Treatment Resistant Depression
Major depression is a common condition that causes significant impairment in human functioning. Symptoms may include persistent sadness, disinterest or apathy, sleep disruption, appetite changes, low energy, impaired concentration, and thoughts of suicide. The treatment goal for major depression is remission, defined as the relative absence of symptoms and restoration of function. For some individuals, first line treatments may be only partially effective, leading to chronic depressive symptoms and poorer functional outcomes. Treatment resistant depression (TRD) is generally defined as a failure of two adequate antidepressant trials in a given depressive episode. When this happens, it is important to have a comprehensive evaluation to develop an aggressive treatment plan.
TRD is fairly common in patients dealing with major depression, and is most often explained by inadequate medication treatment, difficulty taking or tolerating medications, unrecognized psychiatric or medical conditions, substance abuse, or trauma. While physicians have a variety of treatment options available to help their patients, resources are often scarce and scattered across the community. Our goal is to provide comprehensive evaluation and treatment in one place.
With a complex problem like Treatment Resistant Depression, patients may feel they have run out of options. However, our team offers multiple evidence-based strategies to help patients with TRD.
- Medication optimization - this means working with different antidepressant classes, maximizing dosages, and combining different medications to find what works for individual patients. Some drugs require extra monitoring or dietary restrictions.
- Depression-focused Psychotherapy- all talk therapy is not created equal; we use multiple psychotherapy strategies that have demonstrated efficacy in clinical trials.
- Brain stimulation – when medications and psychotherapy aren’t fully effective, or symptoms are severe, electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are considered; these therapies stimulate the brain directly to improve symptoms.
- Clinical trials- some patients may elect to try novel antidepressant interventions in a clinical research trial at our institution; this is voluntary and optional.
TRD can be a tough condition to treat, but doctors and researchers continue to develop new therapies to help patients recover. Our center strives to instill hope and optimism for depression care in the Central Texas Region.