Issues in Treatment-Resistant Depression.
J Clin Psychiatry 2005;66(suppl 8):5-12
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Major depressive disorder is a debilitating disease that imposes significant social and economic
burdens not only on patients but also on society. Although various treatment options are available,
treatment-resistant depression is common. Determining the exact prevalence of treatment-resistant
depression is difficult because definitions vary, as do definitions of antidepressant response. Operational
definitions of antidepressant response, nonresponse, partial response, and remission will be discussed
in this article. Pharmacotherapy options for patients with treatment-resistant depression include
augmentation, combination, and switching therapies; however, data from controlled clinical
trials supporting these therapies are limited. Electroconvulsive therapy and psychotherapy offer additional
treatment strategies. New nonpharmacologic therapies are under investigation. Remission is the
goal of treatment.