The assessment of resistance to antidepressant treatment: Rationale for the Antidepressant Treatment History Form: Short Form (ATHF-SF)

Sackeïm, Harold A.; Aaronson, Scott T.; Bunker, Mark; Conway, Charles R.; Demitrack, Mark A.; George, Mark S.; Prudic, Joan; Thase, Michael E.; Rush, A. John

doi:10.1016/j.jpsychires.2019.03.021

Cited by 77 publications

(48 citation statements)

References 172 publications

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“…As such, the authors of the original ATHF 127 developed an updated and revised version, the short form ATHF (ATHF-SF), as well as an instruction manual and scoring checklist, among other documents. 128 Importantly, the ATHF-SF focuses on the current episode of depression, as opposed to life-time trials of pharmacological treatments, a more streamlined approach to assessing the level of resistance of the current illness episode. Utilizing a standardized approach to understand the level of treatment resistance in the current episode of depression may provide a useful measure of consistency in assessment of TRD.…”

Section: Defining Treatment-resistant Depressionmentioning

confidence: 99%

<p>Management of Treatment-Resistant Depression: Challenges and Strategies</p>

Voineskos

Daskalakis

Blumberger

2020

NDT

284

131

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Treatment-resistant depression (TRD) is a subset of Major Depressive Disorder which does not respond to traditional and first-line therapeutic options. There are several definitions and staging models of TRD and a consensus for each has not yet been established. However, in common for each model is the inadequate response to at least 2 trials of antidepressant pharmacotherapy. In this review, a comprehensive analysis of existing literature regarding the challenges and management of TRD has been compiled. A PubMed search was performed to assemble meta-analyses, trials and reviews on the topic of TRD. First, we address the confounds in the definitions and staging models of TRD, and subsequently the difficulties inherent in assessing the illness. Pharmacological augmentation strategies including lithium, triiodothyronine and second-generation antipsychotics are reviewed, as is switching of antidepressant class. Somatic therapies, including several modalities of brain stimulation (electroconvulsive therapy, repetitive transcranial magnetic stimulation, magnetic seizure therapy and deep brain stimulation) are detailed, psychotherapeutic strategies and subsequently novel therapeutics including ketamine, psilocybin, anti-inflammatories and new directions are reviewed in this manuscript. Our review of the evidence suggests that further large-scale work is necessary to understand the appropriate treatment pathways for TRD and to prescribe effective therapeutic options for patients suffering from TRD.

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Section: Defining Treatment-resistant Depressionmentioning

confidence: 99%

<p>Management of Treatment-Resistant Depression: Challenges and Strategies</p>

Voineskos

Daskalakis

Blumberger

2020

NDT

284

131

View full text Add to dashboard Cite

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“…It depicts our proposed stages of treatment resistance in pediatric depression. These are extrapolated based on similar guidelines in adult depression but adjusted for the different levels of depression in pediatric depression (Ruhe, van Rooijen, Spijker, Peeters, & Schene, 2012;Sackeim et al, 2019). Based on clinical circumstances (e.g., acute suicidality and comorbidity), practitioners may want to skip or reorder certain treatment modalities.…”

Section: Working Definitions Of Treatment Resistance In Pediatric Depmentioning

confidence: 99%

Annual Research Review: Defining and treating pediatric treatment‐resistant depression

