Rejoyn Wants to Treat Your Depression Digitally, but Experts Have Questions
The app-based treatment for major depression disorder has received FDA clearance. Here's what to know before it's available this summer.
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Rejoyn, the first digital prescription app for major depressive disorder, was just cleared by the US Food and Drug Administration. Approval is based on the data from a 13-week trial of 389 participants, which found that those who used Rejoyn had an improvement in depression symptom severity.
Depression is one of the most common mental health conditions people face. A 2023 Gallup report reveals that nearly 18% of American adults report being currently depressed.
Not just anyone can use Rejoyn (developed as CT-152 by Otsuka Pharmaceutical and Click Therapeutics). You must be 22 years or older and have been diagnosed with major depressive disorder. It's an adjunctive treatment option, meaning it's intended to supplement care given by a clinician. It requires a prescription to access.
"It could be of significant help to those who have not fully benefited from medications but who do not have access to or do not want to seek traditional psychotherapy," said Colleen Marshall, chief clinical officer for Two Chairs.
Rejoyn is expected to be available this summer to anyone with a smartphone.
What is Rejoyn?
Rejoyn is an app-based treatment program that lasts six weeks. According to Marshall, app-based interventions can work well under the right conditions.
Instead of focusing on the neurochemical imbalances like other treatments, Rejoyn's programs target the neural networks affected by depression, according to the Otsuka press release. It then aims to use the brain's ability to redirect and alter synaptic connections called neuroplasticity to reduce symptoms over time.
"This app appears to combine more traditional CBT skills with a 'cognitive-emotional training' approach that is designed to help address common thinking biases present in depression. In this case, the tendency for depressed people to more easily remember negative emotional information," Marshall explained. "This component of the app 'trains' users to recall emotional information in an unbiased way, which is supposed to help improve an individual's ability to manage negative emotions."
Read more: 6 Strategies to Unlock Good Sleep While Managing Depression
Basically, the personalized exercises Rejoyn offers are like physical therapy for the brain with therapeutic lessons, brain exercises and personalized messaging.
Within the app, you'll have six tasks to complete each week: three therapeutic lessons and three brain exercises. You can set reminders to ensure you don't miss any tasks. After the six-week treatment course, there is a four-week period in which you will still have access to the therapeutic lessons, though not the brain exercises. After the additional four weeks ends, your access to Rejoyn ends.
How is Rejoyn different from other mental health apps?
Like mental health apps, Rejoyn does not replace clinician-guided care or medication. However, it's considered by the FDA to be a medical device prescribed by a doctor for the treatment of major depressive disorder. That sets it apart from any other wellness app out there.
Instead of simply educating you about MDD or suggesting new habits, Rejoyn's six-week brain-training program aims to target the neural networks that are impacted by depression.
Read more: 7 Techniques That Will Transform How You Manage Your Depression.
Are there any risks to using Rejoyn?
There were no reported side effects during the trial that earned FDA clearance. According to Marshall, since the therapeutic effects Rejoyn offers are small, the risks are correspondingly small. That doesn't mean there aren't things to consider when digitally treating depression.
"The main risk is that there is no therapist or other human support included with the app, meaning that users can't get help in applying any of the skills taught in the app," Marshall said.
People will still depend on their doctor or a crisis lifeline for help in an emergency.
There's still a lot we don't know about Rejoyn
Cognitive-emotional training is considered a novel approach that doesn't have a well-established amount of research behind it. The limited research has found that these types of exercises stimulate the parts of the brain connected to depression: the amygdala and dorsolateral prefrontal cortex.
However, Marshall points out that we don't know if the novel approach that Rejoyn takes adds much to the established cognitive behavioral therapy skills. Without evidence to support that cognitive-emotional training works, it's hard to separate its effects from CBT techniques.
Rejoyn won't replace medication or, for some, traditional therapy. However, it's always good to see more options for people to get help, especially ones that have the potential to expand care to anyone with a smartphone.
"Over the past 10 years or so, there has been a lot of excitement about app-based treatments for mental health conditions, and there are reasons to be optimistic about their potential to expand access to effective treatment," Marshall said. "However, engagement with these approaches is relatively low, and until we are able to improve engagement, the overall impact of app-based approaches will be limited."
Rejoyn won't be for everyone. Depending on your needs and preferences, using an app might not work for you, which is why it's intended to be a supplemental treatment option for those who want it. We don't know yet if insurance companies will cover it.
Rejoyn isn't currently available to download, but it's expected by the summer of 2024. You'll be able to find it on the App Store and Google Play.