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PMID: 22654508 Published · ppublish English Journal Article

Treatment-resistant depression: therapeutic trends, challenges, and future directions.

Patient preference and adherence ·Vol. 6 ·2012-00-00 ·Pages 369-88

Al-Harbi KS

Abstract

Patients with major depression respond to antidepressant treatment, but 10%-30% of them do not improve or show a partial response coupled with functional impairment, poor quality of life, suicide ideation and attempts, self-injurious behavior, and a high relapse rate. The aim of this paper is to review the therapeutic options for treating resistant major depressive disorder, as well as evaluating further therapeutic options. In addition to Google Scholar and Quertle searches, a PubMed search using key words was conducted, and relevant articles published in English peer-reviewed journals (1990-2011) were retrieved. Only those papers that directly addressed treatment options for treatment-resistant depression were retained for extensive review. Treatment-resistant depression, a complex clinical problem caused by multiple risk factors, is targeted by integrated therapeutic strategies, which include optimization of medications, a combination of antidepressants, switching of antidepressants, and augmentation with non-antidepressants, psychosocial and cultural therapies, and somatic therapies including electroconvulsive therapy, repetitive transcranial magnetic stimulation, magnetic seizure therapy, deep brain stimulation, transcranial direct current stimulation, and vagus nerve stimulation. As a corollary, more than a third of patients with treatment-resistant depression tend to achieve remission and the rest continue to suffer from residual symptoms. The latter group of patients needs further study to identify the most effective therapeutic modalities. Newer biomarker-based antidepressants and other drugs, together with non-drug strategies, are on the horizon to address further the multiple complex issues of treatment-resistant depression. Treatment-resistant depression continues to challenge mental health care providers, and further relevant research involving newer drugs is warranted to improve the quality of life of patients with the disorder.

Keywords
antidepressants biomarkers somatic therapies therapeutic options treatment-resistant depression
Authors & Affiliations
1 authors, click to expand affiliations / ORCID
Al-Harbi Khalid Saad
Medical College, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
References (132)
132 references, click to expand
  1. Efficacy, safety and tolerability of Symbyax for acute-phase management of treatment-resistant depression.
    Expert Rev Neurother. 2010 May;10(5):651-70 PMID: 20420487
  2. Rapid decrease in depressive symptoms with an N-methyl-d-aspartate antagonist in ECT-resistant major depression.
    Prog Neuropsychopharmacol Biol Psychiatry. 2011 Jun 1;35(4):1155-9 PMID: 21466832
  3. Tryptophan hydroxylase-2 controls brain serotonin synthesis.
    Science. 2004 Jul 9;305(5681):217 PMID: 15247473
  4. Use of atypical antipsychotics in refractory depression and anxiety.
    J Clin Psychiatry. 2005;66 Suppl 8:13-21 PMID: 16336032
  5. The definition and meaning of treatment-resistant depression.
    J Clin Psychiatry. 2001;62 Suppl 16:10-7 PMID: 11480879
  6. Use of continuation or maintenance electroconvulsive therapy in adolescents with severe treatment-resistant depression.
    J ECT. 2011 Jun;27(2):168-74 PMID: 21233763
  7. Targeting the glutamatergic system to develop novel, improved therapeutics for mood disorders.
    Nat Rev Drug Discov. 2008 May;7(5):426-37 PMID: 18425072
  8. Triple reuptake inhibitors: a premise and promise.
    Psychiatry Investig. 2008 Sep;5(3):142-7 PMID: 20046357
  9. Venlafaxine-mirtazapine combination in the treatment of persistent depressive illness.
    J Psychopharmacol. 2007 Mar;21(2):161-4 PMID: 17329295
  10. Loss-of-function mutation in tryptophan hydroxylase-2 identified in unipolar major depression.
    Neuron. 2005 Jan 6;45(1):11-6 PMID: 15629698
  11. A double-blind placebo-controlled trial of lamotrigine as an antidepressant augmentation agent in treatment-refractory unipolar depression.
