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Abstract
Treatment-resistant depression (TRD) typically refers to inadequate response to at
least one antidepressant trial of adequate doses and duration. TRD is a relatively
common occurrence in clinical practice, with up to 50% to 60% of the patients not
achieving adequate response following antidepressant treatment. A diagnostic re-evaluation
is essential to the proper management of these patients. In particular, the potential
role of several contributing factors, such as medical and psychiatric comorbidity,
needs to be taken into account. An accurate and systematic assessment of TRD is a
challenge to both clinicians and researchers, with the use of clinician-rated or self-rated
instruments being perhaps quite helpful. It is apparent that there may be varying
degrees of treatment resistance. Some staging methods to assess levels of treatment
resistance in depression are being developed, but need to be tested empirically.
Copyright 2003 Society of Biological Psychiatry