title: Therapy of treatment resistant depression: focus on the management of TRD with atypical antipsychotics.
abstract: Treatment-resistant depression (TRD) represents a significant challenge for physicians. About one third of patients with major depressive disorder fail to experience sufficient symptom improvement despite adequate treatment. Despite this high occurrence of TRD there was no general consensus on diagnosis criteria for TRD until 1997 when researchers proposed a model of defining and staging TRD. In 1999, others defined operational criteria for the definition of TRD. Treatment of TRD is commonly separated into pharmacologic and nonpharmacologic methods. This review gives a short overview of these two methods. The nonpharmacologic methods include psychotherapy, electroconvulsive therapy, and vagus nerve stimulation. Pharmacologic methods include switching to another antidepressant monotherapy, and augmentation or combination with two or more antidepressants or other agents. This review especially focuses on the augmentation of the antidepressant therapy with atypical antipsychotics.
authors.affiliation: Department of General Psychiatry, Medical University of Vienna, A-1090 Vienna, Austria. nikolas.klein@medunivien.ac.at
authors.forename: Nikolas
authors.initials: N
authors.lastname: Klein
authors.forename: Julia
authors.initials: J
authors.lastname: Sacher
authors.forename: Helene
authors.initials: H
authors.lastname: Wallner
authors.forename: Johannes
authors.initials: J
authors.lastname: Tauscher
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D018432:Drug Resistance, Multiple; D006801:Humans
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents