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Last Updated on April 28, 2023

Clinical depression is a serious health condition that impacts more than 15 million American adults and is called to become the second most frequent health problem on the planet by the year 2020. Although depression is a treatable illness, about 10 to 30 percent of people experience treatment-resistant depression.

“Treatment-resistant depression implies the individual has not responded adequately to treatments tried,” explains Kathleen Franco, MD, professor of medicine and psychiatry at Cleveland Clinic Lerner College of Medicine in Ohio. This could mean that:

  • Drug is not functioning at all
  • Medicine is just partly working
  • Depression comes back while taking drug

What Causes Treatment-Resistant Depression?

“A related physical sickness is one reason why a disorder could be hard to take care of,” says Dr. Franco. Common health conditions that may cause treatment-resistant depression include anemia and hypothyroidism. Other possible factors behind treatment-resistant depression could be:

  • Medicines. Some drugs that are used to treat blood pressure like methyldopa (Aldomet), reserpine (Serapsil), along with the class of drugs called beta blockers are recognized to generate depression more difficult to deal with.

  • Substance abuse.
    Abuse of alcohol or drugs or addictive eating disorders can interfere with melancholy treatment.
  • Sort of melancholy. Specific forms of depression such as psychotic, bipolar, or atypical depression may be more likely to be treatment-resistant.
  • Conformity. Folks who don’t take their medicines as prescribed or don’t take their medicine because of side effects may be treatment-resistant.

Symptoms of Treatment-Resistant Depression

For those who have some of these symptoms for more than two weeks despite being on antidepressant medication, you may have treatment-resistant depression:

  • Feeling depressed, anxious, or empty
  • Feeling guilty, worthless, or hopeless
  • Changes in sleep or eating habits
  • Decline of interest in pleasurable activities
  • Loss of mental attention
  • Reduction of physical energy

Diagnosis and Treatment of Treatment-Resistant Depression

Analysis of treatment-resistant depression needs to be considered when the patient has had no relief despite numerous treatments for established periods of time at frequency and the correct dose, says Franco. Although research shows that only one in three people with depression become symptom-free after the primary medication they try, you will find several choices for treatment-resistant depression:

  • Optimization. In many cases individuals with depression are not receiving the best results from their first drug since the drug is just not taken in a high enough dose or to get a long enough period of time. A patient may need to take the medicine for up to 10 to 12 weeks to get a full answer.
  • Substitution. Substitution to a different class of antidepressant medication might help. Studies reveal that 30 to 50 percent of individuals with treatment-resistant depression reacted well after replacing an antidepressant that works in a different way.
  • Combination. Taking more than one kind of antidepressant drugs may help. There is certainly the possibility of increased unwanted effects, although combining antidepressant drugs works as well or better than substitution.
  • Psychotherapy. Adding talk therapy using a mental health professional can help. In a National Institute of Mental Health study, teenagers with treatment-resistant depression did better when they switched to another type of antidepressant and added psychotherapy compared with merely switching drugs alone.
  • Neurostimulation. This is a kind of therapy by which electrical impulses are accustomed to take care of depression. Electroconvulsive therapy (ECT) is the best treatment for clinical depression that does not respond to other treatment. Electrodes are positioned on the head to deliver electrical impulses. Another kind of neurostimulation that has been approved for treatment-resistant depression is vagal nerve stimulation, in which electrodes are put on the chest.
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For those who have treatment-resistant depression, do not give up. You might need to work along with your physician for a while to get the proper drug or combination of psychotherapy and medications. Let your doctor know in the event you are experiencing any side effects, and not discontinue taking drug by yourself. Eventually, remember that 80 to 90 percent of individuals with depression do get better.

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