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Major depressive disorder presents staggering burdens to the health and well-being of the human race. In 2004, the World Health Organization ranked major depression the number one cause of disability among all medical conditions worldwide. A growing body of research, most notably the STAR*D study of 2006, has documented what most practicing clinicians already knew: Existing treatments for major depression fall far short. More often than not, initial courses of medication do not work. Some argue that there have been no significant pharmacological breakthroughs in the treatment of depression for more than 20 years. Perhaps the most sobering evidence of our general failure to find effective treatments is the fact that rates of suicide (linked to depression in the vast majority of cases) have not significantly changed over the past 50 years. In the most general sense, then, major depressive disorder is treatment resistant.
In this important and ambitious book, the editors tackle the subject of treatment resistant depression (TRD), defining treatment resistance as “failure to achieve remission after two evidence-based antidepressant treatment courses known to have been of acceptable dose and duration.” Drawing from the work of the University of Michigan's Comprehensive