Demographic analysis & management strategies for treatment resistant depression

Abstract

Purpose: A substantial proportion of Major depressive disorder patients do not react properly to antidepressants and are classified as having Treatment Resistant Depression (TRD). This study was undertaken to evaluate the demographic profile and management strategies for TRD in psychiatric department of a tertiary care super-specialty hospital. Methods: In this prospective observational study, a total of 27 subjects diagnosed with TRD were enrolled. Treatment resistant cases in the hospital setting were identified by using Montgomery Asberg Depression Rating Scale (MADRS). We evaluated the demographic profile, major adverse drug reactions and treatment provided for those patients and monitored for improvement of conditions. Results: The demographic profile result shows that females had predominance over males. Furthermore, family history also had a strong correlation with the occurrence of TRD. Sertraline, Venlafaxine and Sodium valproate combination was majorly used in the treatment of TRD patients. Among them, Venlafaxine was used commonly in TRD and the MADRS scores shown improvement in patient condition. Apart from drug therapy ECT when given in combination with antipsychotics were also effective in TRD. The major ADRs shown by TRD patients include weight changes, GI problems and sexual dysfunction.