In this trial, we specifically chose patients suffering from resistant depression as defined by the most stringent criteria (21). Treatment approaches to patients with this degree of refractory depression have received little systematic ...
Author: Jay D. Amsterdam
Publisher: Raven Press (ID)
Focuses on endogenous depression which does not respond well to conventional pharmacological or electroconvulsive therapy. Over 40 investigators present findings and views on the nosology, classification, etiology and diagnosis of therapy-resistant depression and provide treatment strategies.
International Journal of ' Neuropsychopharmacology , 6(1), 41-49. Alpert, J.E., Mischoulon, D., Rubenstein, G.E., et al. (2002). Folinic acid (Leucovorin) as an adjunctive treatment for SSRI-refractory depression.
Author: George I. Papakostas
Publisher: World Scientific
1. Major depressive disorder and treatment-resistant depression. 1.1. Major depressive disorder. 1.2. Treatment-resistant depression (TRD). 1.3. Demographic and clinical risk factors for resistant depression -- 2. Monoaminergic-based strategies : "Single-acting" agents. 2.1. Monoamine precursors for depression. 2.2. Selective serotonin reuptake inhibitors (SSRIs). 2.3. Serotonin receptor antagonists and agonists. 2.4. Serotonin reuptake enhancers. 2.5. [symbol]-2 adrenergic receptor agonists and antagonists. 2.6. Norepinephrine reuptake inhibitors (NRIs). 2.7. Selective [symbol] adrenergic receptor agonists. 2.8. Dopamine-selective agents -- 3. Monoaminergic-based strategies : "Dual-acting" agents. 3.1. Tricyclic antidepressants (TCAs). 3.2. Serotonin-norepinephrine reuptake inhibitors (SNRIs). 3.3. 5HT-2 and [symbol]-2 adrenergic receptor antagonists. 3.4. Norepinephrine-dopamine reuptake inhibitors -- 4. Monoaminergic-based strategies : "Triple-acting " agents. 4.1. Monoamine oxidase inhibitors (MAOIs). 4.2. Serotonin-norepinephrine-dopamine reuptake inhibitors. 4.3. Catechol-O-methyltransferase (COMT) inhibitors -- 5. Polypharmacy from the onset of treatment. 5.1. Adjunctive treatment with monoaminergic agents. 5.2. Adjunctive treatment with neuroendocrine agents. 5.3. Other agents -- 6. Polypharmacy strategies for treatment-resistant depression. 6.1. Adjunctive treatment with monoaminergic agents. 6.2. Adjunctive treatment with neuroendocrine agents. 6.3. Other agents -- 7. Monotherapy strategies for resistant depression. 7.1. Increasing the dose of antidepressants. 7.2. Switching antidepressants due to lack of efficacy -- 8. Non-pharmacologic approaches for resistant depression. 8.1. Device-based therapies. 8.2. Psychotherapy. 8.3. Exercise. 8.4. Yoga and meditation -- 9. Pharmacotherapy of relapse/recurrence prevention and treatment. 9.1. Antidepressant continuation and maintenance therapy studies. 9.2. Special topics in the pharmacotherapy of relapse prevention. 9.3. Treatment of depressive relapse/recurrence -- 10. Pharmacologic strategies to enhance antidepressant tolerability. 10.1. Adjunctive therapy. 10.2. Switching antidepressants due to intolerance -- 11. Agents operating on non-monoaminergic neurotransmitter systems. 11.1. GABA-ergic treatments. 11.2. Glycine and glutamate-based treatments. 11.3. Agents with combined GABA-ergic and glutamatergic activity. 11.4. Other anticonvulsants. 11.5. Neurokinin-receptor antagonists. 11.6. Nicotinic receptor-based treatments. 11.7. Cannabinoids and endocannabinoids. 11.8. Opioidergic therapies. 11.9. Other neurotransmitter systems -- 12. Neuroendocrine-based agents. 12.1. Hypothalamic-pituitary-gonadal axis (HPG). 12.2. Hypothalamic-pituitary-adrenal axis (HPA). 12.3. Hypothalamic-pituitary-thyroid axis (HPT). 12.4. Melatonin and melatonergic agents. 12.5. Other hormones -- 13. Metabolic-based and other agents. 13.1. Metabolic-based agents. 13.2. Agents with unknown mechanism of action -- 14. Biological predictors, moderators, and mediators of efficacy. 14.1. Definition and significance of mediators of outcome. 14.2. Genetic markers. 14.3. Neurophysiology. 14.4. Molecular biology
Author: Stuart A. MontgomeryPublish On: 2013-02-06
Hatterrer, J. A. & Gorman, J. M. (1990) Thyroid function in refractory depression, in Treatment Strategies for Refractory Depression (ed. S. P. Roose & A. H. Glassman), American Psychiatry Press, Washington, DC, USA, pp. 171–191.
