Cited by 796Treatment of Major DepressionElectroconvulsive Therapy StudiesTranscranial Magnetic Stimulation Studies

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Treatment-resistant depression: therapeutic trends, challenges, and future directions

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Al-harbi·2012·Patient Preference and Adherence

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Abstract

BACKGROUND: Patients with major depression respond to antidepressant treatment, but 10%-30% of them do not improve or show a partial response coupled with functional impairment, poor quality of life, suicide ideation and attempts, self-injurious behavior, and a high relapse rate. The aim of this paper is to review the therapeutic options for treating resistant major depressive disorder, as well as evaluating further therapeutic options. METHODS: In addition to Google Scholar and Quertle searches, a PubMed search using key words was conducted, and relevant articles published in English peer-reviewed journals (1990-2011) were retrieved. Only those papers that directly addressed treatment options for treatment-resistant depression were retained for extensive review. RESULTS: Treatment-resistant depression, a complex clinical problem caused by multiple risk factors, is targeted by integrated therapeutic strategies, which include optimization of medications, a combination of antidepressants, switching of antidepressants, and augmentation with non-antidepressants, psychosocial and cultural therapies, and somatic therapies including electroconvulsive therapy, repetitive transcranial magnetic stimulation, magnetic seizure therapy, deep brain stimulation, transcranial direct current stimulation, and vagus nerve stimulation. As a corollary, more than a third of patients with treatment-resistant depression tend to achieve remission and the rest continue to suffer from residual symptoms. The latter group of patients needs further study to identify the most effective therapeutic modalities. Newer biomarker-based antidepressants and other drugs, together with non-drug strategies, are on the horizon to address further the multiple complex issues of treatment-resistant depression. CONCLUSION: Treatment-resistant depression continues to challenge mental health care providers, and further relevant research involving newer drugs is warranted to improve the quality of life of patients with the disorder.

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The serotonin syndrome
Sternbach, H. A. (1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.6.705 · Cited by 1,349
Targeting the glutamatergic system to develop novel, improved therapeutics for mood disorders
Sanacora, G., Zarate, C. A., Krystal, J. H., & Manji, H. K. (2008) · Nature Reviews Drug Discovery · doi:10.1038/nrd2462 · Cited by 894
DEFINITION AND EPIDEMIOLOGY OF TREATMENT-RESISTANT DEPRESSION
Fava, M., & Davidson, K. G. (1996) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(05)70283-5 · Cited by 797
Untitled work
(2001) · PubMed · Cited by 780
Untitled work
(1997) · PubMed · Cited by 727
Switching to Another SSRI or to Venlafaxine With or Without Cognitive Behavioral Therapy for Adolescents With SSRI-Resistant Depression
Brent, D. A., Emslie, G. J., Clarke, G. N., Wagner, K. D., Asarnow, J. R., Keller, M., Vitiello, B., Ritz, L., Iyengar, S., Abebe, K. Z., et al. (2008) · JAMA · doi:10.1001/jama.299.8.901 · Cited by 713
Tryptophan Hydroxylase-2 Controls Brain Serotonin Synthesis
Zhang, X., Beaulieu, J., Sotnikova, T. D., Gainetdinov, R. R., & Caron, M. G. (2004) · Science · doi:10.1126/science.1097540 · Cited by 683
Suicide attempts and nonsuicidal self-injury in the treatment of resistant depression in adolescents: findings from the TORDIA study
Asarnow, J. R., Porta, G., Spirito, A., Emslie, G., Clarke, G., Wagner, K. D., Vitiello, B., Keller, M., Birmaher, B., McCracken, J., et al. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2011.04.003 · Cited by 632
Comorbid depression and anxiety spectrum disorders
Gorman, J. M. (1996) · Depression and Anxiety · doi:10.1002/(sici)1520-6394(1996)4:4 · Cited by 629
Vagus nerve stimulation (VNS™) for treatment-resistant depression: efficacy, side effects, and predictors of outcome
Sackeim, H. (2001) · Neuropsychopharmacology · doi:10.1016/s0893-133x(01)00271-8 · Cited by 568
Treatment-Resistant Depression
Stolerman, I. P., & Price, L. H. (2015) · Springer eBooks · doi:10.1007/978-3-642-36172-2_200431 · Cited by 485
Deep brain stimulation for treatment-resistant depression: follow-up after 3 to 6 years
Kennedy, S. H., Giacobbe, P., Rizvi, S. J., Placenza, F. M., Nishikawa, Y., Mayberg, H. S., & Lozano, A. M. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.10081187 · Cited by 481
Loss-of-Function Mutation in Tryptophan Hydroxylase-2 Identified in Unipolar Major Depression
Zhang, X., Gainetdinov, R. R., Beaulieu, J.-M., Sotnikova, T. D., Burch, L. H., Williams, R. B., Schwartz, D. A., Krishnan, K. R. R., & Caron, M. G. (2005) · Neuron · doi:10.1016/j.neuron.2004.12.014 · Cited by 473
If at First You Donʼt Succeed
Connolly, K. R., & Thase, M. E. (2010) · Drugs · doi:10.2165/11587620-000000000-00000 · Cited by 468
Treatment resistant depression: methodological overview and operational criteria
Souery, D., Amsterdam, J. D., de Montigny, C., Lecrubier, Y., Montgomery, S., Lipp, O., Racagni, G., Zohar, J., & Mendlewicz, J. (1999) · European Neuropsychopharmacology · doi:10.1016/s0924-977x(98)00004-2 · Cited by 443
Use of the International Classification of Functioning, Disability and Health (ICF) as a conceptual framework and common language for disability statistics and health information systems
Kostanjsek, N. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-s4-s3 · Cited by 434 · cited 1×
