Treatment Strategies for Refractory Depression [Number 25]

Over the years there have been many published articles and symposia on the diagnosis and treatment of refractory depression, but there have been surprisingly few data. This paucity of data reflects the absence of an effective, sustained research effort on this topic.

The authors of Treatment Strategies for Refractory Depression review all available controlled studies as well as the results of open clinical trials to help the clinician answer questions often faced in the clinical setting. Does the treatment fit the illness? Are the patients truly refractory to treatment or simply inadequately treated, and if indeed they appear to be treatment-resistant, resistant to what treatment? Is the methodology appropriately rigorous in studies assessing the effectiveness of alternative treatments in "treatment resistant" depressions? Do factors such as chronicity or personality characteristics predict poor response? Among the many subjects addressed in this volume are lithium augmentation, the use of monoamine oxidase inhibitors, ECT, tricyclic nonresponse, serotonergic agents, thyroid function, chronic depressive disorders, and the effect of Axis II disorders on treatment outcome. Seventeen leading authorities on refractory depression contribute to this volume, the outgrowth of a symposium presented at an annual meeting of the American Psychiatric Association.

Steven P. Roose, M.D., is Associate Professor of Clinical Psychiatry, College of Physicians and Surgeons, Columbia University; and Research Psychiatrist, New York State Psychiatric Institute.

Alexander H. Glassman, M.D., is Professor of Clinical Psychiatry, College of Physicians and Surgeons, Columbia University; and Chief of Clinical Psychopharmacology, New York State Psychiatric Institute.