    J Clin Psychiatry. 2011 Oct;72(10):1405-12 PMID: 21367355
  12. STAR*D: revising conventional wisdom.
    CNS Drugs. 2009 Aug;23(8):627-47 PMID: 19594193
  13. Why do you need to move beyond first-line therapy for major depression?
    J Clin Psychiatry. 2010;71 Suppl 1:4-9 PMID: 20977873
  14. Cognitive therapy versus medication in augmentation and switch strategies as second-step treatments: a STAR*D report.
    Am J Psychiatry. 2007 May;164(5):739-52 PMID: 17475733
  15. Treatment-resistant depression: new therapies on the horizon.
    Ann Clin Psychiatry. 2003 Mar;15(1):59-70 PMID: 12839433
  16. Adapting Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression: A Clinical Case Study.
    Cogn Behav Pract. 2011 Aug;18(3):362-370 PMID: 22211062
  17. Treatment resistant depression: methodological overview and operational criteria.
    Eur Neuropsychopharmacol. 1999 Jan;9(1-2):83-91 PMID: 10082232
  18. Venlafaxine in treatment-resistant major depression: a Canadian multicenter, open-label trial.
    J Clin Psychopharmacol. 1999 Oct;19(5):401-6 PMID: 10505581
  19. Outcome of a 4-step treatment algorithm for depressed inpatients.
    J Clin Psychiatry. 2006 Aug;67(8):1266-71 PMID: 16965206
  20. Nortriptyline for treatment-resistant depression.
    J Clin Psychiatry. 2003 Jan;64(1):35-9 PMID: 12590621
  21. Treatment-resistant depression: prevalence, risk factors, and treatment strategies.
    J Clin Psychiatry. 2011 May;72(5):e18 PMID: 21658343
  22. When at first you don't succeed: sequential strategies for antidepressant nonresponders.
    J Clin Psychiatry. 1997;58 Suppl 13:23-9 PMID: 9402916
  23. The serotonin syndrome.
    Am J Psychiatry. 1991 Jun;148(6):705-13 PMID: 2035713
  24. Improving antidepressant adherence.
    J Clin Psychiatry. 2003;64 Suppl 18:25-30 PMID: 14700452
  25. Treatment of imipramine-resistant recurrent depression, IV: A double-blind crossover study of tranylcypromine for anergic bipolar depression.
    Am J Psychiatry. 1992 Feb;149(2):195-8 PMID: 1734739
  26. Risk of adverse events in treatment-resistant depression: propensity-score-matched comparison of antidepressant augment and switch strategies.
    Gen Hosp Psychiatry. 2012 Mar-Apr;34(2):192-200 PMID: 22079151
  27. A pilot study of the efficacy and safety of paroxetine augmented with risperidone, valproate, buspirone, trazodone, or thyroid hormone in adult Chinese patients with treatment-resistant major depression.
    J Clin Psychopharmacol. 2011 Oct;31(5):638-42 PMID: 21869688
  28. Treatment-resistant depression in adolescents: review and updates on clinical management.
    Depress Anxiety. 2011 Nov;28(11):946-54 PMID: 21898710
  29. Antidepressant failure: augmentation or substitution?
    J Psychiatry Neurosci. 1995 Jan;20(1):7-9 PMID: 7865503
  30. Efficacy of venlafaxine in patients with major depressive disorder who have unsustained or no response to selective serotonin reuptake inhibitors: an open-label, uncontrolled study.
    Clin Ther. 2002 Jul;24(7):1194-200 PMID: 12182262
  31. Pharmacologic approaches to treatment resistant depression: a re-examination for the modern era.
    Expert Opin Pharmacother. 2010 Apr;11(5):709-22 PMID: 20151847
  32. Double-blind switch study of imipramine or sertraline treatment of antidepressant-resistant chronic depression.
    Arch Gen Psychiatry. 2002 Mar;59(3):233-9 PMID: 11879161
  33. Suicide attempts and nonsuicidal self-injury in the treatment of resistant depression in adolescents: findings from the TORDIA study.