“…According to the World Health Organization International Classification of Functioning, Disability and Health, that includes psychiatric disorders, 39 including major depression and treatment-resistant depression, the participation level of patients with depression is an important treatment…”
Antidepressant Efficacy of the Antimuscarinic Drug Scopolamine: A Randomized, Placebo-Controlled Clinical Trial
Furey, M. L., & Drevets, W. C. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.10.1121 · Cited by 417
Deep Brain Stimulation for Treatment-Resistant Depression: Follow-Up After 3 to 6Years
Ballenger, J. C. (2012) · Yearbook of Psychiatry and Applied Mental Health · doi:10.1016/j.ypsy.2011.08.041 · Cited by 365
The Impact of Medication Resistance and Continuation Pharmacotherapy on Relapse following Response to Electroconvulsive Therapy in Major Depression
Sackeïm, H. A., Prudic, J., Devanand, D. P., Decina, P., KERR, B., & Malitz, S. (1990) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199004000-00004 · Cited by 361
A multicenter pilot study of subcallosal cingulate area deep brain stimulation for treatment-resistant depression: Clinical article
Lozano, A. M., Giacobbe, P., Hamani, C., Rizvi, S. J., Kennedy, S. H., Kolivakis, T. T., Debonnel, G., Sadikot, A. F., Lam, R. W., Howard, A. K., et al. (2012) · Journal of Neurosurgery · doi:10.3171/2011.10.jns102122 · Cited by 356
Cognitive Therapy Versus Medication in Augmentation and Switch Strategies as Second-Step Treatments: A STAR*D Report
Thase, M. E., Friedman, E. S., Biggs, M. M., Wisniewski, S. R., Trivedi, M. H., Luther, J. F., Fava, M., Nierenberg, A. A., McGrath, P. J., Warden, D., et al. (2007) · American Journal of Psychiatry · doi:10.1176/ajp.2007.164.5.739 · Cited by 332
A Preliminary, Open Study of the Combination of Fluoxetine and Desipramine for Rapid Treatment of Major Depression
Nelson, J. C. (1991) · Archives of General Psychiatry · doi:10.1001/archpsyc.1991.01810280019002 · Cited by 294
Recovery from depression, work productivity, and health care costs among primary care patients
Simon, G. E., Revicki, D. A., Heiligenstein, J. H., Grothaus, L. C., VonKorff, M., Katon, W. J., & Hylan, T. R. (2000) · General Hospital Psychiatry · doi:10.1016/s0163-8343(00)00072-4 · Cited by 267
Convulsive therapy: a review of the first 55 years
Fink, M. (2001) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00367-0 · Cited by 266
GABAB Receptors, Schizophrenia and Sleep Dysfunction
Kantrowitz, J., Citrome, L., & Javitt, D. (2009) · CNS Drugs · doi:10.2165/00023210-200923080-00001 · Cited by 258
A Placebo-Controlled Comparison of Lithium and Triiodothyronine Augmentation of Tricyclic Antidepressants in Unipolar Refractory Depression
Joffe, R. T. (1993) · Archives of General Psychiatry · doi:10.1001/archpsyc.1993.01820170065008 · Cited by 257
Prospective, long-term, multicenter study of the naturalistic outcomes of patients with treatment-resistant depression
Dunner, D. L., Rush, A. J., Russell, J. M., Burke, M., Woodard, S., Wingard, P., & Allen, J. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0501 · Cited by 234 · cited 1×
“A naturalistic study revealed that most patients with a substantial degree of treatment resistance continue to have significant symptoms and functional disability when receiving their usual treatment.(36) Finally, the adverse effects of medication and poor compliance determined by poverty and low education may be addi…”
Transcranial direct current stimulation in treatment resistant depression: A randomized double-blind, placebo-controlled study
Palm, U., Schiller, C., Fintescu, Z., Obermeier, M., Keeser, D., Reisinger, E., Pogarell, O. M., Nitsche, M. A., Möller, H. ‐., & Padberg, F. (2011) · Brain stimulation · doi:10.1016/j.brs.2011.08.005 · Cited by 234
Therapeutic Options for Treatment-Resistant Depression
Shelton, R. C., Osuntokun, O. O., Heinloth, A. N., & Corya, S. A. (2010) · CNS Drugs · doi:10.2165/11530280-000000000-00000 · Cited by 212
Staging methods for treatment resistant depression. A systematic review
Ruhé, H. G., van Rooijen, G., Spijker, J., Peeters, F. P. M. L., & Schene, A. H. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.02.020 · Cited by 210
Fluoxetine Treatment of Patients With Major Depressive Disorder Who Failed Initial Treatment With Sertraline
Thase, M. E., Blomgren, S. L., Birkett, M. A., Apter, J. T., & Tepner, R. G. (1997) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v58n0103 · Cited by 204
Venlafaxine for Treatment-Resistant Unipolar Depression
NIERENBERG, A. A., FEIGHNER, J. P., RUDOLPH, R., COLE, J. O., & SULLIVAN, J. (1994) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199412000-00008 · Cited by 198
Rapid decrease in depressive symptoms with an N-methyl-d-aspartate antagonist in ECT-resistant major depression
Ibrahim, L. A., Diazgranados, N., Luckenbaugh, D. A., Machado‐Vieira, R., Baumann, J., Mallinger, A. G., & Zarate, C. A. (2011) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2011.03.019 · Cited by 191
Venlafaxine and paroxetine in treatment-resistant depression: Double-blind, randomised comparison
Poirier, M.-F., & Boyer, P. (1999) · British Journal of Psychiatry · doi:10.1192/bjp.175.1.12 · Cited by 185
Antidepressant Agents for the Treatment of Chronic Pain and Depression
Jann, M. W., & Slade, J. H. (2007) · Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy · doi:10.1592/phco.27.11.1571 · Cited by 172
Venlafaxine and paroxetine in treatment-resistant depression
Gregson, J. R. (1999) · The British Journal of Psychiatry · doi:10.1192/bjp.175.6.591a · Cited by 171
Treatment of imipramine-resistant recurrent depression, IV: A double- blind crossover study of tranylcypromine for anergic bipolar depression
(1992) · American Journal of Psychiatry · doi:10.1176/ajp.149.2.195 · Cited by 167
Diagnosis and management of patients with bipolar II disorder.
