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Treatment‐resistant depression in adolescents: review and updates on clinical management
Author(s) -
Maalouf Fadi T.,
Atwi Mia,
Brent David A.
Publication year - 2011
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.20884
Subject(s) - depression (economics) , electroconvulsive therapy , suicidal ideation , treatment resistant depression , psychiatry , anxiety , medicine , clinical psychology , psychology , modalities , poison control , schizophrenia (object oriented programming) , injury prevention , antidepressant , social science , sociology , economics , macroeconomics , environmental health
Treatment‐resistant depression (TRD) in adolescents is prevalent and impairing. We here review the definition, prevalence, clinical significance, risk factors, and management of TRD in adolescents. Risk factors associated with TRD include characteristics of depression (severity, level of hopelessness, and suicidal ideation), psychiatric and medical comorbidities, environmental factors (family conflict, maternal depression, and history of abuse), and pharmacokinetics and other biomarkers. Management options include review of the adequacy of the initial treatment, re‐assessment for the above‐noted factors that might predispose to treatment resistance, switching antidepressants, and augmentation with medication or psychotherapy. Other modalities, such as electroconvulsive therapy, vagal nerve stimulation, and repetitive transcranial magnetic stimulation, are also reviewed. Depression and Anxiety, 2011. © 2011 Wiley Periodicals, Inc.