Journal of Psychiatry

Abstract

Treatment resistant depression

Jillian Bonzani

Major Depressive Disorder is a mental health disorder that affects nearly 16.1 million adults each year (NIMH, 2018). The disorder is characterized of more than a 2-week period containing more than five of the following symptoms: low mood, anergia, fatigue, weight loss or gain, suicidal ideation, worthlessness, guilt, psychomotor retardation, hypersomnia or insomnia, and impaired concentration (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, 2014).

Treatment-resistant depression (TRD) is defined as depression that has failed to respond to two adequate pharmacological interventions. TRD can last months to years with no relief. Those with TRD expierience decrease in quality of life, impaired cognitive function, increase in inpatient hospitalizations, increased risk for suicide (Mathew et al., 2019). Alternative treatments are such as electroconvulsive therapy (ECT), and ketamine infusions are not used until a person has had at least two failed trials of antidepressants. The cost of the treatments can be high, not covered by insurance, and can cause more serious side effects than most pharmacological treatments.

The purpose of this study is to examine evidence based, peer reviewed studies that can determine the best alternative treatment for depression. The rationale for doing this study is to create a better quality of life, improvement and remission of depressive symptoms, and better health outcomes. The value of this study is to apply in clinical practice the most effective treatment for TRD, educating patients with TRD of their alternative options. The research question for the literature review is “In people with Major Depressive Disorder, what is the effect of ECT, in comparison to ketamine, on improvement in their depressive symptoms over one year?” This study will examine the efficacy, side effects, and remission of the treatments.

Thirteen primary resources were critiqued and analyzed for this scholarly research project. All studies that were analyzed were quantitative (Basso et al., 2019; Fava et al., 2018; Ghasemi et al., 2015; Kellner et al., 2016; Kellner et al., 2016; Kheirabadi et al., 2019; Lee et al., 2015; Mathew et al., 2019; Phillips et al., 2020; Sakurai et al., 2015; Semovska et al., 2016; Sharma et al., 2020; Singh et al., 2016). The critique of the articles included research of the designs, methods and instruments used in these twelve studies which were all reviewed for validity and reliability of measurement tools in order to determine the integrity and credibility of the studies (Coughlan et al., 2007).

Published Date: 2021-05-24;