Outcome MeasureDepression

MADRS

Montgomery–Åsberg Depression Rating Scale

41 Papers in Blossom

About This Instrument

The Montgomery–Åsberg Depression Rating Scale (MADRS) is a 10-item clinician-rated diagnostic questionnaire used to measure the severity of depressive episodes. Developed by Stuart Montgomery and Marie Åsberg in 1979, it was designed to be especially sensitive to treatment-related changes in depression severity. Each item is scored on a 0–6 scale, with total scores ranging from 0 to 60. The MADRS assesses apparent sadness, reported sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, lassitude, inability to feel, pessimistic thoughts, and suicidal thoughts. It is one of the most commonly used primary endpoints in psychedelic depression trials, including landmark psilocybin studies by Compass Pathways and others. The MADRS is preferred over the HAM-D in many modern trials because of its greater sensitivity to change and reduced emphasis on somatic symptoms.

Clinical Thresholds

060
Normal
Score 0–6
Mild
Score 7–19
Moderate
Score 20–34
Severe
Score 35–60

Outcome Data Across Studies

Reported results for MADRS across 5 studies with quantitative data.

Outcome data across 25 study arm–timepoint observations
SD
A Novel, Brief, Fully Automated Intervention to Extend the Antidepressant Effect of a Single Ketamine Infusion: A Randomized Clinical Trial
2022Primary
Ketamine + Cognitive Training(experimental)05332.35.7—
A Novel, Brief, Fully Automated Intervention to Extend the Antidepressant Effect of a Single Ketamine Infusion: A Randomized Clinical Trial
2022Primary
Ketamine + Cognitive Training(experimental)153—Δ2.20.001
A Novel, Brief, Fully Automated Intervention to Extend the Antidepressant Effect of a Single Ketamine Infusion: A Randomized Clinical Trial
2022Primary
Ketamine + Cognitive Training(experimental)3053—Δ1.20.019
A Novel, Brief, Fully Automated Intervention to Extend the Antidepressant Effect of a Single Ketamine Infusion: A Randomized Clinical Trial
2022Primary
Ketamine + Sham Training(active_comparator)150—Δ—0.001
A Novel, Brief, Fully Automated Intervention to Extend the Antidepressant Effect of a Single Ketamine Infusion: A Randomized Clinical Trial
2022Primary
Ketamine + Sham Training(active_comparator)3050—Δ0.00.019
A Novel, Brief, Fully Automated Intervention to Extend the Antidepressant Effect of a Single Ketamine Infusion: A Randomized Clinical Trial
2022Primary
Saline + Cognitive Training(inactive)05132.65.1—
A Bayesian Reanalysis of a Trial of Psilocybin versus Escitalopram for Depression
2023Secondary
Psilocybin + placebo(experimental)42—7.0Δ——
A Bayesian Reanalysis of a Trial of Psilocybin versus Escitalopram for Depression
2023Secondary
Psilocybin + escitalopram(active_comparator)42——Δ——
A phase 1/2 trial to assess safety and efficacy of a vaporized 5-methoxy-N,N-dimethyltryptamine formulation (GH001) in patients with treatment-resistant depression
2023Primary
Dose A(experimental)0433.0——
A phase 1/2 trial to assess safety and efficacy of a vaporized 5-methoxy-N,N-dimethyltryptamine formulation (GH001) in patients with treatment-resistant depression
2023Primary
Dose A(experimental)24-21.0Δ——

Papers Using MADRS

Open Accessindividual

Single dose IV ketamine for adolescent suicidal ideation in the emergency department: a pilot randomized trial

This double-blind, randomised, placebo-controlled pilot trial (n=20) tested a single IV dose of ketamine for suicidal thoughts in adolescents attending the emergency department. It found the study was feasible and well tolerated, but ketamine did not clearly reduce suicidal ideation at 40 minutes, although fewer participants were admitted to hospital at the initial visit.

Published
Journal
BMC Psychiatry
Authors
Schlegelmilch, M., Plint, A. C., Barrowman, N., Gray, C., Crawford, T., Kutcher, S. A., Bhatt, M.
Open Accessindividual

GH001 vs Placebo in Patients With Treatment-Resistant Depression A Randomized Clinical Trial

This randomised, double-blind, placebo-controlled Phase IIb trial (n=81) found that a single-day inhaled synthetic mebufotenin treatment (GH001; 5-MeO-DMT) reduced depression symptoms more than placebo in adults with treatment-resistant depression, with remission in over half of those treated. No severe or serious adverse events were reported during the placebo-controlled period.

