Unipolar depression in adults: Treatment of resistant depression. Accessed March 1, National Alliance on Mental Illness. Sanacora G, et al. A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA Psychiatry. Lebow J. Overview of psychotherapies.
Ionescu DF, et al. Pharmacological approaches to the challenge of treatment-resistant depression. Dialogues in Clinical Neuroscience. Bewernick B, et al. Update on neuromodulation for treatment-resistant depression. De Sousa RT, et al.
Challenging treatment-resistant major depressive disorder: A roadmap for improved therapeutics. Current Neuropharmacology. Thase M, et al. Ketamine and esketamine for treating unipolar depression in adults: Administration, efficacy, and adverse effects. Accessed March 2, Dold M, et al.
Evidence-based pharmacotherapy of treatment-resistant unipolar depression. International Journal of Psychiatry in Clinical Practice. Daly EJ, et al. Efficacy of esketamine nasal spray plus oral antidepressant treatment for relapse prevention in patients with treatment-resistant depression: A randomized clinical trial.
Accessed March 3, National Institute of Mental Health. Acceptance and commitment therapy ACT. Department of Veterans Affairs. Accessed March 4, Zaccariello MJ expert opinion. Mayo Clinic, Rochester, Minn. Croarkin PE expert opinion.
Dhami P, et al. Feasibility and clinical effects of theta burst stimulation in youth with major depressive disorders: An open-label trial. Journal of Affective Disorders. Spravato prescribing information. Janssen Pharmaceuticals, Inc. Accessed March 28, After a flood, are food and medicines safe to use?
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Alzheimer's stages Alzheimer's test: Detection at the earliest stages Ambien: Is dependence a concern? Antidepressant withdrawal: Is there such a thing? Antidepressants and alcohol: What's the concern? Antidepressants and weight gain: What causes it? Antidepressants: Can they stop working? Depression symptoms , such as sleep issues and appetite problems, may continue despite patient compliance with treatment.
At other times, the symptoms resolve briefly but come back. It's important to remember that even if depression does not respond to the first couple of treatments, that doesn't mean it cannot be treated. But it may require a different approach to treatment.
You should work with your doctor to monitor your symptoms and response to treatment so that you can find an option that works for you. Consequences for people with treatment-resistant depression can be significant. Treatment-resistant depression can manifest as:. Because standard treatments do not work well or at all, people may begin to experience profound hopelessness.
Symptoms can drag on for months without feeling any relief or improvement in mood. Doctors and researchers are not entirely sure what causes treatment-resistant depression. Some theories include:. If you have been treated for depression but your symptoms have not improved, you should talk to your doctor. Treatment-resistant depression is not an official diagnosis included in the Diagnostic and Statistical Manual of Mental Disorders DSM-5 , nor is it consistently defined.
Some experts suggest that it is defined as having had two different antidepressant trials without relief, while others suggest that it can take as many as four different treatments before depression should be identified as resistant. In any case, you should always talk to your doctor about your symptoms and concerns.
If you have not experienced any relief, only minimal relief, or a complete return of symptoms, you may need a different type of antidepressant or other approaches to your treatment.
If your doctor believes that you have treatment-resistant depression, they may recommend a different dosage, medication, or treatment approach. Your doctor may also refer you to a psychiatric consultant for additional treatment advice and options. Before a physician or psychiatrist will consider a medication a treatment failure, they will consider the following questions:.
If a psychiatrist determines that your current medication is a failure, there are some other treatment options that affect brain chemistry in a different way. Those options include:. If you aren't already attending psychotherapy, a referral may be made to a mental health professional who offers it. While there are many different types of psychotherapy that have been found to be beneficial in depression, cognitive behavioral therapy CBT has data that found it effective for treatment-resistant depression.
Patients attending CBT may learn a variety of skills to manage their symptoms and improve their functioning. The goals of CBT often involve reframing negative thoughts, problem-solving, increasing social interaction, and increasing activity level. CBT may also help reduce sleep problems.
Some other types of therapy that may also be helpful include interpersonal therapy, dialectical behavioral therapy, and psychodynamic therapy in both individual and group settings. Here are some additional procedures that may be effective for treatment-resistant depression:.
Dealing with treatment-resistant depression can be difficult for a number of reasons. Similar results were found in another study that looked at the use of methylphenidate with antidepressants and one that evaluated using modafinil with antidepressants. Even though these studies found no overall benefit, they did show some improvement in symptoms, such as fatigue and tiredness.
They might also be an option if you have attention deficit hyperactivity disorder as well as depression. Lisdexamfetamine is one of the best-studied stimulants used for treatment-resistant depression. Although some studies have found improved symptoms when combined with antidepressants, other research has found no benefit. An analysis of four studies of lisdexamfetamine and antidepressants found that the combination was no more beneficial than taking antidepressants alone.
With a little time and patience, you and your doctor can develop a treatment plan that improves your symptoms. The National Alliance on Mental Illness offers a program called Peer to Peer that involves 10 free educational sessions that break down everything from talking to your doctor to staying current on the latest research.
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