Treatment resistance in unipolar depression and other disorders. Diagnostic concerns and treatment possibilities.

The disorders discussed in this article share common problems with treatment-resistant depression both in research and clinical treatment. Lack of clear treatment-resistant definitions leads to difficulties in comparing the results of research studies. The absence of double-blind, placebo-controlled studies that match alternative treatments against each other creates confusion for the clinician who has to decide on a treatment paradigm. The future will, no doubt, see an increase in interest in treatment-resistant research and the answer to some of these questions. Although this review emphasizes the work that remains to be done before treatment resistance becomes a curiosity of the past, it also highlights the wealth of treatment options available to clinicians and their patients. As long as treatment-resistant patients are amendable to trying new therapies, hope that their depressions will lift remains.