Treatment resistant depression:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1996
|
| Schriftenreihe: | The psychiatric clinics of North America
19,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 179 - 412 Ill., graph. Darst. |
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Datensatz im Suchindex
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| adam_text | TREATMENT RESISTANT DEPRESSION
CONTENTS
Preface xi
Mady Hornig Rohan and Jay D. Amsterdam
Definition and Epidemiology of Treatment Resistant
Depression 179
Maurizio Fava and Katharine G. Davidson
Although many depressed patients do improve with adequate
antidepressant treatment, a significant proportion fails to reach
acceptable levels of functioning and well being. Currently, how¬
ever, there is no universally accepted definition of treatment
resistance in unipolar depression (TRD). This article proposes an
operational definition of TRD and discusses partial response,
nonresponse, and methodologic issues that emerge in the assess¬
ment of resistance. Finally, possible predictors of failure to re¬
spond are reviewed, and an attempt is made to estimate the
prevalence of TRD.
Management of Treatment Resistant Unipolar and
Chronically Depressed Patients 201
Victor I. Reus
Treatment of the chronically depressed unipolar patient is a chal¬
lenging enterprise that requires not only a current and in depth
understanding of pharmacologic mechanisms but also persever¬
ance and an ability to convey and sustain therapeutic optimism.
Failure of response to treatment often is concluded erroneously,
and close attention to optimizing the medication trial is necessary
and sometimes sufficient. An array of innovative drug combina¬
tion strategies remains for the truly refractory, and, if pursued in
a logical progression, likely will result in success for the majority
of individuals.
I THE PSYCHIATRIC CLINICS OF NORTH AMERICA
VOLUME 19 • NUMBER 2 • JUNE 1996 vii
Treatment Resistant Bipolar Depression 215
Gary S. Sachs
This article begins with a conceptual overview of treatment
resistant bipolar depression and discusses characteristics of bipo¬
lar illness and factors that influence treatment outcome. The liter¬
ature on treatments for bipolar depression is reviewed, including
topics such as antidepressant efficacy and treatment emergent
mania. Strategies are offered to improve clinical treatment out¬
come. Emphasis is placed on careful clinical assessment and pro¬
spective mood charting, and a treatment algorithm that limits the
use of standard antidepressant agents is presented.
Management of Psychotic, Treatment Resistant Depression 237
Anthony J. Rothschild
Psychotic depression is more common than is generally realized,
and it is encountered frequently in clinical practice. Unfortu¬
nately, as few as 17% of patients recover with treatment and
remain well for 12 months. Relapse or recurrence has been re¬
ported in 50% to 92% of patients. This article focuses on treatment
approaches and alternatives for patients with psychotic, treat¬
ment resistant depression.
Treatment Resistant Depression in Children and Adolescents 253
Barbara Geller, Richard D. Todd, Joan Luby, and
Kelly N. Botteron
Treatment resistance in depressed children and adolescents can¬
not be fully defined yet because of the paucity of controlled
studies that demonstrate efficacy. This article addresses several
of the age specific, developmental considerations that may im¬
pinge on treatment response. Areas covered include familial
genetic, psychosocial, and neuroimaging issues, and controlled
studies done to date are reviewed.
Management of Treatment Resistance in the Depressed
Geriatric Patient 269
Barbara A. Kamholz and Alan M. Mellow
The identification and treatment of depression in elderly patients
often is problematic, particularly when a medical problem or
physical dysfunction is an additional consideration. This article
reviews the epidemiology of geriatric depression, addresses
definitions of treatment resistance in this population, and dis¬
cusses specific clinical problems that render adequate treatment
difficult. The existing literature that addresses the utility of spe¬
cific somatic therapies also is discussed. The article concludes
with a discussion of the frail elderly, and recommendations for
treatment planing are made.
Viii CONTENTS
Sfe,,:
The Role of Axis II Comorbidity in the Management of
Patients with Treatment Resistant Depression 287
Michael E. Thase
Many treatment resistant depressed patients have features of one
or more personality disorders. This article reviews the broader
relationship between personality disorders and depression and
discusses the pathways by which the former may reduce the
probability of treatment response. Modifications in treatment
planning are suggested, and psychotherapeutic strategies are rec¬
ommended to facilitate the treatment of personality disordered
patients with refractory depressive states.
