Cognitive-Behavioral Management of Drug-Resistant Major Depressive Disorder

Background: The application of cognitive-behavioral treatment to drug-resistant major depression has received little research attention.

Method: Nineteen patients who failed to respond to at least two trials of antidepressant drugs of adequate dosages and duration were treated by cognitive-behavioral methods in an open trial.

Results: Three patients dropped out of treatment. The remaining 16 patients displayed a significant (p

Conclusion: These preliminary results suggest that a trial of cognitive-behavioral therapy by an experienced therapist should be performed before labeling an episode of major depression as “refractory” or “treatment resistant.” These latter terms should apply only when a psychotherapeutic effort has been made. Until then, it seems more appropriate to define depression as “drug refractory” or “drug treatment resistant.”