Treatment resistant depression

Abstract

Abstract Approximately 50% of patients with major depressive disorder do not respond to their first antidepressant treatment. With more antidepressant treatment trials, an individual s likelihood of achieving remission decreases. Furthermore, treatment resistance has significant negative effects on global functioning. Therefore it is crucial that researchers and clinicians have a thorough understanding of treatment-resistant depression (TRD) and its potential treatments. TRD is broadly defined as a failure to achieve an adequate response to one or more adequate trials of antidepressant therapy. Treatment strategies include optimization, switching, combination, and augmentation. In more severe cases, neuromodulation may be employed. Ketamine and psychedelics are currently under investigation and show preliminary efficacy in rapidly improving depressive symptoms.