Abstract
Introduction. Major depressive disorder is common worldwide and one of the pathologies with the highest global burden. The dysfunction, the frequency of relapses and the high rate of suicide make this disorder a serious health problem. There is a delay for patients to receive diagnosis and optimal treatment, which decreases the response rate, increases dysfunction, and presents residual symptoms. One of the best predictors of early response is receiving treatment as soon as possible. While early treatment is associated with high remission rates if started before the first month, treatment after the third month is associated with low remission rates. It is called inadequate response to antidepressant treatment when the patient does not achieve 50 % improvement with a standardized treatment and implies a high risk for the patient of symptomatic chronification and a brutal negative impact on their functioning. Methodology. A group of experts analyzed the evidence from specific bibliographic searches and agreed on the pertinent recommendations. Recommendations. Treatment based on measurements is necessary to determine the degree of response and guide effective and timely treatment to achieve the best results in the management of depression. Periodic measurements must be made to determine the result and make decisions. Antidepressant pharmacological optimization, combination and adjuvant strategies are described for better patient management and algorithms for decision making are included. How to overcome the challenges of treating inappropriate response in major depressive disorder is discussed.
Published Version
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