    J Am Acad Child Adolesc Psychiatry. 2011 Aug;50(8):772-81 PMID: 21784297
  34. Nefazodone therapy in patients with treatment-resistant or treatment-intolerant depression and high psychiatric comorbidity.
    Clin Ther. 1999 Apr;21(4):733-40 PMID: 10363738
  35. Long-term outcome of adolescent depression initially resistant to selective serotonin reuptake inhibitor treatment: a follow-up study of the TORDIA sample.
    J Clin Psychiatry. 2011 Mar;72(3):388-96 PMID: 21208583
  36. A preliminary, open study of the combination of fluoxetine and desipramine for rapid treatment of major depression.
    Arch Gen Psychiatry. 1991 Apr;48(4):303-7 PMID: 2009031
  37. Nicotinic antagonist augmentation of selective serotonin reuptake inhibitor-refractory major depressive disorder: a preliminary study.
    J Clin Psychopharmacol. 2008 Jun;28(3):340-4 PMID: 18480694
  38. The place for the tricyclic antidepressants in the treatment of depression.
    Aust N Z J Psychiatry. 1999 Jun;33(3):323-7 PMID: 10442787
  39. The impact of medication resistance and continuation pharmacotherapy on relapse following response to electroconvulsive therapy in major depression.
    J Clin Psychopharmacol. 1990 Apr;10(2):96-104 PMID: 2341598
  40. The art of prescribing. Monotherapy antidepressant: a thing of the past? Implications for the treatment of major depressive disorder.
    Perspect Psychiatr Care. 2007 Jul;43(3):142-5 PMID: 17576307
  41. The assessment and treatment of refractory depression.
    J Clin Psychiatry. 1994 Feb;55 Suppl:20-6 PMID: 8077165
  42. Switching to another SSRI or to venlafaxine with or without cognitive behavioral therapy for adolescents with SSRI-resistant depression: the TORDIA randomized controlled trial.
    JAMA. 2008 Feb 27;299(8):901-913 PMID: 18314433
  43. Antidepressant agents for the treatment of chronic pain and depression.
    Pharmacotherapy. 2007 Nov;27(11):1571-87 PMID: 17963465
  44. Navigating the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study: practical outcomes and implications for depression treatment in primary care.
    Prim Care. 2007 Sep;34(3):505-19, vi PMID: 17868757
  45. Meta-Review of Metanalytic Studies with Repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Major Depression.
    Clin Pract Epidemiol Ment Health. 2011;7:167-77 PMID: 22135698
  46. Treatment-resistant depression in Hispanic patients.
    J Clin Psychiatry. 2010 Jun;71(6):e12 PMID: 20573322
  47. Definition and epidemiology of treatment-resistant depression.
    Psychiatr Clin North Am. 1996 Jun;19(2):179-200 PMID: 8827185
  48. Are atypical antipsychotic drugs also atypical antidepressants?
    Aust N Z J Psychiatry. 2001 Oct;35(5):631-8 PMID: 11551279
  49. Early weight gain as a predictor of substantial weight gain with olanzapine/fluoxetine combination: an analysis of 2 adult studies in treatment-resistant depression.
    J Clin Psychopharmacol. 2011 Jun;31(3):337-40 PMID: 21508852
  50. If at first you don't succeed: a review of the evidence for antidepressant augmentation, combination and switching strategies.
    Drugs. 2011 Jan 1;71(1):43-64 PMID: 21175239
  51. What Are the Implications of the STAR*D Trial for Primary Care? A Review and Synthesis.
    Prim Care Companion J Clin Psychiatry. 2008;10(2):91-6 PMID: 18458732
  52. Introduction of vagus nerve stimulation into a maintenance electroconvulsive therapy regimen: a case study and cost analysis.
