Past Issues

Treatment-resistant Depression

David L. Dunner

 This overview begins with the issue of definitions of treatment-resistant depres- sion. From the most common definition of “failure to respond to at least two treat- ment trials that were delivered at adequate dose and for an adequate duration of time,” the author has advanced the idea that treatment-resistant depression could be defined as a first treatment failure to one adequate treatment trial. The outcomes in patients with complicated treatment-resistant major depression are presented first. The major portion of this overview is devoted to the descriptions of various strate- gies from switching antidepressants to augmenting existing antidepressant with an- other psychotropic drug. Neuromodulating techniques (transcranial magnetic stimu- lation and Vagus nerve stimulation) as well as the issue of treatment resistant bipolar depression are also covered at the end of the overview.
Key Word treatment-resistance, switching of antidepressant, augmentation of antide-pressant therapy, STAR*D
Editorial Committe, Taiwanese Journal of Psychiatry
9F-3, 22, Song-Jiang Rd., Taipei 104, Taiwan
Email/ │ TEL/886-2-2567-8295 │ FAX/886-2-2567-8218