Published
Journal
JAMA Psychiatry
Authors
Cubała, W. J., Bajbouj, M., Bauer, M., Baune, B. T., Cardoner, N., Devlin, F., Doolin, K., Dueñas Herrero, R. M., Elices, M., Feeney, A., Gałuszko-Węgielnik, M., Jakuszkowiak-Wojten, K., Janů, L., Kelly, J. R., Ledden, K., Maclsaac, R., Madero, S., McInerney, S. J., Montejo, A. L., Nawka, A., Páleníček, T., Pérez Solà, V., Ramaekers, J. G., Reif, A., Ritter, P., Ryan, F., Svendsen, C. B., Sweeney, C., Terwey, T. H., Trivedi, M. H., Valcheva, V., Vieta, E., Thase, M. E.
Open Accessindividual

Intranasal 5-MeO-DMT Concomitant with SSRI for Treatment-Resistant Depression: A Proof-of-Concept Trial

This open-label phase 2a trial (n=12) tested a single intranasal dose of 5-MeO-DMT given alongside stable SSRI treatment in adults with treatment-resistant depression and found it was generally well tolerated, with mostly short-lived nasal and stomach side effects. Depressive symptoms fell quickly and stayed lower over 12 weeks in both dose groups.

Published
Journal
CNS Drugs
Authors
Seynaeve, M., Dunbar, F., Hindocha, C., Ermakova, A. O., Pierce, M., Conley, R. R., Roberts, C.
Open Accessindividual

LSD microdosing for major depressive disorder: Mood and pharmacokinetic outcomes from a Phase 2a trial

This open-label trial (n=19) found that repeated microdosed LSD (8 to 20 μg) was associated with short-term improvements in daily mood, but not same-day changes in self-reported depression, in people with major depressive disorder. It also provided pharmacokinetic data for sublingual LSD and found no evidence of tolerance or sensitisation across the 8-week dosing regimen.

Published
Journal
Progress in Neuro-Psychopharmacology and Biological Psychiatry
Authors
Daldegan-Bueno, D., Donegan, C. J., Sumner, R., Forsyth, A., Jeong, S. H., Evans, W., Alshakhouri, M., Murphy, R. J., Reynolds, L., Hoeh, N., Allen, N., Sundram, F., Menkes, D. B., Muthukumaraswamy, S.
Paywallindividual

A phase 2 uncontrolled, open-label study of intranasal BPL-003 (5-methoxy-N,N-dimethyltryptamine) in patients with treatment-resistant depression

This 12‑week, open‑label Phase IIa trial of a single 10 mg intranasal dose of 5‑MeO-DMT (BPL‑003) in patients (n=12) with treatment‑resistant major depressive disorder, found that the drug was generally well tolerated with mostly mild–moderate adverse events and rapid discharge readiness (median ~98 minutes). A rapid and sustained mean MADRS reduction of 12–13 points was observed from Day 2 through Day 85, with most participants meeting response criteria and several achieving remission, supporting further evaluation in larger controlled trials.

Published
Journal
Journal of Psychopharmacology
Authors
Roberts, C., Seynaeve, M., Ermakova, A. O., Dunbar, F., Wells, H., Puri, A., Bird, C., Rucker, J. J.
Open Accessindividual

Long-term treatment with esketamine nasal spray in patients with treatment resistant depression: Results from the ESCAPE-LTE study

This Phase IV single-arm long-term extension trial (n=183) found that the vast majority of patients with treatment-resistant depression who achieved remission with esketamine nasal spray (plus an antidepressant) did not relapse over 136 weeks of treatment, with side effects largely resolving the same day and no new safety concerns identified.

Published
Journal
European Neuropsychopharmacology
Authors
Reif, A., Anıl, Y. A., Bitter, I., Buyze, J., Frey, R., Godinov, Y., Haggström, L., Kambarov, Y., Nielsen, R., Oliveira-Maia, A., von Holt, C., Cubała, W., DJ, F., AH, Y.

Quick Facts

Full Name
Montgomery–Åsberg Depression Rating Scale
Domain
Depression
Papers Indexed
41
Score Range
0–60
Interpretation
Lower = better
Unit
points
Reference
Visit
All Measures