PMID- 28525197
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 0035-3639 (Print)
IS  - 0035-3639 (Linking)
VI  - 38
IP  - 1
DP  - 2017
TI  - [Treatment resistant depression: actuality and perspectives in 2017].
PG  - 16-25
AB  - Major depressive disorder (MDD) affects 3 to 17 % of adults. 15 to 30 % of 
      patients with MDD suffer from treatment resistant depression (TRD). No 
      international consensus defines TRD. The most common definition is " MDD that is 
      not enough improved after two successive and different classes of antidepressant 
      treatments in appropriate dose and duration ". The appropriate dose corresponds 
      to maximal dose accepted by scientific reports and clinical recommendations, 
      while the appropriate duration is around 6 weeks. TRD is diagnosed after 
      excluding a pseudoresistant depression, that is related to weak compliance or to 
      somatic and psychiatric differential diagnosis. As well as in MDD, molecular, 
      neuro-anatomical and metabolic disturbances are involved in TRD. A decreased 
      cerebral plasticity induced by low level of Brain-Derived Neurotrophic Factor 
      (BDNF) is also reported. Several authors describe that the cerebral atrophy and 
      the dopaminoglutaminergic system disturbances are more severe in TRD than in MDD. 
      In contrast to MDD treatment, TRD treatment is most often physical treatment. 
      Electroconvulsive therapy (ECT) followed by a tricyclic antidepressant and/or 
      lithium is the most effective treatment. Deep brain stimulation and vagal nerve 
      stimulation reach also a high rate of remission but they are both very invasive 
      technique. Repetitive transcranial magnetic stimulation in TRD seems to be 
      effective in TRD but lower than ECT. There are two majors purposes for this 
      review. First it may help the clinician to understand the TRD's complexity and 
      also it details the kind of treatment useful to care it.
FAU - Lucas, N
AU  - Lucas N
AD  - Service de Psychiatrie, C.H.U. Ambroise Pare, Mons.
FAU - Hubain, P
AU  - Hubain P
AD  - Service de Psychiatrie, Hopital Erasme, Bruxelles.
FAU - Loas, G
AU  - Loas G
AD  - Service de Psychiatrie, Hopital Erasme, Bruxelles.
FAU - Jurysta, F
AU  - Jurysta F
AD  - Service de Psychiatrie, Hopital de Jolimont, La Louviere.
LA  - fre
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Depression resistante au traitement : actualite et perspective en 2017.
PL  - Belgium
TA  - Rev Med Brux
JT  - Revue medicale de Bruxelles
JID - 8003474
OTO - NOTNLM
OT  - Depressive disorder
OT  - Neuro-stimulation therapy
OT  - Neurophysiology
OT  - Treatment resistant depression
EDAT- 2017/05/20 06:00
MHDA- 2017/05/20 06:01
CRDT- 2017/05/20 06:00
PHST- 2017/05/20 06:00 [entrez]
PHST- 2017/05/20 06:00 [pubmed]
PHST- 2017/05/20 06:01 [medline]
PST - ppublish
SO  - Rev Med Brux. 2017;38(1):16-25.