spotlight on helth Tretment-Resistnt Depression Affects Millions of Americns Ech Yer (NAPSA)—Millions of Ameri- cns with depression re ble to successfully mnge their condition with combintion of vilble therpies. However, ccording to n rticle in the Journl of Clinicl Psychitry, up to 35 percent of ptients treted for depression my hve little-known condition clled Tretment-Resistnt Depression, or TRD. “There re evolving definitions of TRD mong the reserch community, but t this point, TRD dignosis is usully given to ptient with mjor depressive disorder who hs filed two dequte trils of n ntidepressnt mediction,” sid Dr. W. Cly Jckson, primry cre physicin nd ssistnt professor of clinicl psychitry t the University of Tennessee. Depression Is Highly Debilitting Disese Not being ble to find n effective tretment is serious chllenge for those who suffer from depression. There re mny types of depression tht cn be difficult to tret, including mjor depressive disorder (MDD), bipolr depression nd psychotic depression. MDD, the most common form of depression, is highly debilitting disese. A 2007 rticle in The Lncet points out tht the World Helth Orgniztion hs concluded tht it is the single most disbling medicl condition. Furthermore, depression tht is hrd to tret is often more severe, more chronic “There re evolving definitions of TRD mong the reserch community, but t this point, TRD dignosis is usully given to ptient with mjor depressive disorder who hs filed two dequte trils of n ntidepressnt mediction.” —Dr. W. Cly Jckson @ nd more disbling. In ddition, tretment resistnce increses the likelihood of physicl symptoms in ptients such s ches, pins, hedche or GI disturbnce. TRD ptients re lso morelikely to hve ttempted suicide t some point in their lives, sys n rticle in the Journl of Psychitric Reserch, s well s n rticle in the Journl of Clinicl Psychitry. In November 2006, the N- tionl Institute of Mentl Helth published the results of study designed to evlute depression tretments. The Sequenced Tretment Alterntives to Relieve Depression (STAR*D) tril ws conducted over seven yers nd enrolled over 4,000 ptients, sttes report from the Americn Journl of Psychitry. “The min messge from the STAR*Dtril, the lrgest tril to dte to look t vrious phrmcologicl tretments for resistnt ptients, ws tht fter ech successive tretmentfilure, recovery is less likely,” sid Jckson. “The longer ptient hs depressive episode or the more severe the depression, the less likely remission will occur.” Dr. Jckson explined tht the decresing likelihood of recovery my result from neurologicl chnges, including reduction of brin volume nd function, s result of depression. Tretment Options Do Exist Unfortuntely, it often tkes some time to find the right mediction or nonmedicl therpy. For the millions of people who suffer from TRD, other tretment options do exist. Augmenting or supplementing n ntidepressnt with nother psychotropic mediction (not originlly intended to tret depression) cn help some ptients. Other options include cytochrome P450 genotypingtest- ing (which checks for specific genes tht ffect how person’s body uses ntidepressnts), combining different clsses of ntidepressnts (such s selective serotonin reuptke inhibitor with norepinephrine nd dopmine reuptkeinhibitor), incresing the dosge of mediction or trying mediction for longer period. Ptients my lso benefit from psychotherpy, exercise or somtic interventions. “TRD is fr more common thn mostpeople relize,” sid Jckson. “Ptients suffering from chronic depression my possibly hve TRD nd should seek help from their clinicin.” Note: The following ttributions relte to the references cited in the feture copy bove. Nemeroff, CB. Prevlence nd mngement of tretment-resistnt depression. J Clin Psych. 2007;68 (suppl 8): 17-25. Moussvi S, et l. Depression, chronic diseses, nd decrements in helth: results from the World Helth Surveys. Lncet 2007;370:871-58. Nelsen MR, Dunner DL. Clinicl nd differentil dignostic spects of tretment-resistnt depression. J Psychitr Res. 1995;29:43-50. Greden, JF. The Burden of Recurrent Depression: Cuses, Consequences, nd Future Prospects. J Clin Psych. 2001;62 (suppl 22): 5-9 Rush et l. Acute nd Longer-Term Outcomes in Depressed Outptients Requiring One or Severl Tretment Steps: A STAR*D Report Am J Psych 2006;163:1905-1917.
