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Updated: Jun 10, 2025
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MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
Published on: August 11, 2015
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Treatment-resistant depression: molecular mechanisms and management
Mayanja M Kajumba1, Angelina Kakooza-Mwesige2,3, Noeline Nakasujja4
1Department of Mental Health and Community Psychology, Makerere University, P. O. Box 7062, Kampala, Uganda. mayanja.kajumba@mak.ac.ug.
Molecular Biomedicine
|October 16, 2024
Summary
Depression
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Depression is heterogeneous, lacking subtype-specific biomarkers.
- Conventional antidepressants are ineffective for ~66% of patients.
- Current treatments often involve trial-and-error, leading to treatment resistance.
Purpose of the Study:
- Review evidence on depression pathogenesis and treatment response.
- Discuss current and emerging therapeutic approaches.
- Highlight limitations in understanding depression etiology and treatment.
Main Methods:
- Review of preclinical and clinical studies.
- Analysis of neurotransmitter systems, inflammation, stress, HPA axis, genetics, and psychoneurophysiology.
- Evaluation of pharmacological and non-pharmacological treatments.
Main Results:
- Depression pathogenesis and treatment response involve complex interplay of multiple factors.
- Current hypotheses inadequately explain these interactional mechanisms.
- Limited success in discovering effective antidepressant treatments.
Conclusions:
- Effective treatment-resistant depression (TRD) management requires targeting multiple interacting mechanisms.
- Personalized and subtype-specific therapies, like multi-target pharmacotherapies combined with psychotherapy, are needed.
- Future research should focus on interaction mechanisms for novel biomarkers and therapies.
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