A highlight from What Works Best in Treatment Resistant Depression Part 1

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On at least two antidepressants. But what is a meaningful recovery a meaningful recovery does not mean one hundred percent remission. Seventy eighty percent is often used as a cutoff here. But it's the patient's life that we treating not the rating scale so what we really mean by meaningful recovery is that they will once again functioning in their work working relationships and no longer insignificant distress. So how good are antidepressants of bringing about this kind of meaningful recovery. Not as much as we'd like only one in three people reach for recovery on the first antidepressant trial. And here's a tip. It takes longer than the usual full weeks on an antidepressant trial to reach that full recovery. So as long as they're seeing some improvement after four weeks on an antidepressant the best step is to continue it and allow those gains to build. How much longer. Another one to two months if we could all the remitters in the star d trial fifty percent required more than six weeks to remit and forty percent required more than eight weeks. But what if they don't respond at all and you need to switch to antidepressant number to hear the chance of recovery between twenty to twenty five percent and if that fails and you have to switch again the chances are around twelve percent when you add these numbers up a little over half of patients are able to achieve full remission after two antidepressant trials and this is all based on this study trial which did not have a placebo so a good chunk of those recovery rates. Were probably not due to the antidepressant at all so when we're talking about treatment resistant depression. We're talking about nearly half of the patients with depression.

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