Treatment-Resistant Depression: Approaches to Treatment
Journal of Psychosocial Nursing and Mental Health Services – August 30, 2021
Source: OpenAlex
Summary
Nearly 30% of individuals with major depressive disorder experience treatment-resistant depression (TRD), failing to achieve remission after multiple antidepressant trials. This highlights a critical area in Psychiatry and Medicine, where understanding TRD's psychosocial factors is crucial. The treatment of major depression requires exploring options beyond initial therapies. Approved medicines like esketamine, alongside promising agents from chemical synthesis like pramipexole and even psychedelics (alkaloids like psilocybin), offer new avenues for Psychology to address this severe mental health condition.
Abstract
Approximately 30% of people treated for a major depressive episode will not achieve remission after two or more treatment trials of first-line antidepressants and are considered to have treatment-resistant depression (TRD). Because the odds of remission decrease with every subsequent medication trial, it is important for clinicians to understand the characteristics and risk factors for TRD, subtypes of major depressive disorder that are more likely to be less responsive to first-line anti-depressants, and the available treatment options. In the current article, we review the approved treatments for TRD, including esketamine, and the evidence for psilocybin and pramipexole. Although limited in specificity, guidelines to help prescribers identify person-centered treatments for TRD are available. [ Journal of Psychosocial Nursing and Mental Health Services, 59 (9), 7–11.]