Yatham, L. N. (2005) · PubMed · Cited by 163
A comparison of triiodothyronine and thyroxine in the potentiation of tricyclic antidepressants
Joffe, R. T., & Singer, W. (1990) · Psychiatry Research · doi:10.1016/0165-1781(90)90029-5 · Cited by 156
Effects of Risperidone Augmentation in Patients with Treatment-Resistant Depression: Results of Open-Label Treatment Followed by Double-Blind Continuation
Rapaport, M. H., Gharabawi, G. M., Canuso, C. M., Mahmoud, R. A., Keller, M. B., Bossie, C. A., Turkoz, I., Lasser, R. A., Loescher, A., Bouhours, P., et al. (2006) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301113 · Cited by 149
Ziprasidone Augmentation of Selective Serotonin Reuptake Inhibitors (SSRIs) for SSRI-Resistant Major Depressive Disorder
Papakostas, G. I., Petersen, T., Nierenberg, A. A., Murakami, J. L., Alpert, J. E., Rosenbaum, J. F., & D, M. F. M. (2004) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v65n0212 · Cited by 148
Double-blind Switch Study of Imipramine or Sertraline Treatment of Antidepressant-Resistant Chronic Depression
Thase, M. E., Rush, A. J., Howland, R. H., Kornstein, S. G., Kocsis, J. H., Gelenberg, A. J., Schatzberg, A. F., Koran, L. M., Keller, M. B., Russell, J. M., et al. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.3.233 · Cited by 146
Long-Term Outcome of Adolescent Depression Initially Resistant to Selective Serotonin Reuptake Inhibitor Treatment
Vitiello, B., Emslie, G. J., Clarke, G., Wagner, K. D., Asarnow, J. R., Keller, M. B., Birmaher, B. B., Ryan, N. D., Kennard, B. D., Mayes, T. L., et al. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05885blu · Cited by 128
Nicotinic Antagonist Augmentation of Selective Serotonin Reuptake Inhibitor-Refractory Major Depressive Disorder: A Preliminary Study
George, T. P., Sacco, K. A., Vessicchio, J. C., Weinberger, A. H., & Shytle, R. D. (2008) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e318172b49e · Cited by 128
A randomized double-blind sham-controlled comparison of unilateral and bilateral repetitive transcranial magnetic stimulation for treatment-resistant major depression
Blumberger, D. M., Mulsant, B. H., Fitzgerald, P. B., Rajji, T. K., Ravindran, A. V., Young, L. T., Levinson, A. J., & Daskalakis, Z. J. (2012) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2011.579163 · Cited by 118
Switching Antidepressant Class Does Not Improve Response or Remission in Treatment-Resistant Depression
Souery, D., Serretti, A., Calati, R., Oswald, P., Massat, I., Konstantinidis, A., Linotte, S., Bollen, J., Demyttenaere, K., Kasper, S. F., et al. (2011) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3182228619 · Cited by 118
Economic implications of treatment-resistant depression among employees
Greenberg, P., Corey-Lisle, P. K., Birnbaum, H., Marynchenko, M., & Claxton, A. (2004) · PharmacoEconomics · doi:10.2165/00019053-200422060-00003 · Cited by 113
EICOSAPENTAENOIC ACID IN TREATMENT‐RESISTANT DEPRESSION ASSOCIATED WITH SYMPTOM REMISSION, STRUCTURAL BRAIN CHANGES AND REDUCED NEURONAL PHOSPHOLIPID TURNOVER
Puri, B. K., Counsell, S. J., Hamilton, G., Richardson, A. J., & Horrobin, D. F. (2001) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2001.tb11122.x · Cited by 110
Issues in treatment-resistant depression.
