Back الاكتئاب المقاوم للعلاج Arabic Depresión resistente al tratamiento Spanish Dépression résistante French דיכאון עמיד HE Depressão resistente a tratamento Portuguese Терапевтически резистентная депрессия Russian
| Treatment-resistant depression | |
|---|---|
| Other names | Treatment-refractory depression |
| Specialty | Psychiatry |
| Symptoms | Depressive mood, anhedonia, low energy |
| Complications | Self-harm, suicide |
Treatment-resistant depression (TRD) is major depressive disorder in which an affected person does not respond adequately to at least two different antidepressant medications at an adequate dose and for an adequate duration.[1] Inadequate response has most commonly been defined as less than 25% reduction in depressive symptoms following treatment with an antidepressant.[2] Many clinicians and researchers question the construct validity and clinical utility of treatment-resistant depression as currently conceptualized.[3][4]
Other factors that may contribute to inadequate treatment are: a history of repeated or severe adverse childhood experiences, early discontinuation of treatment, failure to consider psychotherapy and other psychosocial interventions, patient noncompliance, misdiagnosis, cognitive impairment, low income and other social determinants, and concurrent medical conditions, including comorbid psychiatric disorders.[2] Cases of treatment-resistant depression may also be referred to by which medications people are resistant to (e.g.: SSRI-resistant).[5] Adding further treatments such as aripiprazole or quetiapine is weakly supported as of 2022.[6]
- ^ Wijeratne C, Sachdev P (September 2008). "Treatment-resistant depression: critique of current approaches". The Australian and New Zealand Journal of Psychiatry. 42 (9): 751–762. doi:10.1080/00048670802277206. PMID 18696279. S2CID 2848646.
- ^ a b Sforzini L, Worrell C, Kose M, Anderson IM, Aouizerate B, Arolt V, et al. (March 2022). "A Delphi-method-based consensus guideline for definition of treatment-resistant depression for clinical trials". Molecular Psychiatry. 27 (3): 1286–1299. doi:10.1038/s41380-021-01381-x. PMC 9095475. PMID 34907394.
- ^ Malhi, Gin S.; Das, Pritha; Mannie, Zola; Irwin, Lauren (2019). "Treatment-resistant depression: problematic illness or a problem in our approach?". British Journal of Psychiatry. 214 (1): 1–3. doi:10.1192/bjp.2018.246. ISSN 0007-1250.
failure to respond is often the result of administering inappropriate treatment, which occurs principally because of paradigm failure
- ^ Rost, Felicitas; Booker, Thomas; Gonsard, Aneliya; de Felice, Giulio; Asseburg, Lorena; Malda-Castillo, Javier; Koutoufa, Iakovina; Ridsdale, Hannah; Johnson, Rebecca; Taylor, David; Fonagy, Peter (2024). "The complexity of treatment-resistant depression: A data-driven approach". Journal of Affective Disorders. 358: 292–301. doi:10.1016/j.jad.2024.04.093.
Our findings reveal a complex and multifaceted condition and call for an urgent reconceptualization of TRD, which encompasses many interdependent variables and experiences.
- ^ Berman RM, Narasimhan M, Charney DS (1997). "Treatment-refractory depression: definitions and characteristics". Depression and Anxiety. 5 (4): 154–164. doi:10.1002/(sici)1520-6394(1997)5:4<154::aid-da2>3.0.co;2-d. PMID 9338108. S2CID 33974050.
- ^ Nuñez, Nicolas A; Joseph, Boney; Pahwa, Mehak; Kumar, Rakesh; Resendez, Manuel Gardea; Prokop, Larry J; Veldic, Marin; Seshadri, Ashok; Biernacka, Joanna M; Frye, Mark A; Wang, Zhen; Singh, Balwinder (January 2022). "Augmentation strategies for treatment resistant major depression: A systematic review and network meta-analysis". Journal of Affective Disorders. 302: 385–400. doi:10.1016/j.jad.2021.12.134. PMC 9328668. PMID 34986373.