Numerous approaches have been used to de ne and stage treatment-resistant depression (TRD) as well as to nd predictors of treatment outcome. Nevertheless, TRD remains a complex disorder, with high morbidity and mortality. This paper brie y reviews current guidelines for managing TRD, summarising the best pharmacological strategies and ‘next steps’ of psychological and physical treatments. When depressed patients fail to remit after two or more conventional antidepressant treatments, combined approaches, targeting multiple molecular, psychological and physical mechanisms, seem to be the most e ective strategy.
|Cutting Edge Psychiatry in Practice
|Published - Feb 2019