Keller, M. B. (2005) · PubMed · Cited by 108
Treatment Resistant Depression— Advances in Somatic Therapies
Kennedy, S. H., & Giacobbe, P. (2007) · Annals of Clinical Psychiatry · doi:10.1080/10401230701675222 · Cited by 108
Nortriptyline for Treatment-Resistant Depression
Nierenberg, A. A., Papakostas, G. I., Petersen, T., Kelly, K. E., Iacoviello, B. M., Worthington, J. J., Tedlow, J. R., Alpert, J. E., & D, M. F. M. (2003) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v64n0108 · Cited by 106
Meta-Review of Metanalytic Studies with Repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Major Depression
Dell’Osso, B., Camuri, G., Castellano, F., Vecchi, V., Benedetti, M., Bortolussi, S., & Altamura, A. C. (2011) · Clinical Practice & Epidemiology in Mental Health · doi:10.2174/1745017901107010167 · Cited by 105
Treatment-resistant depression in adolescents: review and updates on clinical management
Maalouf, F. T., Atwi, M., & Brent, D. A. (2011) · Depression and Anxiety · doi:10.1002/da.20884 · Cited by 102
Therapeutic options in treatment-resistant depression
Vieta, E., & Colom, F. (2011) · Annals of Medicine · doi:10.3109/07853890.2011.583675 · Cited by 101
Impact of Physical and Sexual Abuse on Treatment Response in the Treatment of Resistant Depression in Adolescent Study (TORDIA)
Shamseddeen, W. A., Asarnow, J. R., Clarke, G. N., Vitiello, B., Wagner, K. D., Birmaher, B. B., Keller, M. B., Emslie, G. J., Iyengar, S., Ryan, N. D., et al. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2010.11.019 · Cited by 95
Efficacy and Safety of Mirtazapine in Major Depressive Disorder Patients After SSRI Treatment Failure
D, M. F. M., Dünner, D. L., Greist, J. H., Preskorn, S., Trivedi, M. H., Zajecka, J., & Cohen, M. (2001) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v62n0603 · Cited by 94
THE MANAGEMENT OF TREATMENT-RESISTANT DEPRESSION IN DISORDERS ON THE INTERFACE OF PSYCHIATRY AND MEDICINE
Gruber, A. J., Hudson, J. I., & Pope, H. G. (1996) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(05)70292-6 · Cited by 93
Venlafaxine in Treatment-Resistant Major Depression: A Canadian Multicenter, Open-Label Trial
de Montigny, C., Silverstone, P. H., Debonnel, G., Blier, P., & Bakish, D. (1999) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199910000-00003 · Cited by 84
Response to an open trial of a second SSRI in major depression.
Joffe, R. T., LEVITT, A. J., Sokolov, S. T. H., & Young, L. T. (1996) · PubMed · Cited by 84
Lorazepam treatment of acute and chronic catatonia in two mentally retarded brothers.
Gaind, G. S., Rosebush, P. I., & Mazurek, M. F. (1994) · PubMed · Cited by 78
A Double-Blind Placebo-Controlled Trial of Lamotrigine as an Antidepressant Augmentation Agent in Treatment-Refractory Unipolar Depression
Barbee, J. G., Thompson, T. R., Jamhour, N. J., Stewart, J. W., Conrad, E. J., Reimherr, F. W., Thompson, P. M., & Shelton, R. C. (2011) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05355gre · Cited by 78
Cognitive Therapy Versus Medication in Augmentation and Switch Strategies as Second-Step Treatments: A STAR*D Report
Thase, M. (2007) · American Journal of Psychiatry · doi:10.1176/appi.ajp.164.5.739 · Cited by 77
Pharmacologic approaches to treatment resistant depression: a re-examination for the modern era
Philip, N. S., Carpenter, L. L., Tyrka, A. R., & Price, L. H. (2010) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656561003614781 · Cited by 76
What Are the Implications of the STAR*D Trial for Primary Care?
Huynh, N., & McIntyre, R. S. (2008) · The Primary Care Companion to The Journal of Clinical Psychiatry · doi:10.4088/pcc.v10n0201 · Cited by 75
Managing treatment-resistant major depression.
Nelson, J. C. (2003) · PubMed · Cited by 68
Examination of the Utility of Psychotherapy for Patients with Treatment Resistant Depression: A Systematic Review
TRIVEDI, R. B., Nieuwsma, J. A., & Williams, J. W. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1608-2 · Cited by 66
Venlafaxine extended release versus citalopram in patients with depression unresponsive to a selective serotonin reuptake inhibitor
Lenox‐Smith, A., & Jiang, Q. L. (2008) · International Clinical Psychopharmacology · doi:10.1097/yic.0b013e3282f424c2 · Cited by 64
Relapse in patients on long-term fluoxetine treatment: response to increased fluoxetine dose.
