Abstract
Treatment-resistant depression (TRD) is characterized by a failure to achieve remission or respond to multiple antidepressant trials of adequate dose and duration in the current episode. Up to a third of patients with Major Depressive Disorder fail to achieve remission after four established treatments, denoting TRD. After each sequential treatment, there is a decreased probability of achieving remission, with a relapse rate of 83% after the fourth treatment. Deep brain stimulation (DBS) has been explored clinically using various targets, although several large randomized controlled trials did not show a difference between stimulation and sham control. BROADEN, the pivotal RCT investigating subcallosal cingulate (SCC) DBS for TRD, was halted early after 6-months by the sponsor due low likelihood of success. However, long-term follow-up (LTFU) data revealed continued, sustained improvement in depressive symptom severity, prompting a further look into the possibility of DBS as a therapeutic option for TRD.
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