Author: Stuart A. Montgomery
Publisher: John Wiley & Sons
Successful management of patients with treatment-resistant depression is going to require a thorough understanding of the biological basis for both the depression and its failure to respond to standard treatments. This book clearly and succinctly summarizes the latest scientific research and its applications in clinical practice. A first step is a clear definition of what constitutes treatment-resistant depression so that clinical trials and other studies are using common criteria, enabling comparison and meta-analysis of their outcomes. The opening chapter reviews definitions and predictors of originating from different fields and discusses their usefulness in clinical practice and clinical research. The next chapter proposes a new definition, adapting terminology from medicine. Biological classification requires identification of genetic risk factors: with gene variants accounting for 50% of the variance in the clinical outcomes of antidepressant treatments this is clearly a fruitful area of research. Chapter 3 describes several genes already associated with treatment-resistant depression and, while further work is needed to translate findings into clinical recommendations, predicts that genetic prediction of TRD could became a widespread clinical reality within a few years. Most patients with TRD will be treated pharmacologically and three chapters review the latest evidence for pharmacological best practice, including switching strategies for antidepressants, the role of antipsychotics and augmentation strategies to complement lithium. There are two major alternatives to pharmacotherapy: neuromodulation and psychotherapy. The brain intervention chapter summarizes clinical research and experience with electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation, deep brain stimulation and magnetic seizure therapy. The final chapter reviews the literature pertaining to the effectiveness of various forms of psychotherapy in patients who have not responded to antidepressant pharmacotherapy, revealing that patients who have not responded to one or two trials of antidepressant medication have a 30%-50% chance of responding to a focused psychotherapy. It proposes indications for psychotherapy in TRD and summarizes general therapeutic principles.
Author: Joao Luciano de QuevedoPublish On: 2022-03-31
However, unlike the RANZP and similar to CANMAT, the MPG algorithm provides an extensive list of potential treatment options for refractory depression, including less studied or more controversial treatment modalities, ...
Author: Joao Luciano de Quevedo
Publisher: Academic Press
Managing Treatment-Resistant Depression: Road to Novel Therapeutics defines TRD for readers, discussing the clinical and epidemiological predictors, economic burden and neurobiological factors. In addition, staging methods for treatment resistance are fully covered in this book, including serotonin specific reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, other classes of antidepressants, including tricyclic antidepressants and monoamine oxidase inhibitors, augmentation strategies, and newer antidepressant treatments like ketamine and esketamine. In addition, evidence supporting the use of psychotherapies and neuromodulation strategies are also reviewed. Written by top experts in the field, this book is the first of its kind to review all methods of treatment for TRD. Defines Treatment-Resistant Depression and Staging Treatment Intensity Includes Treatment-Resistant Depression options for children, adolescents, geriatrics, during pregnancy, and during post-partum and menopause transitions Discusses the use of Ketamine and Esketamine for treatment-resistant depression
Treatment resistant depression : a clinical perspective . Canadian Journal of Psychiatry , 33 , 788-92 . McGrath , P.J. , Stewart , J.W. , Harrison , W. et al . ( 1987 ) . Treatment of refractory depression with a monoamine oxidase ...
Author: Jay D. Amsterdam
Publisher: Cambridge University Press
This timely book assesses all aspects of treatment-resistant depression and will be invaluable to professionals.
Table 4.9 Staging of treatment - resistant depression Previous treatment Stage 0 1 2 3 4 5 Has not had a single adequate ... Treatment - refractory depression There is no agreed definition of treatment - refractory depression ( TRD ) ...
