Definition of Treatment-Resistant Depression in the Medicare Population

Project Summary Title and Description

Title
Definition of Treatment-Resistant Depression in the Medicare Population
Description
The purpose of this technology assessment is to review the current definitions of treatment-resistant depression (TRD), to assess how closely current TRD treatment studies fit the most common definition, and to suggest how to improve TRD treatment research.
Attribution
N/A
Authors of Report
N/A
Methodology description
Our search for Key Questions 1-5 looked at literature published from 1/1/1995 through 4/1/2017, and our search for Key Questions 6-11 looked at literature published from 1/1/2005 through 4/1/2017. We conducted systematic literature searches for publications indexed in MEDLINE®, EMBASE, PsycINFO, and Cochrane Library. Other materials searched included consensus statements, clinical practice guidelines, and relevant government reports; website sources were Clinicaltrials.gov, Guideline.gov (AHRQ’s National Guidelines Clearinghouse), HSRProj (Health Services Research Projects in Progress database), and UpToDate®. Eligible studies for Key Questions 1-5 considered all sources noted above (including systematic reviews) except for individual intervention trials; intervention trials were only eligible for Key Questions 6-11.
PROSPERO
N/A
DOI
10.26300/4j7h-jk02
Notes
All of the report's systematic review study data were entered retrospectively to SRDR, via direct file uploading as Word documents (one each for Key Questions 6, 7, 8, 9, and 11; two for Key Question 10).
Funding Source
This systematic review was proposed as a large Technology Assessment by the Centers for Medicare & Medicaid Services and conducted by the RTI-UNC Evidence-based Practice Center for the Agency for Healthcare Research and Quality.

Key Questions

1. What definitions of TRD appear in these sources and do definitions converge on a best one?
2. What methods do investigators use to diagnose this condition in clinical research, and does a consensus exist about the best ways to reach a clear diagnosis?
3. What measures (i.e., endpoints or outcomes) exist to determine the success or failure of treatment in TRD studies; what clinical focus do they represent (e.g., severity); what psychometric and other properties do they have?
4. What research designs do investigators use in TRD studies and does any consensus exist about best approaches to minimize bias and placebo effects and other elements of study design (e.g., length)?
5. What are the risk factors for TRD?
6. What are the inclusion criteria for patients in these studies, specifically concerning patient characteristics, prior treatments, and diagnostic characteristics?
7. How do these criteria compare or contrast with definitions encountered in the narrative review?
8. What were primary characteristics of included studies, such as design, run-in or wash-out periods, and length?
9. How were included studies designed to account for TRD risk factors identified in the narrative review?
10. What are relationships between risk factors and results of included TRD studies?
11. What variables or information did included studies report (e.g., patient outcomes, time to relapse, treatment adherence, attrition, and use of health care resources)?

Associated Extraction Forms

Associated Studies (each link opens a new tab)