    J ECT. 2007 Jun;23(2):114-9 PMID: 17548984
  53. Treatment resistant depression--advances in somatic therapies.
    Ann Clin Psychiatry. 2007 Oct-Dec;19(4):279-87 PMID: 18058285
  54. Venlafaxine and paroxetine in treatment-resistant depression. Double-blind, randomised comparison.
    Br J Psychiatry. 1999 Jul;175:12-6 PMID: 10621762
  55. The short- and long-term efficacy of paroxetine HCl: B. Data from a double-blind crossover study and from a year-long term trial vs. imipramine and placebo.
    Psychopharmacol Bull. 1989;25(2):272-6 PMID: 2532374
  56. Relapse in patients on long-term fluoxetine treatment: response to increased fluoxetine dose.
    J Clin Psychiatry. 1995 Feb;56(2):52-5 PMID: 7852252
  57. Lithium addition in treatment-resistant depression.
    Int Clin Psychopharmacol. 1994 Jun;9 Suppl 2:31-5 PMID: 7930494
  58. Transcranial direct current stimulation in treatment resistant depression: a randomized double-blind, placebo-controlled study.
    Brain Stimul. 2012 Jul;5(3):242-251 PMID: 21962978
  59. Managing treatment-resistant major depression.
    J Clin Psychiatry. 2003;64 Suppl 1:5-12 PMID: 12625799
  60. Are patients who are intolerant to one SSRI intolerant to another?
    Psychopharmacol Bull. 1992;28(3):253-6 PMID: 1480728
  61. A randomized, single-blind, comparison of duloxetine with bupropion in the treatment of SSRI-resistant major depression.
    J Affect Disord. 2012 Jan;136(1-2):172-176 PMID: 21862138
  62. The use of antidepressants in novel combination therapies.
    J Clin Psychiatry. 2003;64 Suppl 2:14-8 PMID: 12625794
  63. Practical management of treatment-resistant depression.
    Am Fam Physician. 1998 Dec;58(9):2059-62 PMID: 9861879
  64. Evolving refractory major depressive disorder diagnostic and treatment paradigms: toward closed-loop therapeutics.
    Front Neuroeng. 2010 May 31;3:7 PMID: 20631824
  65. A multicenter pilot study of subcallosal cingulate area deep brain stimulation for treatment-resistant depression.
    J Neurosurg. 2012 Feb;116(2):315-22 PMID: 22098195
  66. [Deep brain stimulation in the treatment of therapy-refractory depression].
    Rev Neurol. 2008 Nov 1-15;47(9):477-82 PMID: 18985598
  67. Long-term impact of residual symptoms in treatment-resistant depression.
    Can J Psychiatry. 2011 Sep;56(9):549-57 PMID: 21959030
  68. Prospective, long-term, multicenter study of the naturalistic outcomes of patients with treatment-resistant depression.
