[Pharmacotherapy in resistance depression]

This article reviews pharmacological approaches used to overcome treatment resistance in patients with serious unipolar depressive disorders. Resistant depression is defined as depression the symptoms of which persist despite adequate treatment. Main causes of unsuccessful treatment are incorrect diagnosis, inadequate duration of treatment or inadequate dosage. Other reasons for resistance are also discussed in the article. There are three basic strategies in treatment of resistance: optimization of treatment, substitution-replacement of the current treatment with a different one, combination-concurrent use of several treatments to enhance the effect. Treatment recommendations related to these strategies are discussed.