continued first/second-line treatment’ represents those with prescription durations from the previous step that continued up until death or the study end date.

Abbreviation: SSRI – Selective serotonin reuptake inhibitor, SNRI – Selective norepinephrine reuptake inhibitor, TCA – Tricyclic antidepressant, MAOI – Monoamine oxidase inhibitor, AD - Antidepressant. The ‘Atypical’ group includes other antidepressants with mechanisms of action that are different from the major antidepressant classes.