Posted by wcfrench on October 16, 2002, at 16:41:43
Wonderful people
I saw this on a TV show, and I'm not sure if it's been posted here before, but I wanted to make sure everyone here knows about it. There's a study going on around the U.S. for treatment-resistant depression. You can visit the website and take the preliminary screening to see if you qualify. I'll save you some time and post the crux of it here. It says that it involves taking a combination of two "novel" medicines, or just one of the two, decided by chance. And by novel, probably meaning that the medicines are unique from other antidepressants. I hope some people can benefit from this since I am sure a lot of us are in this boat.
The URL is www.trialfordepression.com
Here is the info
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Treatment-Resistant Depression (TRD) OverviewThe information in this section is provided by Veritas Medicine.
Despite significant advances in the treatment of depression, currently available antidepressant medications do not work for everyone. As many as 30% to 40% of patients with major depressive disorder do not respond to a course of treatment with antidepressants. And a significant number of patients do not respond to multiple treatment courses. These individuals have a condition now recognized as treatment-resistant depression (TRD). TRD is known as depression that persists or shows only slight improvement after standard treatment with antidepressant medications.
Because there are many causes for the symptoms of depression, and because depression covers a range of symptoms associated with complex biological changes in the brain, there can be many reasons why standard treatments fail to relieve depressive symptoms.
Evaluation and Diagnosis
The diagnosis of TRD is made when symptoms of depression persist or show only slight improvement, despite appropriate treatment with medications. Before a diagnosis of TRD can be made, it is necessary to carefully examine a patient's medical history (including an assessment of their adherence to the prescribed medication regimen) and to complete laboratory tests that can help identify potential causes of depression.NOTE: The failure to treat depression properly is not the same as treatment-resistant depression.
Causes of TRD
Depression is associated with a variety of changes in the structure and function of the brain. Treatment-resistant depression has been specifically related to changes in the front portion of the cortex of the brain and a deep structure connected to this region known as the striatum. Psychological and social factors such as prior treatment failures, stress, or coping styles may also be important in TRD. TRD does not necessarily indicate the presence of additional psychiatric illness such as a personality disorder, but may be associated with stable and sustained depressive traits.Treatment Strategies for TRD
When a patient appears to have TRD, it is first necessary to verify that the failed treatments have been given properly and that the patient has adhered to the treatment regimen. Detectable medical causes of depression, such as reduced thyroid function, should also be identified. Medication-based treatment strategies for TRD can take one of a variety of approaches, such as:Switching Therapies (discontinuing one antidepressant and starting another) — Some individuals will have noticeably different responses to medications even when the newer medication is in same class of antidepressants (such as the SSRI class). The important point here is that different medications, no matter how similar their primary function, may have subtle differences that impact the treatment of the individual patient. When switching medications, however, many physicians prefer to change to a different class of antidepressant.
Combination therapy (adding one or more additional antidepressant medications to those already in use) — The existing evidence suggests that broadening the antidepressant treatment regimen to include two drugs that work differently than each other is more likely to be successful than using either drug alone. In this strategy, a new medication will be added to existing treatment; the patient does not have to withdraw from the original medication during the add-on process. However, the effectiveness of this strategy requires further scientific study.
Augmentation (adding other medications that are not antidepressants themselves, but that boost or augment the antidepressant already in use) — Many augmentation strategies exist for boosting the effects of an antidepressant medication. The addition of thyroid hormone and lithium are common strategies. Other augmenting agents, such as beta-blockers (used for migraine and heart conditions) and a variety of vitamin, hormone, and herbal strategies, require additional study. Recent evidence suggests that blocking cortisol (a stress-related hormone) can treat psychotic depression, but the role of cortisol-blocking medications in TRD remains to be determined.
Additionally, non-medication-based therapies can also be used to treat TRD. They include electroconvulsive therapy (ECT), transcranial magnetic stimulation (TCMS), and vagus nerve stimulation (VNS). ECT is a well-established treatment for TRD, whereas TCMS and VNS are potential therapies requiring more study.
Summary
Treatment-resistant depression is diagnosed when an individual fails to respond to a standard antidepressant treatment. Individuals with TRD can suffer sustained impairment in their quality of life. Further research is needed to better understand this condition. Future treatment of TRD may involve the use of novel medications.
poster:wcfrench
thread:123911
URL: http://www.dr-bob.org/babble/20021012/msgs/123911.html