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E-Book

E-Book, Englisch, 232 Seiten, E-Book

Kasper / Montgomery Treatment-Resistant Depression


1. Auflage 2013
ISBN: 978-1-118-55673-3
Verlag: John Wiley & Sons
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 232 Seiten, E-Book

ISBN: 978-1-118-55673-3
Verlag: John Wiley & Sons
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)



Successful management of patients with treatment-resistantdepression is going to require a thorough understanding of thebiological basis for both the depression and its failure to respondto standard treatments. This book clearly and succinctly summarizesthe latest scientific research and its applications inclinical practice.
A first step is a clear definition of what constitutestreatment-resistant depression so that clinical trials and otherstudies are using common criteria, enabling comparison andmeta-analysis of their outcomes. The opening chapter reviewsdefinitions and predictors of originating from different fields anddiscusses their usefulness in clinical practice and clinicalresearch. The next chapter proposes a new definition,adapting terminology from medicine.
Biological classification requires identification of geneticrisk factors: with gene variants accounting for 50% of the variancein the clinical outcomes of antidepressant treatments this isclearly a fruitful area of research. Chapter 3 describesseveral genes already associated with treatment-resistantdepression and, while further work is needed to translate findingsinto clinical recommendations, predicts that genetic prediction ofTRD could became a widespread clinical reality within a fewyears.
Most patients with TRD will be treated pharmacologically andthree chapters review the latest evidence for pharmacological bestpractice, including switching strategies for antidepressants, therole of antipsychotics and augmentation strategies to complementlithium.
There are two major alternatives to pharmacotherapy:neuromodulation and psychotherapy. The brain interventionchapter summarizes clinical research and experience withelectroconvulsive therapy, transcranial magnetic stimulation, vagusnerve stimulation, deep brain stimulation and magnetic seizuretherapy. The final chapter reviews the literature pertainingto the effectiveness of various forms of psychotherapy in patientswho have not responded to antidepressant pharmacotherapy, revealingthat patients who have not responded to one or two trials ofantidepressant medication have a 30%-50% chance of responding to afocused psychotherapy. It proposes indications forpsychotherapy in TRD and summarizes general therapeuticprinciples.

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Weitere Infos & Material


List of Contributors vii
Foreword ix
1 Definitions and Predictors of Treatment-resistant Depression1
Daniel Souery and William Pitchot
2 Treatment-resistant Depression: A Separate Disorder - ANew Approach 21
Hans-Jürgen Möller, Florian Seemüller, RebeccaSchennach and Ramesh K. Gupta
3 Genetics of Treatment-resistant Depression 43
Chiara Fabbri, Stefano Porcelli and Alessandro Serretti
4 Is There a Role for Switching Antidepressants inTreatment-resistant Depression? 91
Stuart Montgomery
5 The Role of Atypical Antipsychotics in Inadequateresponse andTreatment-resistant Depression 107
Siegfried Kasper and Elena Akimova
6 Lithium, Thyroid Hormones and Further Augmentation Strategiesin Treatment-resistant Depression 129
Robert Haußmann and Michael Bauer
7 The Role of Nonpharmacological Interventions inTreatment-resistant Depression 159
Thomas E. Schläpfer and Sarah Kayser
8 The Role of Psychotherapy in the Management ofTreatment-resistant Depression 183
Michael E. Thase
Index 209


Professor Dr Kasper is Professor of Psychiatry and Chairmanof the Department of General Psychiatry at the Medical Universityof Vienna, Austria. He is Honorary Professor at the University ofHong Kong, China. He concentrates on the biological bases ofmental disorders and their possible treatment approaches. He hasconducted studies in psychopathological as well as clinical areas.Dr Kasper is a frequent national and international speaker and isactively involved in research programmes studying depression,anxiety, psychosis, and dementia, authoring over 800 researchreports and reviews. Dr Kasper serves on the editorial boards ofnumerous learned journals, including European Archives ofPsychiatry and Neuroscience, European Psychiatry, and EuropeanNeuropsychopharmacology. He is Co-editor in-chief of theInternational Journal of Psychiatry in Clinical Practice.
Professor Montgomery was Professor of Psychiatry atImperial College, University of London until his retirement in 1996when he became Emeritus Professor of Psychiatry. He has greatbreadth of experience in the field of psychotropic medicine withseminal work in depression, anxiety disorders, suicide preventionand schizophrenia. He has published 26 books and more than 400papers. Professor Montgomery is editor of International ClinicalPsychopharmacology and was editor of EuropeanNeuropsychopharmacology for 20 years. He also serves on theeditorial board of numerous scientific journals.



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