The management of resistant depression.
Between 10 and 30% of depressed patients, mostly bipolar, develop a therapy-resistant illness. The known causes of such chronic evolutions are discussed: misdiagnosis (underlying schizophrenia, personality disorder or dementia), drug-induced depression (neuroleptics), systemic disease (hypothyroidism, multiple sclerosis, cardiovascular or neoplastic disease etc.), or lack of efficacy (drug compliance, insufficient dosage). Remedies are suggested: adequate dosage, drug combination (Newcastle cocktail. tricyclic antidepressant + MAOI, imipramine + T3), carbamazepine in lithium-resistant cases, alprazolam, reduction in vanadium intake, sleep deprivation, psychosurgery.
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000628:therapy*; D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D003951:Diagnostic Errors; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D016651:Lithium Carbonate; D008297:Male; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use; D011612:Psychosurgery; D012892:Sleep Deprivation; D014284:Triiodothyronine / Q000627:therapeutic use
D000929:Antidepressive Agents, Tricyclic; D008996:Monoamine Oxidase Inhibitors; D014284:Triiodothyronine; D016651:Lithium Carbonate; D008094:Lithium