Community Strategy for Treatment Resistant Depression Pharmacological: Bibliographic Review
Abstract
Introduction: Treatment-resistant depression is a serious disorder that does not respond to several antidepressants, affecting quality of life and increasing the risk of suicide. Although advances have been made, such as the use of ketamine and esketamine, care remains insufficient, so multidisciplinary management is required, combining pharmacological, psychological and electroconvulsive approaches.
Objectives: to determine a comprehensive community strategy that provides effective support and management for people with depression who are resistant to pharmacological treatment.
Materials and methods: a bibliographic review was carried out in PubMed, Cochrane, Science Direct and Elsevier, with the terms "depression", "resistance", "treatment", "psychotherapy" and "pharmacotherapy". From 100 articles published between 2019 and 2024, 22 relevant articles were selected on current therapeutic options for treatment-resistant depression, using DeCS/MeSH terms such as "Treatment-resistant depression", "medicine", "drugs" and "psychotherapy".
Result: Treatment-resistant depression is defined as the lack of response to two or more adequate antidepressant treatments, affecting up to 30% of patients with major depression. Despite advances in pharmacological and psychotherapeutic therapeutic options, the lack of a precise definition hinders research, the development of new therapies, and clinical treatment. Risk factors include advanced age, traumatic events, comorbidities, and the severity of depression. Treatment strategies include the combination of antidepressants, esketamine, brain stimulation therapies, psychotherapy, and multidisciplinary approaches in which the community plays a fundamental role.
Conclusions: Treatment-resistant depression negatively impacts quality of life and carries a high risk of suicide. Its lack of consensus on the definition hinders research. It is associated with sociodemographic factors and comorbidities. Its management requires a multidisciplinary approach that includes pharmacotherapy, psychotherapy, and neurostimulation. Community support plays a fundamental role in the treatment of these patients.
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References
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