Demographic analysis & management strategies for treatment resistant depression: A prospective observational study

T. Balasubramanian; Lina Elizabeth Cherian; A. H Mumthas; C. P Murshid; Jisna Jamal; B. Anandhi; A.R. Abdul Rasheed; P. Balan; M. Karthikeyan

doi:10.53730/ijhs.v6nS3.5270

Authors

Balasubramanian T.
tbaluanandhi@gmail.com
Department of Pharmacology, Al Shifa College of Pharmacy, Perinthalmanna, Kerala, India
Lina Elizabeth Cherian Department of Pharmacology, Al Shifa College of Pharmacy, Perinthalmanna, Kerala, India
Mumthas A. H Department of Pharmacology, Al Shifa College of Pharmacy, Perinthalmanna, Kerala, India
Murshid C. P Department of Pharmacology, Al Shifa College of Pharmacy, Perinthalmanna, Kerala, India
Jisna Jamal Department of Pharmacology, Al Shifa College of Pharmacy, Perinthalmanna, Kerala, India
Anandhi B. The Erode College of pharmacy and research institute, Erode, Tamilnadu, India
A.R. Abdul Rasheed Department of Pharmacology, Al Shifa College of Pharmacy, Perinthalmanna, Kerala, India
Balan P. Department of Pharmacology, Al Shifa College of Pharmacy, Perinthalmanna, Kerala, India
Karthikeyan M. Nirmala College of Pharmacy, Muvattupuzha, Ernakulam, Kerala, India

Keywords:

antipsychotics, sertraline, sodium valproate, treatment resistant depression, venlafaxine

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.

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References

McCarter T. Depression overview. American health and drug benefits. 2008;1(3):44-51.

2.Atiq R. Treatment resistant depression. Hospital physician board review manual. 2006;10(1):2-11.

3.Yiru Fang et al. Comparisons of the Efficacy and Tolerability of Extended- Release Venlafaxine, Mirtazapine, and Paroxetine in Treatment-Resistant Depression A Double-Blind, Randomized Pilot Study in a Chinese Population. Journal of Clinical Psychopharmacology. 2010;30(4):357-364.

Vieta E, Colom F. Therapeutic options in treatment-resistant depression. Ann Med. 2011;43:512–530.

Martín-López LM, Rojo JE, Gibert K. The strategy of combining antidepressants in the treatment of major depression: clinical experience in Spanish outpatients. Depress Res Treat. 2011; 140-194.

Nierenberg AA, Feighner JP, Rudolph R et al. Venlafaxine for treatment- resistant unipolar depression. J Clin Psychopharmacol. 1994;14:419–423.

Fava M. Augmentation and combination strategies in treatment-resistant depression. J Clin Psychiatry. 2001;62(18):4–11.

Khalid Saad Al-Harbi. Treatment-resistant depression: therapeutic trends, challenges, and future directions. Patient Prefer Adherence. 2012;6(2):369– 388.

Bodkin JA, Lasser RA, Wines JD Jr. Combining serotonin reuptake inhibitors and bupropion in partial responders to antidepressant monotherapy. J Clin Psychiatry. 1997;58:137–45.

Carpenter LL, Jocic Z, Hall JM. Mirtazapine augmentation in the treatment of refractory depression. J Clin Psychiatry. 1999;60:45–49.

Corrado Barbui, Matthew Hotopf. Amitriptyline v. the rest: still the leading antidepressant after 40 years of randomised controlled trials. Br J Psychiatry. 2001;178(2):129-144

Thase ME, Rush AJ. Treatment-resistant depression. In: Bloom FE, Kupfer D, Bunney BS, et al, editors. Psychopharmacology: the fourth generation of progress. New York: Raven Press; 1995:1081–97.

Montego et al. Incidence of sexual dysfunction associated with antidepressant agents: A prospective multi center study of 1022 out patients. The journal of clinical psychiatry. 2001;62(3):10-21.