The German health magazine «Apotheken Umschau» reports that treatment-resistant depression is a term used for depression when symptoms do not improve significantly after two different treatment attempts. The magazine explains that treatment-resistant depression occurs as a result of a lack of the active substance in the blood, due to not taking the medication for a sufficient period of time, in a sufficient dose, or regularly. However, the medication may be ineffective even with proper use; for example, interactions with other medications or smoking can lead to a lack of the active substance in the blood. If an antidepressant is ineffective even after increasing the dose, a doctor can prescribe another medication or try a combination with other drugs. It should be noted that there is no single standard approach; individual symptoms, comorbidities, and other limitations should always be taken into account. In the case of treatment-resistant depression, special forms of psychotherapy can be used, such as cognitive-behavioral analysis system of psychotherapy, which was developed for people with severe, chronic, and treatment-resistant depression. There are other treatment options such as electroconvulsive therapy and transcranial magnetic stimulation, as well as a modern method involving ketamine injections or nasal sprays. With these methods as well, the advantages and disadvantages must be carefully balanced.
