Tor, Phern Chern and Amir, Nurmiati and Fam, Johnson and Ho, Roger and Ittasakul, Pichai and Maramis, Margarita and Ponio, Benita and Purnama, Dharmawan Ardi and Rattanasumawong, Wanida and Rondain, Elizabeth and Bin Sulaiman, Ahmad Hatim and Wiroteurairuang, Kannokarn and Chee, Kok Yoon (2022) A Southeast Asia Consensus on the Definition and Management of Treatment-Resistant Depression. Neuropsychiatric Disease and Treatment, 18. pp. 2747-2757. ISSN 1178-2021, DOI https://doi.org/10.2147/NDT.S380792.
Full text not available from this repository.Abstract
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.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.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.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.
| Item Type: | Article |
|---|---|
| Funders: | Johnson and Johnson Pte Ltd. |
| Uncontrolled Keywords: | depression; pharmacotherapy; major depressive disorder; anti-depressive agents; depressive disorder; treatment resistant |
| Subjects: | R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry |
| Divisions: | Faculty of Medicine > Psychological Medicine Department |
| Depositing User: | Ms Koh Ai Peng |
| Date Deposited: | 16 Jul 2024 02:14 |
| Last Modified: | 16 Jul 2024 02:14 |
| URI: | http://eprints.um.edu.my/id/eprint/46302 |
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