While perusing posters at a recent international psychiatry conference, a prominent subject garnering intensive interest was the understanding and treatment of treatment-resistant depression (TRD). The definition of TRD, however, was notably vague: ranging from 1 to as many as 8 failed antidepressant treatment trials. This lack of a consensual TRD definition creates enormous problems: it limits the ability to do comparative treatment research, to understand the biological underpinnings of TRD, and produces ambiguous medical insurance coverage issues. This disparity in defining TRD begs the question: When does major depressive disorder (MDD) become resistant?
Conway CR, George MS, Sackeim HA. Toward an Evidence-Based, Operational Definition of Treatment-Resistant DepressionWhen Enough Is Enough. JAMA Psychiatry. Published online October 26, 2016. doi:10.1001/jamapsychiatry.2016.2586