Prevalence and Management of Treatment-Resistant Depression
J Clin Psychiatry 2007;68(suppl 8):17-25
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Treatment-resistant depression (TRD) is a major public health problem in terms of its prevalence and in
terms of individual suffering and cost to society. Best estimates indicate 12-month prevalence rates of ~3%
for Stage 1 TRD (failure to respond to 1 adequate trial of an antidepressant) and ~2% for Stage 2 TRD (failure
to respond to 2 adequate trials). The current article provides a brief review of the definitions, prevalence,
and various treatment options for TRD, including switching, augmentation, and combination therapies and
use of nonpharmacologic treatments. Given the public health importance of TRD, the relative absence of
adequately powered, double-blind trials is striking.