A Study in Participants With Major Depressive Disorder Who Are Partial Responders to Selective Serotonin Reuptake Inhibitor

Following the Confirmation (CF) Phase, participants were randomized to adjunctive LY2216684
or adjunctive placebo if they had <25% improvement in the Montgomery-Åsberg Depression Rating
Scale (MADRS) total score over the past 3 weeks and a current MADRS total score ≥14.
Participants who did not meet criteria received adjunctive placebo to preserve the blind.

Inclusion Criteria:

- Women of child-bearing potential may participate but must test negative for pregnancy
at the time of study entry; both women/men agree to use a reliable method of birth
control

- Are being treated with one of the following selective serotonin reuptake inhibitors
(SSRIs): escitalopram, citalopram, sertraline, fluoxetine, paroxetine, or fluvoxamine;
for at least 6 weeks prior to investigational product dispensing with at least the
last 4 weeks at a stable, optimized dose

- Drug and dosage should be within the labeling guidelines for the specific country

- Meet criteria for major depressive disorder (MDD), as defined by Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition, Text Revision® (DSM-IV-TR)
criteria

- Meet criteria for partial response, as defined by investigator's opinion that the
participant has experienced a minimal clinically meaningful improvement with SSRI

- Have a GRID 17-Item Hamilton Depression Rating Scale (GRID-HAMD17) total score greater
than or equal to 16 at screening

- Have less than or equal to 75% improvement on the current SSRI at screening determined
by the Massachusetts General Hospital Antidepressant Treatment Response Questionnaire
(MGH-ATRQ)

Exclusion Criteria:

- Have had or currently have any additional ongoing DSM-IV-TR Axis 1 condition other
than major depression within 1 year of screening

- Have had any anxiety disorder that was considered a primary diagnosis within the past
year (including panic disorder, obsessive-compulsive disorder [OCD], post-traumatic
stress disorder [PTSD], generalized anxiety disorder [GAD], and social phobia, but
excluding specific phobias)

- Have a current or previous diagnosis of a bipolar disorder, schizophrenia, or other
psychotic disorder

- Have a history of substance abuse and/or dependence within the past year (drug
categories defined by DSM-IV-TR), not including caffeine and nicotine

- Have an Axis II disorder that, in the judgment of the investigator, would interfere
with compliance with protocol

- Unstable medical conditions that contraindicate the use of LY2216684

- Have any diagnosed medical condition that could be exacerbated by noradrenergic
agents, including unstable hypertension, unstable heart disease, tachycardia,
tachyarrhythmia, narrow-angled glaucoma, history of urinary hesitancy or retention

- Use of excluded concomitant or psychotropic medication other than SSRI

- Have initiated or discontinued hormone therapy within the 3 months prior to enrollment

- History of treatment-resistant depression as shown by lack of response of the current
depressive episode to 2 or more adequate courses of antidepressant therapy at a
clinically appropriate dose for at least 4 weeks or, in the judgment of the
investigator, the participant has treatment-resistant depression

- Have a lifetime history of vagal nerve stimulation (VNS), transcranial magnetic
stimulation (TMS), or psychosurgery

- Have received electroconvulsive therapy (ECT) in the past year