treatment-resistant depression
Also written as: TRD — Treatment-Resistant Depression
Major depression that fails to respond adequately to at least two different antidepressant medications given at therapeutic doses for sufficient duration.
Full Definition
Treatment-resistant depression (TRD) refers to major depressive episodes that do not achieve adequate response or remission despite appropriate treatment with at least two different antidepressant medications from different pharmacological classes, administered at therapeutic doses for adequate duration (typically 6-8 weeks each). This condition affects approximately 30% of patients with major depression and represents a significant clinical challenge requiring specialized approaches. Factors contributing to treatment resistance may include inadequate dosing, poor medication adherence, comorbid conditions, substance use, or underlying bipolar disorder. Management typically involves augmentation strategies, combination therapies, alternative treatments such as ECT or ketamine, or psychotherapy approaches. Accurate identification of TRD is crucial for accessing specialized treatments and avoiding prolonged suffering.
Usage
Usage note: Specific clinical criteria must be met; distinguish from pseudo-resistance due to inadequate dosing or duration.
In Context
- "After failing to respond to both sertraline and bupropion at maximum tolerated doses, the patient met criteria for treatment-resistant depression." — Medication management assessment
- "The specialized mood disorders clinic focuses on innovative treatments for patients with treatment-resistant depression." — Referral information document