Strategies for treatment-resistant depression
Ballas, C.; Staab, J.P.; Evans, D.L.
Psychopharmacology Bulletin 36(4): 39-62
2002
ISSN/ISBN: 0048-5764 PMID: 12858144 Document Number: 546105
Approximately 30% of patients with major depression respond poorly to treatment with any given antidepressant regimen, and as many as 60% to 75% experience residual or recurrent symptoms. Strategies for improving response include extending the duration of each treatment beyond the usual 2-4 weeks, increasing the antidepressant dose, switching to another antidepressant, using two or more antidepressants together, and using adjunctive medications or other treatment modalities. Some of these strategies have strong support from clinical investigations while others are based more on clinical experience. This article reviews the risk factors for treatment resistance and provides strategies for improving treatment outcomes.