TY  - JOUR
PY  - 2022//
TI  - A Southeast Asia consensus on the definition and management of treatment-resistant depression
JO  - Neuropsychiatric disease and treatment
A1  - Tor, Phern Chern
A1  - Amir, Nurmiati
A1  - Fam, Johnson
A1  - Ho, Roger
A1  - Ittasakul, Pichai
A1  - Maramis, Margarita M.
A1  - Ponio, Benita
A1  - Purnama, Dharmawan Ardi
A1  - Rattanasumawong, Wanida
A1  - Rondain, Elizabeth
A1  - Bin Sulaiman, Ahmad Hatim
A1  - Wiroteurairuang, Kannokarn
A1  - Chee, Kok Yoon
SP  - 2747
EP  - 2757
VL  - 18
IS  - 
N2  - INTRODUCTION: Despite the abundance of literature on treatment-resistant depression (TRD), there is no universally accepted definition of TRD and available treatment pathways for the management of TRD vary across the Southeast Asia (SEA) region, highlighting the need for a uniform definition and treatment principles to optimize the management TRD in SEA. <br><br>METHODS: Following a thematic literature review and pre-meeting survey, a SEA expert panel comprising 13 psychiatrists with clinical experience in managing patients with TRD convened and utilized the RAND/UCLA Appropriateness Method to develop consensus-based recommendations on the appropriate definition of TRD and principles for its management. <br><br>RESULTS: The expert panel agreed that "pharmacotherapy-resistant depression" (PRD) is a more suitable term for TRD and defined it as "failure of two drug treatments of adequate doses, for 4-8 weeks duration with adequate adherence, during a major depressive episode". A stepwise treatment approach should be employed for the management of PRD - treatment strategies can include maximizing dose, switching to a different class, and augmenting or combining treatments. Non-pharmacological treatments, such as electroconvulsive therapy and repetitive transcranial magnetic stimulation, are also appropriate options for patients with PRD. <br><br>CONCLUSION: These consensus recommendations on the operational definition of PRD and treatment principles for its management can be adapted to local contexts in the SEA countries but should not replace clinical judgement. Individual circumstances and benefit-risk balance should be carefully considered while determining the most appropriate treatment option for patients with PRD.<p />  <p>Language: en</p>
LA  - en
SN  - 1176-6328
UR  - http://dx.doi.org/10.2147/NDT.S380792
ID  - ref1
ER  -