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Treatment-Resistant Depression: Approaches to Treatment

Karan S Kverno, Emma Mangano

Journal of Psychosocial Nursing and Mental Health Services August 30, 2021 DOI: 10.3928/02793695-20210816-01 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Review Peer reviewed
Interventions Esketamine Psilocybin Pramipexole
Topics Depression
Keywords Depression economics Pramipexole Psychosocial Mental health Mood
Citations 121
Key findings Approved treatments for TRD include esketamine, with emerging evidence for psilocybin and pramipexole, but guidelines for person-centered treatments are limited in specificity.

Abstract

Approximately 30% of people treated for a major depressive episode will not achieve remission after two or more treatment trials of first-line antidepressants and are considered to have treatment-resistant depression (TRD). Because the odds of remission decrease with every subsequent medication trial, it is important for clinicians to understand the characteristics and risk factors for TRD, subtypes of major depressive disorder that are more likely to be less responsive to first-line anti-depressants, and the available treatment options. In the current article, we review the approved treatments for TRD, including esketamine, and the evidence for psilocybin and pramipexole. Although limited in specificity, guidelines to help prescribers identify person-centered treatments for TRD are available. [ Journal of Psychosocial Nursing and Mental Health Services, 59 (9), 7–11.]

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