    J Clin Psychiatry. 2006 May;67(5):688-95 PMID: 16841617
  69. Augmentation of antidepressants with atypical antipsychotics: a review of the current literature.
    J Psychiatr Pract. 2008 Jan;14(1):34-44 PMID: 18212601
  70. Convulsive therapy: a review of the first 55 years.
    J Affect Disord. 2001 Mar;63(1-3):1-15 PMID: 11246075
  71. Treatment-resistant depression: managed care considerations.
    J Manag Care Pharm. 2007 Jul;13(6 Suppl A):S2-7 PMID: 17672818
  72. A comparison of triiodothyronine and thyroxine in the potentiation of tricyclic antidepressants.
    Psychiatry Res. 1990 Jun;32(3):241-51 PMID: 2201988
  73. Treatment-resistant depressed youth show a higher response rate if treatment ends during summer school break.
    J Am Acad Child Adolesc Psychiatry. 2011 Nov;50(11):1140-8 PMID: 22024002
  74. Vagus nerve stimulation (VNS) for treatment-resistant depression: efficacy, side effects, and predictors of outcome.
    Neuropsychopharmacology. 2001 Nov;25(5):713-28 PMID: 11682255
  75. Staging methods for treatment resistant depression. A systematic review.
    J Affect Disord. 2012 Mar;137(1-3):35-45 PMID: 21435727
  76. Examination of the utility of psychotherapy for patients with treatment resistant depression: a systematic review.
    J Gen Intern Med. 2011 Jun;26(6):643-50 PMID: 21184287
  77. A randomized double-blind sham-controlled comparison of unilateral and bilateral repetitive transcranial magnetic stimulation for treatment-resistant major depression.
    World J Biol Psychiatry. 2012 Sep;13(6):423-35 PMID: 21736507
  78. Mirtazapine for treatment-resistant depression: a preliminary report.
    J Psychiatry Neurosci. 2003 Jan;28(1):55-9 PMID: 12587851
  79. A comparison of comorbid patterns in treatment-resistant unipolar and bipolar depression.
    Can J Psychiatry. 1995 Jun;40(5):270-4 PMID: 7553547
  80. Therapeutic options in treatment-resistant depression.
    Ann Med. 2011 Nov;43(7):512-30 PMID: 21623700
  81. Management of depression in the elderly by general practitioners: I. Use of antidepressants.
    Fam Pract. 1995 Mar;12(1):5-11 PMID: 7665042
  82. Issues in treatment-resistant depression.
    J Clin Psychiatry. 2005;66 Suppl 8:5-12 PMID: 16336031
  83. Fluoxetine treatment of patients with major depressive disorder who failed initial treatment with sertraline.
    J Clin Psychiatry. 1997 Jan;58(1):16-21 PMID: 9055832
  84. The management of treatment-resistant depression in disorders on the interface of psychiatry and medicine. Fibromyalgia, chronic fatigue syndrome, migraine, irritable bowel syndrome, atypical facial pain, and premenstrual dysphoric disorder.
    Psychiatr Clin North Am. 1996 Jun;19(2):351-69 PMID: 8827194
  85. Citalopram versus desipramine in treatment resistant depression: effect of continuation or switching strategies: a randomized open study.
    World J Biol Psychiatry. 2011 Aug;12(5):364-75 PMID: 21718212
  86. [Risk factors and psychosocial disability of treatment-resistant depression].
    Rev Med Suisse. 2011 Sep 21;7(309):1802-5 PMID: 22016934
  87. The management of treatment-resistant depression in the medically ill.
    Psychiatr Clin North Am. 1996 Jun;19(2):329-50 PMID: 8827193
  88. Health care costs of depression in primary care patients in The Netherlands.
    Fam Pract. 2010 Oct;27(5):542-8 PMID: 20530527
  89. Magnetic seizure therapy for treatment-resistant depression.
    Expert Rev Med Devices. 2011 Nov;8(6):723-32 PMID: 22029469
  90. Incremental cost-effectiveness of combined therapy vs medication only for youth with selective serotonin reuptake inhibitor-resistant depression: treatment of SSRI-resistant depression in adolescents trial findings.
    Arch Gen Psychiatry. 2011 Mar;68(3):253-62 PMID: 21383263
  91. Treatment options for the patient who does not respond well to initial antidepressant therapy.
    J Psychiatr Pract. 2009 May;15(3):202-10 PMID: 19461393
  92. Venlafaxine for treatment-resistant unipolar depression.
    J Clin Psychopharmacol. 1994 Dec;14(6):419-23 PMID: 7884023
  93. Dual-dual action? Combining venlafaxine and mirtazapine in the treatment of depression.
    Aust N Z J Psychiatry. 2008 Apr;42(4):346-9 PMID: 18330778
  94. Venlafaxine extended release versus citalopram in patients with depression unresponsive to a selective serotonin reuptake inhibitor.
