title: Clinicians' Views on Treatment-Resistant Depression: 2016 Survey Reports.
abstract: There is a relative paucity of information on both empirical and subjective treatment strategies for treatment-resistant depression (TRD), especially in late life. This paper reviews the findings from two 2016 surveys conducted through the American Psychiatric Association publication the Psychiatric Times and via a member survey by the American Association for Geriatric Psychiatry (AAGP).
  
  
  
  We present the results of the two surveys in terms of descriptive frequencies and percentages and discuss the strengths and weaknesses of various approaches to late-life TRD.
  
  
  
  The Psychiatric Times survey received 468 responses, and the AAGP survey received 117 responses, giving an overall sample of 585 responses. The majority (76.3%) of respondents from both groups believed that a large randomized study comparing the risks and benefits of augmentation and switching strategies for TRD in patients aged 60 years and older would be helpful, and 80% of clinicians believed their practice would benefit from the findings of such a study. Of the treatment strategies that need evidence of efficacy, the most popular options were augmentation/combination strategies, particularly augmentation with aripiprazole (58.7%), bupropion (55.0%), and lithium (50.9%).
  
  
  
  Late-life TRD constitutes a large proportion of clinical practices, particularly of geriatric psychiatry, with lacking evidence of efficacy of most treatment strategies. These surveys indicate a clear need for a large randomized study that compares risks and benefits of augmentation and switching strategies.
authors: the IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia.
authors: Katarina
authors: K
authors: Arandjelovic
authors: the IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; Semel Institute for Neuroscience and Human Behaviour, University of California, Los Angeles, CA, USA; the Discipline of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia.
authors: Harris A
authors: HA
authors: Eyre
authors: Semel Institute for Neuroscience and Human Behaviour, University of California, Los Angeles, CA, USA. Electronic address: hlavretsky@mednet.ucla.edu.
authors: Helen
authors: H
authors: Lavretsky
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000068180:Aripiprazole / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D016642:Bupropion / Q000627:therapeutic use; D061218:Depressive Disorder, Treatment-Resistant / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D018020:Lithium Compounds / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011570:Psychiatry; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D018020:Lithium Compounds; D016642:Bupropion; D000068180:Aripiprazole
keywords: depression; late-life; survey; treatment