Author: George Stein
Publisher: RCPsych Publications
This second edition of Seminars in General Adult Psychiatry provides a highly readable and comprehensive account of modern adult psychiatry. Key features of the first edition that have been retained are the detailed clinical descriptions of psychiatric disorders, and historical sections to give the reader access to the classic studies of psychiatry as well as the current evidence. Additional topics covered here for the first time include liaison psychiatry, psychosexual medicine, clinical epidemiology, and international and cultural psychiatry. Clinical management is given due prominence, with extensive accounts of modern drug management, cognitive therapy, the main psychosocial approaches, and current guidelines such as those published by the National Institute for Health and Care Excellence. An essential text for trainees studying for their MRCPsych, this book is also a one-stop reference work for established practitioners, providing comprehensive coverage of the whole of adult psychiatry.
The direct evidence in support of MAOI treatment of refractory depression is more meager . However , the studies reviewed herein suggest that MAOIs may be effective in some cases in which tricyclics have failed .
Author: Steven P. Roose
Publisher: Amer Psychiatric Pub Incorporated
An assessment of a variety of treatments for refractory depression, this book reviews all controlled studies as well as the results of open clinical trials. Among the subjects addressed are lithium augmentation, ECT and chronic depressive disorders.
speeds up antidepressant response , rather than produces benefit in refractory depression , and its use is not very popular . Buspirone has also been added to SRI therapy for refractory depression , although controlled data are mixed .
Author: S. Nassir Ghaemi
Publisher: Lippincott Williams & Wilkins
This practical guide will aid residents and clinicians in diagnosing and treating the full spectrum of mood disorders. Dr. Ghaemi explains how to accurately diagnose depressive and manic symptoms and bipolar disorder and offers specific, detailed, evidence-based recommendations on pharmacotherapy and psychotherapy of acute and refractory unipolar depression, bipolar depression, and mania. Chapters review the pharmacology of antidepressants, mood stabilizers, and antipsychotic agents and point out these drugs’ advantages and drawbacks in specific clinical situations. Other chapters address clinical dilemmas such as treating rapid-cycling bipolar disorder, distinguishing unipolar from bipolar depression, and tapering bipolar depressed patients off antidepressants.
Numerous case series and seven of nine placebo-controlled trials have established the efficacy of lithium in the treatment of refractory depression (Charney et al., 1995), with response rates typically between 30% and 70%.
Author: Dennis S. Charney
Publisher: Oxford University Press
The new edition of this definitive textbook reflects the continuing reintegration of psychiatry into the mainstream of biomedical science. The research tools that are transforming other branches of medicine - epidemiology, genetics, molecular biology, imaging, and medicinal chemistry - are also transforming psychiatry. The field stands poised to make dramatic advances in defining disease pathogenesis, developing diagnostic methods capable of identifying specific and valid disease entities, discovering novel and more effective treatments, and ultimately preventing psychiatric disorders. The Neurobiology of Mental Illness is written by world-renowned experts in basic neuroscience and the pathophysiology and treatment of psychiatric disorders. It begins with a succint overview of the basic neurosciences followed by and evaluation of the tools that are available for the study of mental disorders in humans. The core of the book is a series of consistently organized sections on the major psychiatric disorders that cover their diagnostic classification, molecular genetics, functional neuroanatomy, neurochemistry and pharmacology, neuroimaging, and principles of pharmacotherapy. Chapters are written in a clear style that is easily accessible to practicing psychiatrists, and yet they are detailed enough to interest researchers and academics.For this second edition, every section has been thoroughly updated, and 13 new chapters have been added in areas where significant advances have been made, including functional genomics and animal models of illness; epidemiology; cognitive neuroscience; postmortem investigation of human brain; drug discovery methods for psychiatric disorders; the neurobiology of schizophrenia; animal models of anxiety disorders; neuroimaging studies of anxiety disorders; developmental neurobiology and childhood onset of psychiatric disorders; the neurobiology of mental retardation; the interface between neurological and psychiatric disorders; the neurobiology of circadian rhythms; and the neurobiology of sleep disorders. Both as a textbook and a reference work, Neurobiology of Mental Illness represents a uniquely valuable resource for psychiatrists, neuroscientists, and their students or trainees.
Addition of risperidone to sertraline improves sertraline-resistant refractory depression without influencing plasma concentrations of sertraline ... Risperidone for treatment-refractory major depressive disorder: a randomized trial.
Author: David Taylor
Publisher: CRC Press
One of the most widely used guides to prescribing psychiatric medications, the Tenth Edition of Maudsley Prescribing Guidelines returns with fully updated content and new sections on the latest topics of interest in the field of psychiatry. A must-have reference for prescribers, nursing staff, pharmacists, family physicians, and other professions i