    Int Clin Psychopharmacol. 2008 May;23(3):113-9 PMID: 18408525
  95. Aripiprazole augmentation strategy in clomipramine-resistant depressive patients: an open preliminary study.
    Eur Neuropsychopharmacol. 2012 Feb;22(2):132-6 PMID: 21784621
  96. Moderate physical exercise and quality of life in patients with treatment-resistant major depressive disorder.
    J Psychiatr Res. 2011 Dec;45(12):1657-9 PMID: 21908006
  97. Olanzapine augmentation of milnacipran for stage 2 treatment-resistant major depression: an open study.
    Hum Psychopharmacol. 2011 Apr;26(3):237-41 PMID: 21638328
  98. Episode length and mixed features as predictors of ECT nonresponse in patients with medication-resistant major depression.
    Brain Stimul. 2012 Jan;5(1):18-24 PMID: 22037132
  99. Treatment-resistant depression in adolescents: is the addition of cognitive behavioral therapy of benefit?
    Psychol Res Behav Manag. 2011;4:97-112 PMID: 22114540
  100. Current perspectives in the management of treatment-resistant depression.
    Dialogues Clin Neurosci. 2004 Mar;6(1):53-60 PMID: 22034070
  101. Clinical inquiries: How should you manage a depressed patient unresponsive to an SSRI?
    J Fam Pract. 2006 Dec;55(12):1081-2, 1087 PMID: 17137547
  102. Practical management of treatment-resistant affective disorders.
    Br J Hosp Med. 1995 Nov 15-Dec 12;54(10):501-6 PMID: 8574492
  103. Ziprasidone augmentation of selective serotonin reuptake inhibitors (SSRIs) for SSRI-resistant major depressive disorder.
    J Clin Psychiatry. 2004 Feb;65(2):217-21 PMID: 15003076
  104. The strategy of combining antidepressants in the treatment of major depression: clinical experience in spanish outpatients.
    Depress Res Treat. 2011;2011:140194 PMID: 21738865
  105. Impact of physical and sexual abuse on treatment response in the Treatment of Resistant Depression in Adolescent Study (TORDIA).
    J Am Acad Child Adolesc Psychiatry. 2011 Mar;50(3):293-301 PMID: 21334569
  106. Use of The International Classification of Functioning, Disability and Health (ICF) as a conceptual framework and common language for disability statistics and health information systems.
    BMC Public Health. 2011 May 31;11 Suppl 4:S3 PMID: 21624189
  107. Sertoli cell therapy: a novel possible treatment strategy for treatment-resistant major depressive disorder.
    Med Hypotheses. 2011 Jul;77(1):35-42 PMID: 21454019
  108. Efficacy, safety and tolerability of quetiapine augmentation in treatment resistant depression: an open-label, pilot study.
    J Affect Disord. 2009 Sep;117(1-2):116-9 PMID: 19171384
  109. Efficacy and safety of mirtazapine in major depressive disorder patients after SSRI treatment failure: an open-label trial.
    J Clin Psychiatry. 2001 Jun;62(6):413-20 PMID: 11465517
  110. Therapeutic options for treatment-resistant depression.
    CNS Drugs. 2010 Feb;24(2):131-61 PMID: 20088620
  111. Topiramate augmentation in patients with resistant major depressive disorder: a double-blind placebo-controlled clinical trial.
    Prog Neuropsychopharmacol Biol Psychiatry. 2011 Jun 1;35(4):970-3 PMID: 21291943
  112. Effects of risperidone augmentation in patients with treatment-resistant depression: Results of open-label treatment followed by double-blind continuation.