The Management of Treatment Resistance in Depressed
Patients with Substance Use Disorders 311
Edward V. Nunes, Deborah Deliyannides, Stephen Donovan,
and Patrick J. McGrath
The combination of substance abuse and depression worsens prog¬
nosis but also provides opportunities. Effective treatment of pre¬
viously unaddressed substance abuse may improve outcome in
treatment resistant depression. Treatment of depression may im¬
prove substance use outcome. Substance abuse may point toward
other comorbid disorders, such as attention deficit or anxiety disor¬
ders, which, if treated, may improve outcome. Recommendations
are developed for the evaluation and management of treatment
resistant patients with depression and substance use disorders.
The Management of Treatment Resistant Depression in the
Medically 111 329
Kathleen Franco Bronson
Depression is a common problem in patients with medical illness.
Comorbidity can increase the likelihood of treatment resistance
and underscores the importance of thorough and definitive evalu¬
ation of all disorders. Treatment selections must be considered
carefully to avoid significant side effects and drug drug interac¬
tions. Metabolic pathways and effects on the identified organ
system will guide the clinician s choice of antidepressant medica¬
tion. Increasing numbers of alternatives and combinations will
assist today s physician in treating depression in the medically ill
patient effectively.
The Management of Treatment Resistant Depression in
Disorders on the Interface of Psychiatry and Medicine:
Fibromyalgia, Chronic Fatigue Syndrome, Migraine, Irritable
Bowel Syndrome, Atypical Facial Pain, and Premenstrual
Dysphoric Disorder 351
Amanda J. Gruber, James I. Hudson, and
Harrison G. Pope, Jr
Several conditions that are on the border between psychiatry and
medicine and frequently refractory to existing treatments are dis
CONTENTS ix
J
cussed. Psychotropic medications, particularly antidepressant
agents, appear to be at least partially effective in the treatment of
these conditions along with their associated depressive symp¬
toms. These findings are not only important clinically but also
suggest a possible relationship between these disorders and de¬
pression.
Treatment Algorithms in Treatment Resistant Depression 371
Jay D. Amsterdam and Mady Hornig Rohan
The application of systematic approaches to the management of
treatment resistant depression has become increasingly important
as the number of available therapeutic options for mood disorders
has grown. The assessment of adequacy of prior treatment, strate¬
gies for augmentation of failed antidepressant trials, the role of
monoamine oxidase inhibitors, and other aspects of a logical and
scientifically informed treatment algorithm approach are re¬
viewed.
Novel Strategies for Treatment Resistant Depression 387
Mady Hornig Rohan, Owen M. Wolkowitz, and
Jay D. Amsterdam
This article describes a highly selective constellation of the more
unique strategies for managing the treatment resistant patient. As
each successive move down the treatment algorithm flowchart
becomes necessary, the risk:benfit ratio may shift toward less
well substantiated, but still biologically informed, strategies. Al¬
though some of the more unusual treatments described in this
article represent minimally charted territories, the more promis¬
ing techniques deserve further exploration.
Index 407
Subscription Information Inside back cover
X CONTENTS
In..
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| physical | XII S., S. 179 - 412 Ill., graph. Darst. |
| publishDate | 1996 |
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| spelling | Treatment resistant depression Mädy Hornig-Rohan, ... guest ed. Philadelphia [u.a.] Saunders 1996 XII S., S. 179 - 412 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier The psychiatric clinics of North America 19,2 Dépression - Traitement médicamenteux Depression drug therapy Depression therapy Depression, Mental Treatment Chronische Depression (DE-588)4198328-2 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Chronische Depression (DE-588)4198328-2 s DE-604 Hornig-Rohan, Mady Sonstige oth The psychiatric clinics of North America 19,2 (DE-604)BV000003374 19,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007254321&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| subject_GND | (DE-588)4198328-2 (DE-588)4143413-4 |
| title | Treatment resistant depression |
| title_auth | Treatment resistant depression |
| title_exact_search | Treatment resistant depression |
| title_full | Treatment resistant depression Mädy Hornig-Rohan, ... guest ed. |
| title_fullStr | Treatment resistant depression Mädy Hornig-Rohan, ... guest ed. |
| title_full_unstemmed | Treatment resistant depression Mädy Hornig-Rohan, ... guest ed. |
| title_short | Treatment resistant depression |
| title_sort | treatment resistant depression |
| topic | Dépression - Traitement médicamenteux Depression drug therapy Depression therapy Depression, Mental Treatment Chronische Depression (DE-588)4198328-2 gnd |
| topic_facet | Dépression - Traitement médicamenteux Depression drug therapy Depression therapy Depression, Mental Treatment Chronische Depression Aufsatzsammlung |
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