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MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
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Published on: August 11, 2015

Treatment-resistant depression: additional perspectives.

M H Rosenzweig1, J D Amsterdam

  • 1Depression Research Unit, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.

Journal of Psychopharmacology (Oxford, England)
|February 1, 2012
PubMed
Summary
This summary is machine-generated.

Treatment-resistant depression (TRD) affects more patients than previously thought, with many experiencing only partial improvement. A broader definition of TRD is needed to capture the full spectrum of antidepressant resistance.

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Area of Science:

  • Psychiatry
  • Pharmacology
  • Clinical Medicine

Background:

  • Treatment-resistant depression (TRD) is often defined narrowly, affecting 10-15% of patients refractory to conventional antidepressants.
  • However, TRD exists on a spectrum, impacting a significant portion of mood disorder patients.
  • Reported antidepressant response rates (60-70%) often reflect partial improvement, not full remission (~25-30%).

Purpose of the Study:

  • To broaden the understanding of treatment-resistant depression (TRD).
  • To highlight the prevalence of partial TRD.
  • To provide a more realistic clinical perspective on TRD.

Main Methods:

  • Review of existing literature on antidepressant treatment outcomes.
  • Analysis of response rates versus remission rates in depression studies.
  • Conceptual framework for understanding TRD spectrum.

Main Results:

  • A majority of patients described as 'improved' may have partial TRD.
  • Only 25-30% of patients achieve clinical remission with antidepressants.
  • A significant number of patients experience only partial response, indicating a broader TRD spectrum.

Conclusions:

  • A wider definition of TRD, encompassing partial resistance, is clinically relevant.
  • Current response rates may obscure the true prevalence of TRD.
  • A spectrum-based view of TRD is essential for accurate diagnosis and treatment.