How common is failure to remit with first-line therapy in the treatment of major depressive disorder (clinical depression) and how is treatment resistance assessed?

Updated: Aug 06, 2020
  • Author: Jerry L Halverson, MD; Chief Editor: David Bienenfeld, MD  more...
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In one third to two thirds of cases of depression, patients fail to remit with first-line therapy. [117, 168] No factors have been identified for reliably predicting whether an individual patient will respond. [168]

Assessment of patients with treatment-resistant depression should include consideration of the following:

  • Accuracy of diagnosis and possible comorbid medical conditions

  • Adequacy of medication dose and duration of treatment, as well as adherence to treatment regimen

  • Possible comorbid psychiatric conditions (eg, substance abuse, anxiety disorders, personality disorders)

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