Current Nosology of Treatment Resistant Depression: A Controversy Resistant to Revision

Fornaro, Michele; Giosue, Patricia

doi:10.2174/17450179010060100020

Cited by 4 publications

(4 citation statements)

References 42 publications

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“…Specifically, patient n. 2 showed two signs suggestive of sub-threshold bipolarity of the otherwise diagnosed DSM-IV MDD: lifetime PD and rapid pop-up response on antidepressants (32, 33) as seldom occurs in DSM-IV-defined full-threshold BD with current MDE (34). Yet, there is no FDA recommendation about the need to systematically assess sub-threshold bipolarity to date.…”

Section: Discussionmentioning

confidence: 99%

The FDA “Black Box” Warning on Antidepressant Suicide Risk in Young Adults: More Harm Than Benefits?

Fornaro

Anastasia

Valchera³

et al. 2019

Front. Psychiatry

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The decision made in the year 2004 by the U.S. Food and Drug Administration (FDA) to require a boxed warning on antidepressants regarding the risk of suicidality in young adults still represents a matter of controversy. The FDA warning was grounded on industry-sponsored trials carried one decade ago or earlier. However, within the past decade, an increasing number of reports have questioned the actual validity of the FDA warning, especially considering a decline in the prescription of the antidepressant drugs associated with an increase in the rate of suicidal events among people with severe depression. The present report provides an overview of the FDA black box warning, also documenting two Major Depressive Disorder patients whose refusal to undergo a pharmacological antidepressant treatment possibly led to an increased risk for suicidal behaviors. The concerns raised by the FDA black box warning need to be considered in real-world clinical practice, stating the associated clinical and public health implications.

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Section: Discussionmentioning

confidence: 99%

The FDA “Black Box” Warning on Antidepressant Suicide Risk in Young Adults: More Harm Than Benefits?

Fornaro

Anastasia

Valchera³

et al. 2019

Front. Psychiatry

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“…Beberapa model pengklasifikasian depresi yang resisten terhadap pengobatan telah diusulkan, semuanya dimaksudkan untuk menjelaskan konsep dari depresi yang resisten terhadap pengobatan. Meskipun beberapa tumpang tindih antara satu dengan yang lainnya, terutama dalam pembobotan parameter kuantitatif dan kualitatif yang digunakan sebagai pertimbangan akan tetapi model klasifikasi saat ini berkontribusi pada penentuan diagnosa yang lebih tepat terhadap terjadinya depresi yang resisten ter-hadap pengobatan [6].…”

Section: Meskipun Tidak Ada Konsensus Pasti Mengenai Tingkatunclassified

“…Sebuah penelitian menunjukkan bahwa beralih dari antidepresan trisiklik ke kelompok antidepresan alternatif dapat menghasilkan tingkat respons positif 50 sampai 60 persen [13]. Selain itu juga dapat dilakukan terapi kombinasi dengan memberikan dua atau lebih agen antidepresan bersamaan misalnya menambahkan trazodone, desipramine atau bupropion dengan fluoxetin dapat menghasilkan respon terapeutik yang berbeda dari pada yang dihasilkan dengan penggunaan fluoksetin saja [6].…”

Section: Jenis Intervensi Neuromodulasiunclassified

Neuromodulation Intervention in Resistant Depression

Prasetya¹,

Basoeki²

2020

JPS

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Treatment-resistant depression occurs in about 20% of all Major Deppresion Disorder patients. In addition to the high cost of treatment to be borne, the high functional disability rate, the suicide rate triggered by the disorder is also quite large. Various efforts were made to overcome this, including dose optimization and duration of treatment, substitution of drug selection, combination therapy and augmentation using non-antidepressant drugs and bilateral electroconvulsion therapy. Current pharmacological options according to some experts are no more efficacious than the 1950s. Clearly, a novel therapeutic approach to treatment - resistant depression disorders is urgently needed. Over the last few decades, there has been a renewed interest in focal neuromodulation as a treatment approach for neuropsychiatric conditions. The neuromodulation-based interventions discussed include Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS), which are non invasive intervention therapy and Vagus Nerve Stimulation (VNS) and Deep Brain Stimulation (DBS), which are invasive interventional therapies. This literature review proves that, although today only TMS and VNS have been approved for use by the Food and Drug Administration (FDA) in the United States, but neuromodilation-based intervention therapy has proven to be promising as a more effective and efficient resistant depression therapy in the future.

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“…The current proposals have undoubtedly contributed to a better assessment of TRD, but the lack of consensus represents an ongoing clinical and nosological controversy (Fornaro et al, 2010). Although some overlap exits between these models, they mainly differ in the weight of quantitative and qualitative parameters considered.…”

Section: Trd Staging Modelsmentioning

confidence: 99%