D, M. F. M., Rappe, S., Pava, J. A., Nierenberg, A. A., Alpert, J. E., & Rosenbaum, J. F. (1995) · PubMed · Cited by 63
Augmentation of Antidepressants with Atypical Antipsychotics: A Review of the Current Literature
Philip, N. S., Carpenter, L. L., Tyrka, A. R., & Price, L. H. (2008) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000308493.93003.92 · Cited by 63
Antidepressant Exposure as a Predictor of Clinical Outcomes in the Treatment of Resistant Depression in Adolescents (TORDIA) Study
Sakolsky, D. J., Perel, J. M., Emslie, G. J., Clarke, G. N., Wagner, K. D., Vitiello, B., Keller, M. B., Birmaher, B. B., Asarnow, J. R., Ryan, N. D., et al. (2010) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e318204b117 · Cited by 63
Adapting Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression
Eisendrath, S., Chartier, M., & McLane, M. (2011) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2010.05.004 · Cited by 60
Treatment-Resistant Depression
Thase, M. E. (2011) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.8133tx4c · Cited by 60
A Pilot Study of the Efficacy and Safety of Paroxetine Augmented With Risperidone, Valproate, Buspirone, Trazodone, or Thyroid Hormone in Adult Chinese Patients With Treatment-Resistant Major Depression
Fang, Y., Yuan, C., Xu, Y., Chen, J., Wu, Z., Cao, L., Yi, Z., Hong, W., Wang, Y., Jiang, K., et al. (2011) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e31822bb1d9 · Cited by 59
Navigating the Sequenced Treatment Alternatives to Relieve Depression (STAR∗D) Study: Practical Outcomes and Implications for Depression Treatment in Primary Care
Cain, R. A. (2007) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2007.05.006 · Cited by 59
Does intolerance or lack of response with fluoxetine predict the same will happen with sertraline?
Zarate, C. A., Kando, J. C., Tohen, M. F., Weiss, M. K., & Cole, J. O. (1996) · PubMed · Cited by 56
Treatment-Resistant Depression: Progress and Limitations
O’Reardon, J. P., & Amsterdam, J. D. (1998) · Psychiatric Annals · doi:10.3928/0048-5713-19981101-08 · Cited by 55
Incremental Cost-effectiveness of Combined Therapy vs Medication Only for Youth With Selective Serotonin Reuptake Inhibitor–Resistant Depression
Lynch, F. L., Dickerson, J. F., Clarke, G. N., Vitiello, B., Porta, G., Wagner, K. D., Emslie, G. J., Asarnow, J. R., Keller, M. B., Birmaher, B. B., et al. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.9 · Cited by 54
The Effectiveness of Electroconvulsive Therapy in Treatment-Resistant Depression
Khalid, N., Atkins, M., Tredget, J., Giles, M., Champney-Smith, K., & Kirov, G. (2008) · Journal of Ect · doi:10.1097/yct.0b013e318157ac58 · Cited by 52
Improving antidepressant adherence.
Nemeroff, C. B. (2003) · PubMed · Cited by 50
A preliminary investigation of the influence of CREB1 gene on treatment resistance in major depression
Serretti, A., Chiesa, A., Calati, R., Massat, I., Linotte, S., Kasper, S. F., Lecrubier, Y., Antonijevic, I. A., Forray, C., & Snyder, L. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.06.025 · Cited by 49
Citalopram versus desipramine in treatment resistant depression: Effect of continuation or switching strategies. A randomized open study
Souery, D., Serretti, A., Calati, R., Oswald, P., Massat, I., Konstantinidis, A., Linotte, S., Kasper, S. F., Montgomery, S., Zohar, J., et al. (2011) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2011.590225 · Cited by 48
Switching to Another SSRI or to Venlafaxine With or Without Cognitive Behavioral Therapy for Adolescents With SSRI-Resistant Depression: The TORDIA Randomized Controlled Trial
Stockman, J. A. (2009) · Yearbook of Pediatrics · doi:10.1016/s0084-3954(08)79063-8 · Cited by 48
Augmentation strategies: focus on anxiolytics.
Joffe, R. T., Aj, L., & Sokolov, S. T. H. (1996) · PubMed · Cited by 47
THE MANAGEMENT OF TREATMENT-RESISTANT DEPRESSION IN THE MEDICALLY ILL
Franco-Bronson, K. (1996) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(05)70291-4 · Cited by 46
Psychostimulants in the therapy of treatment-resistant depression: review of the literature and findings from a retrospective study in 65 depressed patients
Stotz, G., Woggon, B., & Angst, J. (1999) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.1999.1.3/gstotz · Cited by 45
Evolving refractory major depressive disorder diagnostic and treatment paradigms: toward closed-loop therapeutics
Ward, M. P. (2010) · Frontiers in Neuroengineering · doi:10.3389/fneng.2010.00007 · Cited by 44
Venlafaxine—mirtazapine combination in the treatment of persistent depressive illness
Hannan, N., Hamzah, Z., Akinpeloye, H. O., & Meagher, D. J. (2007) · Journal of Psychopharmacology · doi:10.1177/0269881107065738 · Cited by 42
Management of depression in the elderly by general practitioners: I. Use of antidepressants
Orrell, M. W., Collins, E., Shergill, S. S., & Katona, C. (1995) · Family Practice · doi:10.1093/fampra/12.1.5 · Cited by 41
The Place for the Tricyclic Antidepressants in the Treatment of Depression
Boyce, P. M., & Judd, F. K. (1999) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.1999.00580.x · Cited by 41
Efficacy, safety and tolerability of quetiapine augmentation in treatment resistant depression: An open-label, pilot study
Anderson, I. M., Sarsfield, A., & Haddad, P. M. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.12.016 · Cited by 40
Lithium addition in treatment-resistant depression
de Montigny, C. (1994) · International Clinical Psychopharmacology · doi:10.1097/00004850-199406002-00006 · Cited by 40
Why Do You Need to Move Beyond First-Line Therapy for Major Depression?
