Open Access
Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults
Bradley N. Gaynes,Linda J Lux,Stacey Lloyd,Richard A. Hansen,Gerald Gartlehner,Patricia Keener,Shannon Brode,Tammeka Swinson Evans,Daniel E Jonas,Karen Crotty,Meera Viswanathan,Kathleen N. Lohr +11 more
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TLDR
Patients with two or more prior treatment failures are considered to have treatment-resistant depression (TRD); these TRD patients represent a complex population with a disease that is difficult to manage.Abstract:
Major depressive disorder (MDD) is common and costly. Over the course of a year, between 13.1 million and 14.2 million people will experience MDD. Approximately half of these people seek help for this condition, and only 20 percent of those receive adequate treatment. For those who do initiate treatment for their depression, approximately 50 percent will not adequately respond following acutephase treatment; this refractory group has considerable clinical and research interest. Patients with only one prior treatment failure are sometimes included in this group, but patients with two or more prior treatment failures are a particularly important and poorly understood group and are considered to have treatment-resistant depression (TRD). These TRD patients represent a complex population with a disease that is difficult to manage.read more
Citations
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Deep brain stimulation.
TL;DR: Deep brain stimulation is clinically effective in improving motor function of essential tremor, Parkinson's disease and primary dystonia and in relieving obsessive-compulsive disorder.
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The Clinical TMS Society Consensus Review and Treatment Recommendations for TMS Therapy for Major Depressive Disorder
Tarique D. Perera,Mark S. George,Mark S. George,Geoffrey Grammer,Philip G. Janicak,Alvaro Pascual-Leone,Theodore Wirecki +6 more
TL;DR: Daily left prefrontal TMS has substantial evidence of efficacy and safety for treating the acute phase of depression in patients who are treatment resistant or intolerant.
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Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis.
Bradley N. Gaynes,Stacey W Lloyd,Linda J Lux,Gerald Gartlehner,Gerald Gartlehner,Richard A. Hansen,Shannon Brode,Daniel E Jonas,Tammeka Swinson Evans,Meera Viswanathan,Kathleen N. Lohr +10 more
TL;DR: For MDD patients with 2 or more antidepressant treatment failures, rTMS is a reasonable, effective consideration and how long these benefits persist remains unclear.
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Vagus Nerve Stimulation
TL;DR: VNS deserves further study for its potentially favorable effects on cardiovascular, cerebrovascular, metabolic, and other physiologic biomarkers associated with depression morbidity and mortality.
References
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A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression
Carlos A. Zarate,Jaskaran Singh,Paul J. Carlson,Nancy E. Brutsche,Rezvan Ameli,David A. Luckenbaugh,Dennis S. Charney,Husseini K. Manji +7 more
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TL;DR: Transcranial magnetic stimulation was effective in treating major depression with minimal side effects reported and offers clinicians a novel alternative for the treatment of this disorder.
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Timothy I. Mueller,Andrew C. Leon,Martin B. Keller,David A. Solomon,Jean Endicott,William Coryell,Meredith G. Warshaw,Jack D. Maser +7 more
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Depression in older adults
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