lystn

Today’s question is: How to manage treatment-resistant depression? Here is a summary of this episode: The first step in the management of treatment-resistant depression (TRD) is adequate history taking and assessment for comorbidities and bipolar depression. Augmentation is more effective than switching. Adding lithium is effective particularly in suicidal patients. Modafinil and T3 have been shown to be good add-ons in patients with fatigue. Psychosocial interventions such as mindfulness CBT and behavioral activation have been shown to improve outcomes and prevent relapse of depression. Depression may have an underlying inflammatory component and it has been found in some studies that patients with raised CRP above 3 mg/dL did better with nortriptyline than with SSRIs.   Download a PDF of this interview here Become a premium member of the Psychopharmacology Institute