    Neuropsychopharmacology. 2006 Nov;31(11):2505-13 PMID: 16760927
  113. Augmentation strategies in patients with refractory depression.
    Depress Anxiety. 1996-1997;4(4):169-81 PMID: 9166649
  114. Utility of repetitive transcranial stimulation as an augmenting treatment method in treatment-resistant depression.
    Indian J Psychol Med. 2011 Jan;33(1):92-6 PMID: 22021964
  115. Economic implications of treatment-resistant depression among employees.
    Pharmacoeconomics. 2004;22(6):363-73 PMID: 15099122
  116. A preliminary investigation of the influence of CREB1 gene on treatment resistance in major depression.
    J Affect Disord. 2011 Jan;128(1-2):56-63 PMID: 20643483
  117. Cracking the moody brain: lifting the mood with ketamine.
    Nat Med. 2010 Dec;16(12):1384-5 PMID: 21135850
  118. Switching antidepressant class does not improve response or remission in treatment-resistant depression.
    J Clin Psychopharmacol. 2011 Aug;31(4):512-6 PMID: 21694617
  119. Antidepressant efficacy of the antimuscarinic drug scopolamine: a randomized, placebo-controlled clinical trial.
    Arch Gen Psychiatry. 2006 Oct;63(10):1121-9 PMID: 17015814
  120. New approaches to the pharmacological management of major depressive disorder.
    Adv Pharmacol. 2009;57:347-79 PMID: 20230766
  121. Augmentation strategies: focus on anxiolytics.
    J Clin Psychiatry. 1996;57 Suppl 7:25-31; discussion 32-3 PMID: 8690693
  122. Eicosapentaenoic acid in treatment-resistant depression associated with symptom remission, structural brain changes and reduced neuronal phospholipid turnover.
    Int J Clin Pract. 2001 Oct;55(8):560-3 PMID: 11695079
  123. Recovery from depression, work productivity, and health care costs among primary care patients.
    Gen Hosp Psychiatry. 2000 May-Jun;22(3):153-62 PMID: 10880708
  124. Deep brain stimulation for treatment-resistant depression: follow-up after 3 to 6 years.
    Am J Psychiatry. 2011 May;168(5):502-10 PMID: 21285143
  125. The effectiveness of electroconvulsive therapy in treatment-resistant depression: a naturalistic study.
    J ECT. 2008 Jun;24(2):141-5 PMID: 18580559
  126. Treatment-resistant depression: no panacea, many uncertainties. Adverse effects are a major factor in treatment choice.
    Prescrire Int. 2011 May;20(116):128-33 PMID: 21648180
  127. Does intolerance or lack of response with fluoxetine predict the same will happen with sertraline?
    J Clin Psychiatry. 1996 Feb;57(2):67-71 PMID: 8591971
  128. Psychostimulants in the therapy of treatment-resistant depression Review of the literature and findings from a retrospective study in 65 depressed patients.
    Dialogues Clin Neurosci. 1999 Dec;1(3):165-74 PMID: 22034135
  129. Augmentation and combination strategies for complicated depression.
    J Clin Psychiatry. 2009 Nov;70(11):e40 PMID: 20031088
  130. Response to an open trial of a second SSRI in major depression.
    J Clin Psychiatry. 1996 Mar;57(3):114-5 PMID: 8617695
  131. Antidepressant exposure as a predictor of clinical outcomes in the Treatment of Resistant Depression in Adolescents (TORDIA) study.
    J Clin Psychopharmacol. 2011 Feb;31(1):92-7 PMID: 21192150
  132. A placebo-controlled comparison of lithium and triiodothyronine augmentation of tricyclic antidepressants in unipolar refractory depression.
    Arch Gen Psychiatry. 1993 May;50(5):387-93 PMID: 8489327
Article Info
Journal
Patient preference and adherence
Abbr.
Patient Prefer Adherence
ISSN
1177-889X
DOI
10.2147/PPA.S29716
Published
2012-00-00
Epub
2012-00-01
Pages
369-88
Language
English
Region
New Zealand
NLM ID
101475748
PMCID
PMC3363299
External Links
PubMed source DOI: 10.2147/PPA.S29716 PMC Full Text View journal details
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