Culpepper, L. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.9104su1c.01 · Cited by 39
Use of Continuation or Maintenance Electroconvulsive Therapy in Adolescents With Severe Treatment-Resistant Depression
Ghaziuddin, N., Dumas, S. M., & Hodges, E. K. (2011) · Journal of Ect · doi:10.1097/yct.0b013e3181f665e4 · Cited by 38
Are patients who are intolerant to one SSRI intolerant to another?
Brown, W. A., & Harrison, W. M. (1992) · PubMed · Cited by 37
Topiramate augmentation in patients with resistant major depressive disorder: A double-blind placebo-controlled clinical trial
Mowla, A., & Kardeh, E. (2011) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2011.01.016 · Cited by 37
Antidepressant Efficacy of the Antimuscarinic Drug Scopolamine: A Randomized, Placebo-Controlled Clinical Trial
Ballenger, J. C. (2008) · Yearbook of Psychiatry and Applied Mental Health · doi:10.1016/s0084-3970(08)70778-3 · Cited by 37
Cracking the moody brain: Lifting the mood with ketamine
Murrough, J. W., & Charney, D. S. (2010) · Nature Medicine · doi:10.1038/nm1210-1384 · Cited by 36
Treatment-Resistant Depressed Youth Show a Higher Response Rate if Treatment Ends During Summer School Break
Shamseddeen, W. A., Clarke, G. N., Wagner, K. D., Ryan, N. D., Birmaher, B. B., Emslie, G. J., Asarnow, J. R., Porta, G., Mayes, T. L., Keller, M. B., et al. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2011.07.022 · Cited by 36
The short- and long-term efficacy of paroxetine HCl: B. Data from a double-blind crossover study and from a year-long term trial vs. imipramine and placebo.
Peselow, E. D., Am, F., Goodnick, P. J., Barouche, F., & Rr, F. (1989) · PubMed · Cited by 36
Moderate physical exercise and quality of life in patients with treatment-resistant major depressive disorder
Mota-Pereira, J., Carvalho, S., Silvério, J., Fonte, D., Pizarro, A. I. N., Teixeira, J., Ribeiro, J. C., & Ramos, J. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.08.008 · Cited by 35
Episode length and mixed features as predictors of ECT nonresponse in patients with medication-resistant major depression
Perugi, G., Medda, P., Zanello, S., Toni, C., & Cassano, G. (2011) · Brain stimulation · doi:10.1016/j.brs.2011.02.003 · Cited by 35
The use of antidepressants in novel combination therapies.
Shelton, R. C. (2003) · PubMed · Cited by 33
Efficacy of venlafaxine in patients with major depressive disorder who have unsustained or no response to selective serotonin reuptake inhibitors: an open-label, uncontrolled study
Kaplan, E. M. (2002) · Clinical Therapeutics · doi:10.1016/s0149-2918(02)80029-7 · Cited by 32
Treatment-resistant depression in adolescents: is the addition of cognitive behavioral therapy of benefit?
Hetrick, S. E., Cox, & Merry (2011) · Psychology Research and Behavior Management · doi:10.2147/prbm.s13780 · Cited by 30
Are Atypical Antipsychotic Drugs also Atypical Antidepressants?
Parker, G. B., Parker, G. B., & Malhi, G. S. (2001) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/0004867010060512 · Cited by 30
Treatment-Resistant Depression: New Therapies on the Horizon
Trivedi, M. H. (2003) · Annals of Clinical Psychiatry · doi:10.3109/10401230309085670 · Cited by 30
Treatment-resistant depression: new therapies on the horizon.
Trivedi, M. H. (2003) · Annals of Clinical Psychiatry · doi:10.1023/a:1023232727217 · Cited by 29
Outcome of a 4-Step Treatment Algorithm for Depressed Inpatients
Birkenhäger, T. K., van den Broek, W. W., Moleman, P., & Bruijn, J. A. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0814 · Cited by 28
A randomized, single-blind, comparison of duloxetine with bupropion in the treatment of SSRI-resistant major depression
Rosso, G., Rigardetto, S., Bogetto, F., & Maina, G. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.07.026 · Cited by 28
Dual–Dual Action? Combining Venlafaxine and Mirtazapine in the Treatment of Depression
Malhi, G. S., Ng, F., & Berk, M. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670701881587 · Cited by 26
Magnetic seizure therapy for treatment-resistant depression
Hoy, K. E., & Fitzgerald, P. B. (2011) · Expert Review of Medical Devices · doi:10.1586/erd.11.55 · Cited by 26
Triple Reuptake Inhibitors: A Premise and Promise
Marks, D. M., Pae, C., & Patkar, A. A. (2008) · Psychiatry Investigation · doi:10.4306/pi.2008.5.3.142 · Cited by 26
Health care costs of depression in primary care patients in The Netherlands
Bosmans, J. E., de Bruijne, M. C., de Boer, M. R., van Hout, H. P. J., Steenwijk, P. V., & van Tulder, M. W. (2010) · Family Practice · doi:10.1093/fampra/cmq033 · Cited by 24
Practical management of treatment-resistant depression.