Dwyer

Stringaris

Brent

et al. 2020

Child Psychology Psychiatry

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Background Adolescent major depressive disorder (MDD) is a significant health problem, associated with substantial morbidity, cost, and mortality. Depression is a significant risk factor for suicide, which is now the second leading cause of death in young people. Up to twenty per cent of adolescents will experience MDD before adulthood, and while a substantial proportion will improve with standard‐of‐care treatments (psychotherapy and medication), roughly one third will not. Methods Here, we have reviewed the literature in order to discuss the concept of treatment‐resistant depression (TRD) in adolescence, examine risk factors, diagnostic difficulties, and challenges in evaluating symptom improvement, and providing guidance on how to define adequate medication and psychotherapy treatment trials. Results We propose a staging model for adolescent TRD and review the treatment literature. The evidence base for first‐ and second‐line treatments primarily derives from four large pediatric clinical trials (TADS, TORDIA, ADAPT, and IMPACT). After two medications and a trial of evidence‐based psychotherapy have failed to alleviate depressive symptoms, the evidence becomes quite thin for subsequent treatments. Here, we review the evidence for the effectiveness of medication switches, medication augmentation, psychotherapy augmentation, and interventional treatments (i.e., transcranial magnetic stimulation, electroconvulsive therapy, and ketamine) for adolescent TRD. Comparisons are drawn to the adult TRD literature, and areas for future pediatric depression research are highlighted. Conclusions As evidence is limited for treatments in this population, a careful consideration of the known risks and side effects of escalated treatments (e.g., mood stabilizers and atypical antipsychotics) is warranted and weighed against potential, but often untested, benefits.

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“…The level of DTD must also be substantial and clear as evidenced by the failure to respond adequately to standard psychiatric management. These failed antidepressant trials will be verified using the modified Antidepressant Treatment History Form (ATHF) [37]. This is a clinician-rated scale used to collect information on the adequacy and response to previous antidepressant treatments, such as medications, trials of ECT, rTMS, psychotherapy, and newer antidepressants and medication combinations.…”

Section: Participants and Eligibilitymentioning

confidence: 99%

Vagus nerve stimulation as adjunctive therapy in patients with difficult-to-treat depression (RESTORE-LIFE): study protocol design and rationale of a real-world post-market study

et al. 2020

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Background Depressive illness is associated with significant adverse consequences for patients and their families, and for society. Clinical challenges are encountered in the management of patients suffering from depression whether they are designated difficult-to-treat or treatment-resistant. Prospective serial depression treatment trials have shown that less than 40% of patients with major depressive disorder remit with an initial pharmacotherapy trial, and a progressively smaller proportion of patients remit with each subsequent trial. For patients who suffer from difficult-to-treat depression (DTD), treatments should focus on patient-centred symptom control, patient functioning, and improving patient quality of life. Among the treatment options for patients with DTD is Vagus Nerve Stimulation (VNS) Therapy. VNS Therapy involves intermittent electrical stimulation of the left cervical vagus nerve and has been shown to be efficacious for long-term management of patients with DTD. Methods RESTORE-LIFE is a prospective, observational, multi-site, global post-market study intended to assess short-, mid-, and long-term effectiveness and efficiency outcomes in a ‘real-world’ setting among patients with DTD treated with adjunctive VNS Therapy. A minimum of 500 patients will be implanted with a VNS Therapy System at up to 80 global sites. Eligible patients will participate in a baseline visit between 1 and 6 weeks before device implant and will be followed for a minimum of 36 months and a maximum of 60 months. The diagnosis of depression and comorbid disorders will be determined using the Mini-International Neuropsychiatric Interview (MINI). The primary endpoint is response rate, defined as a decrease of ≥50% in Montgomery Åsberg Depression Rating Scale (MADRS) total score from baseline to 12 months post-implant. Discussion A standardized approach in the management of DTD may not be appropriate for the treatment of such a complex heterogenous patient population. This study has been designed to evaluate whether VNS Therapy meaningfully improves and sustains clinical and depressive symptom outcomes in patients with DTD. This study will investigate the durability of VNS response in DTD and utility of VNS for long-term disease management of DTD. In addition, the study results will potentially clarify clinical, functional, and health economic questions in a real-world patient population with DTD. Trial registration ClinicalTrials.gov NCT03320304. Registered 25 October 2017

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The assessment of resistance to antidepressant treatment: Rationale for the Antidepressant Treatment History Form: Short Form (ATHF-SF)

Cited by 77 publications

References 172 publications

<p>Management of Treatment-Resistant Depression: Challenges and Strategies</p>

<p>Management of Treatment-Resistant Depression: Challenges and Strategies</p>

Annual Research Review: Defining and treating pediatric treatment‐resistant depression

Vagus nerve stimulation as adjunctive therapy in patients with difficult-to-treat depression (RESTORE-LIFE): study protocol design and rationale of a real-world post-market study

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