Study: NCT03852160

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Esketamine 28 mg
Description: Participants will receive 28 mg esketamine as nasal spray (Initial dose for elderly participants with 65-74 years of age on Day 1 and then uptitrated to 56 mg on Day 4).

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Esketamine 56 mg
Description: Participants will receive 56 mg esketamine as nasal spray (Initial dose for participants with 18-64 years of age) on Day 1. The dose may be increased/may remain same based on the efficacy and tolerability. Participants with 65 to 74 years of age will receive esketamine 56 mg from Day 4 onwards.

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Esketamine 84 mg
Description: Participants may receive 84 mg (maximum uptitrated esketamine dose). The dose may be decreased/may remain same based on the efficacy and tolerability.

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: Placebo
Description: Participants will receive matching placebo as nasal spray.

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Escitalopram
Description: Escitalopram can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for escitalopram is 5 mg once daily (for elderly participants) and 10 mg once daily (for adults). The dose may be increased to 10 mg (for elderly participants) and 20 mg (for adults) once daily at the discretion of treating physician/investigator.

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: Escitalopram
Description: Escitalopram can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for escitalopram is 5 mg once daily (for elderly participants) and 10 mg once daily (for adults). The dose may be increased to 10 mg (for elderly participants) and 20 mg (for adults) once daily at the discretion of treating physician/investigator.

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Sertraline
Description: Sertraline can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for sertraline is 50 mg once daily and may be increased up to 200 mg once daily.

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: Sertraline
Description: Sertraline can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for sertraline is 50 mg once daily and may be increased up to 200 mg once daily.

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Duloxetine
Description: Duloxetine can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for duloxetine is 60 mg once daily and may be increased to 120 mg once daily.

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: Duloxetine
Description: Duloxetine can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for duloxetine is 60 mg once daily and may be increased to 120 mg once daily.

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Mirtazapine
Description: Mirtazapine can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for mirtazapine is 15 to 30 mg once daily and may be increased to 45 mg once daily.

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: Mirtazapine
Description: Mirtazapine can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for mirtazapine is 15 to 30 mg once daily and may be increased to 45 mg once daily.

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Agomelatine
Description: Agomelatine can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for agomelatine is 25 mg once daily and may be increased to 50 mg once daily after 2 weeks.

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: Agomelatine
Description: Agomelatine can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for agomelatine is 25 mg once daily and may be increased to 50 mg once daily after 2 weeks.

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Bupropion
Description: Bupropion can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for bupropion is 150 mg once daily and may be increased to 300 mg once daily after 4 weeks.

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: Bupropion
Description: Bupropion can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for bupropion is 150 mg once daily and may be increased to 300 mg once daily after 4 weeks.

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Trazodone Prolonged Release
Description: Trazodone prolonged release can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for trazodone prolonged release is 75 to 150 mg once or twice daily and may be increased up to 450 mg (adults) and 300 mg (elderly).

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: Trazodone Prolonged Release
Description: Trazodone prolonged release can be selected as the oral antidepressant medication based on investigator's discretion. The initial dose for trazodone prolonged release is 75 to 150 mg once or twice daily and may be increased up to 450 mg (adults) and 300 mg (elderly).