Cadieux, R. J. (1998) · PubMed · Cited by 24
Long-Term Impact of Residual Symptoms in Treatment-Resistant Depression
Fekadu, A., Wooderson, S. C., Rane, L. J., Markopoulou, K., Poon, L., & Cleare, A. J. (2011) · The Canadian Journal of Psychiatry · doi:10.1177/070674371105600906 · Cited by 23
Efficacy, safety and tolerability of Symbyax®for acute-phase management of treatment-resistant depression
Bobo, W. V., & Shelton, R. C. (2010) · Expert Review of Neurotherapeutics · doi:10.1586/ern.10.44 · Cited by 22
Mirtazapine for treatment-resistant depression: a preliminary report
Wan, D. D. C., Kundhur, D., Solomons, K., Yatham, L. N., & Lam, R. W. M. (2003) · Journal of Psychiatry and Neuroscience · doi:10.1139/jpn.0306 · Cited by 21
Mirtazapine versus sertraline after SSRI non-response
Thase, M. E., Kremer, C. M. E., & Rodrigues, H. (2001) · European Neuropsychopharmacology · doi:10.1016/s0924-977x(01)80503-4 · Cited by 20
A Comparison of Comorbid Patterns in Treatment-Resistant Unipolar and Bipolar Depression
Sharma, V., Mazmanian, D. S., Persad, E., & Kueneman, K. (1995) · The Canadian Journal of Psychiatry · doi:10.1177/070674379504000509 · Cited by 20
Utility of Repetitive Transcranial Stimulation as an Augmenting Treatment Method in Treatment-Resistant Depression
Jhanwar, V. G., Bishnoi, R. J., & Jhanwar, M. R. (2011) · Indian Journal of Psychological Medicine · doi:10.4103/0253-7176.85406 · Cited by 18
Augmentation and Combination Strategies for Complicated Depression
Fava, M. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.8001tx13c · Cited by 18
Introduction of Vagus Nerve Stimulation Into a Maintenance Electroconvulsive Therapy Regimen
Warnell, R. L., & Elahi, N. (2007) · Journal of Ect · doi:10.1097/yct.0b013e3180616647 · Cited by 18
Pharmacological management of treatment-resistant depression
Cowen, P. J. (1998) · Advances in Psychiatric Treatment · doi:10.1192/apt.4.6.320 · Cited by 17
Treatment Options for the Patient Who Does Not Respond Well to Initial Antidepressant Therapy
Preskorn, S. (2009) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000351880.30013.2a · Cited by 15
Current perspectives in the management of treatment-resistant depression
Parikh, R. M., & Lebowitz, B. D. (2004) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2004.6.1/rparikh · Cited by 15
New Approaches to the Pharmacological Management of Major Depressive Disorder
Witkin, J. M., & Li, X. (2009) · Advances in pharmacology · doi:10.1016/s1054-3589(08)57009-8 · Cited by 14
Estimulación cerebral profunda para el tratamiento de la depresión resistente
Torres, C. V., & Lozano, A. M. (2008) · Revista de Neurología · doi:10.33588/rn.4709.2008491 · Cited by 13
Risk of adverse events in treatment-resistant depression: propensity-score-matched comparison of antidepressant augment and switch strategies
Hansen, R. A., Dusetzina, S. B., Ellis, A. R., Stürmer‎, T., Farley, J. F., & Gaynes, B. N. (2011) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2011.10.001 · Cited by 13
Aripiprazole augmentation strategy in clomipramine-resistant depressive patients: An open preliminary study
Fabrazzo, M., Perris, F., Monteleone, P., Esposito, G., Catapano, F., & Maj, M. (2011) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2011.06.006 · Cited by 13
The Strategy of Combining Antidepressants in the Treatment of Major Depression: Clinical Experience in Spanish Outpatients
Martín‐Lopez, L. M., Rojo, E., Gibert, K., Martín‐Sánchez, J. C., Sperry, L., Duñó, L., Bulbena, A., & Vallejo, J. (2011) · Depression Research and Treatment · doi:10.1155/2011/140194 · Cited by 13
Treatment-Resistant Depression: Managed Care Considerations
Tierney, J. G. (2007) · Journal of Managed Care Pharmacy · doi:10.18553/jmcp.2007.13.s6-a.2 · Cited by 13
ARE PATIENTS WHO ARE INTOLERANT TO ONE SSRI, INTOLERANT TO ANOTHER?
Brown, W. A., & Quitkin, F. M. (1992) · Clinical Neuropharmacology · doi:10.1097/00002826-199202001-00157 · Cited by 13
Practical management of treatment-resistant affective disorders.
