[Other therapeutic strategies].

Area of Science:

• Neuroscience
• Pharmacology

Context:

• Treatment-resistant depression (TRD) presents a significant clinical challenge, often requiring third or fourth-line treatment strategies.
• Traditional treatments like non-selective, irreversible monoamine oxidase inhibitors (MAOIs) necessitate strict dietary restrictions and drug interaction monitoring.

Purpose:

• To review emerging and adjunctive therapeutic strategies for managing treatment-resistant depression.
• To highlight the potential of nutritional supplements, glutamate antagonists, and dopamine/norepinephrine agonists in TRD management.

Summary:

• Non-selective, irreversible monoamine oxidase inhibitors (MAOIs) are established as later-line treatments for TRD but require careful management.
• Nutritional supplements like omega-3 fatty acids show promise when combined with existing antidepressant therapies.
• The glutamate antagonist ketamine demonstrates efficacy as a standalone treatment for TRD.
• Dopamine and/or norepinephrine agonists, including methylphenidate, modafinil, and pramipexole, may enhance antidepressant treatment when used adjunctively.

Impact:

• This review provides insights into alternative and supplementary treatment options for patients with treatment-resistant depression.
• Understanding these diverse therapeutic avenues can guide clinicians in optimizing care for refractory depression.
• Highlights the potential for personalized treatment approaches in managing complex depressive disorders.