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Introduction to Treatment Resistant Depression

According to the definition, if depression symptoms continue to cause distress after a patient has tried two different types of antidepressants, the patient is suffering from Treatment Resistant Depression (TRD).


Other possibilities for treatment-resistant depression


Sometimes, however, things are not that simple. To determine if a patient is suffering from treatment-resistant depression, doctors must first determine the patient's compliance with medications. If the patient is not taking the medication at all, how can it be refractory?


Also, the doctor needs to know if the patient has taken adequate doses of antidepressants and how long they have been taking them. Generally, antidepressants take at least one to two weeks to work, so if you give up after taking them for only a few days, you will not be able to test the effectiveness of the antidepressant.


Sometimes, other bodily conditions can also cause depression, such as anemia, hypothyroidism, and so on. If these  problems are not solved, the symptoms of depression will not be cleared even with the use of antidepressants.


In addition, other psychiatric disorders can also cause symptoms of depression, such as psychosis, personality disorders and so on. These diseases are treated differently from depression, and if antidepressants are used alone, they may not help the condition.


Treatment of treatment resistant depression


"Treatment Resistant" depression is not "incurable" depression, and with patience, a way out can be found. In addition to switching to another antidepressant, some doctors will try other types of psychiatric medications, such as antipsychotics and mood stabilizers. In addition to medications, ECT, newer treatments such as magnetic brain stimulation (rTMS) and the glutaminergic drug Esketamine are among valid treatments for treatment resistant depression.

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