Pk, B., Ad, H., & Al, M. (1996) · PubMed · Cited by 12
Augmentation Strategies
Thase, M. E. (2009) · CNS Spectrums · doi:10.1017/s1092852900003515 · Cited by 12
Sertoli cell therapy: A novel possible treatment strategy for treatment-resistant major depressive disorder
Loftis, J. M. (2011) · Medical Hypotheses · doi:10.1016/j.mehy.2011.03.017 · Cited by 11
Treatment-resistant depression
Simpson, G. M., & Kessel, J. B. (1991) · British Journal of Psychiatry · doi:10.1192/bjp.159.1.162b · Cited by 11
Triple reuptake inhibitors: Next-generation antidepressants
Liang, Y., & Richelson, E. (2008) · Primary psychiatry · Cited by 11
Nefazodone therapy in patients with treatment-resistant or treatment-intolerant depression and high psychiatric comorbidity
Sajatovic, M., DiGiovanni, S. K., Fuller, M. A., Belton, J., DeVega, E., Marqua, S., & Liebling, D. S. (1999) · Clinical Therapeutics · doi:10.1016/s0149-2918(00)88324-1 · Cited by 10
Antidepressant failure: augmentation or substitution?
Joffe, R. T., & Levitt, A. J. (1995) · PubMed · Cited by 9
Olanzapine augmentation of milnacipran for stage 2 treatment‐resistant major depression: an open study
Boku, S., Inoue, T., Honma, H., Matsubara, S., Nakagawa, S., & Koyama, T. (2011) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.1197 · Cited by 8
Treatment-Resistant Depression in Hispanic Patients
Podawiltz, A., & Culpepper, L. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.8153tx3cc · Cited by 7
Clinical inquiries: How should you manage a depressed patient unresponsive to an SSRI?
Triezenberg, D., Vachon, D. O., Helmen, J., & Schneider, D. (2006) · PubMed · Cited by 6
Venlafaxine-mirtazapine combination in the treatment of persistent depressive illness
Hannan, N., Hamzah, Z., Akinpeloye, H. O., & Meagher, D. (2006) · Journal of Psychopharmacology · doi:10.1177/0269881106065738 · Cited by 6
Early Weight Gain as a Predictor of Substantial Weight Gain With Olanzapine/Fluoxetine Combination
Degenhardt, E. K., Jamal, H. H., Tormey, S., & Case, M. G. (2011) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3182196e64 · Cited by 5
Treatment-resistant depression: no panacea, many uncertainties. Adverse effects are a major factor in treatment choice.
(2011) · PubMed · Cited by 5
The Art of Prescribing.
Antai-Otong, D. (2007) · Perspectives In Psychiatric Care · doi:10.1111/j.1744-6163.2007.00123.x · Cited by 4
Combined Drug Treatment Strategies for Major Depression
Nelson, J. C. (1998) · Psychiatric Annals · doi:10.3928/0048-5713-19980401-05 · Cited by 4
Lithium Addition in Treatment-Resistant Depression
de Montigny, C., Cournoyer, G., & Grünberg, F. (1986) · The Canadian Journal of Psychiatry · doi:10.1177/070674378603100833 · Cited by 4
Augmentation of antidepressant effects with 5HT-1A antagonists. Basic and clinical studies
Artigas, F., Romero, L. I., Pérez, V., & Álvarez, E. (1996) · European Neuropsychopharmacology · doi:10.1016/0924-977x(96)87373-1 · Cited by 3
10.1016/s0084-3970(09)79124-8
(2000) · Time to knit · doi:10.1016/s0084-3970(09)79124-8 · Cited by 3
[Risk factors and psychosocial disability of treatment-resistant depression].
Baud, P. (2011) · PubMed · Cited by 1

Research works printed but not linked: 4

[5]American Psychiatric Association Practice Guideline for the Treatment of Patients with Major Depression 2000 Diagnostic and Statistical Manual of Mental Disorders 4th Edition Text Revision Washington, DC American Psychiatric Association 2000
[37]Phillips KA Nierenberg AA The assessment and treatment of refractory depression J Clin Psychiatry 1994 55 20 26 8077165
[82]Nemeroff CB Use of atypical antipsychotics in refractory depression and anxiety J Clin Psychiatry 2005 66 Suppl 8 13 21 16336032
[110]Torres CV Lozano AM Deep brain stimulation in the treatment of therapy-refractory depression Rev Neurol 2008 47 477 482 18985598

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Authors: Al-harbi
Venue: Patient Preference and Adherence
Publisher: Informa UK Limited
Published: 2012-05
Volume: 6
Pages: 369
ISSN: 1177-889X (ISSN-L)
DOI: 10.2147/ppa.s29716
PMC: PMC3363299
OpenAlex: W2016292245
Cited by: 796
References: 155
Citations by year: 2026: 75 · 2025: 76 · 2024: 104 · 2023: 95 · 2022: 107 · 2021: 91 · 2020: 63 · 2019: 56 · 2018: 38 · 2017: 33 · 2016: 18 · 2015: 15 · 2014: 14 · 2013: 6 · 2012: 3
FWCI: 8.94
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc
creativecommons.org/licenses/by-nc/3.0/ (vor)
Locations: Patient Preference and Adherence (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
Funders: King Saud bin Abdulaziz University for Health Science
Topics: Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords: treatment-resistant depression, major depressive disorder, antidepressant augmentation, antidepressant switching, antidepressant combination therapy, electroconvulsive therapy, repetitive transcranial magnetic stimulation, deep brain stimulation, vagus nerve stimulation, transcranial direct current stimulation, magnetic seizure therapy, psychosocial interventions, relapse

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Treatment-resistant depression: therapeutic trends, challenges, and future directions

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