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08:20
MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
Published on: August 11, 2015
Treatment-resistant depression: managed care considerations.
1University of Texas Health Science Center Medical School, San Antonio, TX 78258, USA. jgtierney@swnp.xohost.com
Journal of Managed Care Pharmacy : JMCP
|September 20, 2007
Summary
Treatment-resistant depression (TRD) requires careful management. Effective strategies involve adherence to treatment guidelines, including dose titration, augmentation, or switching to agents with different mechanisms of action to improve patient outcomes.
Area of Science:
- Pharmacology
- Psychiatry
- Health Economics
Background:
- Treatment-resistant depression (TRD) poses significant clinical and economic challenges in managed care settings.
- Defining TRD remains inconsistent, but it generally refers to depression unresponsive to adequate treatment.
Purpose of the Study:
- To review the disease state of TRD.
- To examine therapeutic options for persistent depression within managed care.
- To assess the cost-effectiveness of TRD management strategies.
Main Methods:
- Review of American Psychiatric Association (APA) treatment guidelines.
- Analysis of evidence supporting various therapeutic interventions for persistent depression.
- Evaluation of clinical and economic components of TRD care.
Main Results:
- APA guidelines suggest dose titration, augmentation, or switching therapy for non-responsive depression.
- Switching to an agent with a different mechanism of action may enhance treatment efficacy.
- Continuous therapy and adherence to recommended durations improve patient outcomes.
Conclusions:
- Effective TRD management emphasizes patient compliance and selection of treatments minimizing early discontinuation.
- Limited data currently exist on the most cost-effective therapeutic options for TRD.
- Managed care providers would benefit from customizable models to evaluate TRD management cost-effectiveness.
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