TitleAuthorsYear
High (20-Hz) and low (1-Hz) frequency transcranial magnetic stimulation as adjuvant treatment in medication-resistant depression2006
Unilateral low frequency versus sequential bilateral repetitive transcranial magnetic stimulation: is simpler better for treatment of resistant depression?2010
A randomized double-blind sham-controlled comparison of unilateral and bilateral repetitive transcranial magnetic stimulation for treatment-resistant major depression2012
A controlled study of repetitive transcranial magnetic stimulation in medication-resistant major depression2006
A double blind randomized trial of unilateral left and bilateral prefrontal cortex transcranial magnetic stimulation in treatment resistant major depression2012
Transcranial magnetic stimulation in the treatment of depression: a double-blind, placebo-controlled trial2003
A randomized, controlled trial of sequential bilateral repetitive transcranial magnetic stimulation for treatment-resistant depression2006
Right and left dorsolateral pre-frontal rTMS treatment of refractory depression: a randomized, sham-controlled trial2010
Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial2007
Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial2010
Repetitive transcranial magnetic stimulation (rTMS) in combination with escitalopram in patients with treatment-resistant major depression: a double-blind, randomised, sham-controlled trial2008
Long-lasting effects of high frequency repetitive transcranial magnetic stimulation in major depressed patients2007
The effects of repetitive transcranial magnetic stimulation on depressive symptoms and the P(300) event-related potential2006
Daily left prefrontal repetitive transcranial magnetic stimulation in the acute treatment of major depression: clinical predictors of outcome in a multisite, randomized controlled clinical trial2009
Efficacy and safety of adjunctive cariprazine in inadequate responders to antidepressants: a randomized, double-blind, placebo-controlled study in adult patients with major depressive disorder2016
Predictors and Moderators of Remission With Aripiprazole Augmentation in Treatment-Resistant Late-Life Depression: An Analysis of the IRL-GRey Randomized Clinical Trial2016
Efficacy and safety of a form of cranial electrical stimulation (CES) as an add-on intervention for treatment-resistant major depressive disorder: A three week double blind pilot study2015
Efficacy, safety, and tolerability of augmentation pharmacotherapy with aripiprazole for treatment-resistant depression in late life: a randomised, double-blind, placebo-controlled trial2015
Lithium and Valproate Levels Do Not Correlate with Ketamine's Antidepressant Efficacy in Treatment-Resistant Bipolar Depression2015
Mindfulness-based cognitive therapy vs. psycho-education for patients with major depression who did not achieve remission following antidepressant treatment2015
A Randomized Sham-Controlled Trial of Deep Brain Stimulation of the Ventral Capsule/Ventral Striatum for Chronic Treatment-Resistant Depression2015
The effect of electroconvulsive therapy on neurocognitive function in treatment-resistant bipolar disorder depression2014
Pilot study of feasibility of the effect of treatment with tDCS in patients suffering from treatment-resistant depression treated with escitalopram2015
Neurocognitive effects of ketamine and association with antidepressant response in individuals with treatment-resistant depression: a randomized controlled trial2015
Effectiveness of lithium in subjects with treatment-resistant depression and suicide risk: results and lessons of an underpowered randomised clinical trial2014
Anti-anhedonic effect of ketamine and its neural correlates in treatment-resistant bipolar depression2014
Dose-remission of pulsating electromagnetic fields as augmentation in therapy-resistant depression: a randomized, double-blind controlled study2014
Treatment-resistant bipolar depression: a randomized controlled trial of electroconvulsive therapy versus algorithm-based pharmacological treatment2015
The efficacy and safety of low frequency repetitive transcranial magnetic stimulation for treatment-resistant depression: the results from a large multicenter French RCT2014
Duloxetine-bupropion combination for treatment-resistant atypical depression: a double-blind, randomized, placebo-controlled trial2014
Clinical effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: the CoBalT randomised controlled trial2014
A randomized controlled trial of intranasal ketamine in major depressive disorder2014
Interest of targeting either cortical area Brodmann 9 or 46 in rTMS treatment for depression: a preliminary randomized study2014
Accelerated HF-rTMS in treatment-resistant unipolar depression: Insights from subgenual anterior cingulate functional connectivity2014
Cost-effectiveness of cognitive-behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: economic evaluation of the CoBalT Trial2014
Antidepressant efficacy of high and low frequency rTMS at 110% of motor threshold versus sham stimulation over left prefrontal cortex2014
Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial2013
A randomized, double-blind, placebo-controlled trial of pramipexole augmentation in treatment-resistant major depressive disorder2013
Intensive HF-rTMS treatment in refractory medication-resistant unipolar depressed patients2013
Extended-release quetiapine fumarate (quetiapine XR) monotherapy and quetiapine XR or lithium as add-on to antidepressants in patients with treatment-resistant major depressive disorder2013
The effects of aripiprazole on the subscales of the Kellner Symptom Questionnaire in treatment resistant depression2013
The effects of stimulation parameters on clinical outcomes in patients with vagus nerve stimulation implants with major depression
Serum levels of brain-derived neurotrophic factor are unchanged after transcranial direct current stimulation in treatment-resistant depression2013
Equivalent beneficial effects of unilateral and bilateral prefrontal cortex transcranial magnetic stimulation in a large randomized trial in treatment-resistant major depression2013
Effects of S-ketamine as an anesthetic adjuvant to propofol on treatment response to electroconvulsive therapy in treatment-resistant depression: a randomized pilot study2013
Cognitive behavioural therapy as an adjunct to pharmacotherapy for primary care based patients with treatment resistant depression: results of the CoBalT randomised controlled trial2013
L-methylfolate as adjunctive therapy for SSRI-resistant major depression: results of two randomized, double-blind, parallel-sequential trials2012
Mortality and suicide risk in treatment-resistant depression: an observational study of the long-term impact of intervention2012
Vagus nerve stimulation therapy randomized to different amounts of electrical charge for treatment-resistant depression: acute and chronic effects2013
Existential dynamic therapy (VITA) for treatment-resistant depression with cluster C disorder: matched comparison to treatment as usual2012
Antidepressant monotherapy compared with combinations of antidepressants in the treatment of resistant depressive patients: a randomized, open-label study2013
Replication of ketamine's antidepressant efficacy in bipolar depression: a randomized controlled add-on trial2012
A double-blind, placebo-controlled study of aripiprazole adjunctive to antidepressant therapy among depressed outpatients with inadequate response to prior antidepressant therapy (ADAPT-A Study)2012
Subcallosal cingulate deep brain stimulation for treatment-resistant unipolar and bipolar depression2012
Treating depression after initial treatment failure: directly comparing switch and augmenting strategies in STAR*D2012
Risk of adverse events in treatment-resistant depression: propensity-score-matched comparison of antidepressant augment and switch strategies2012
Transcranial direct current stimulation in treatment resistant depression: a randomized double-blind, placebo-controlled study2012
Efficacy of dose increase among nonresponders to low-dose aripiprazole augmentation in patients with inadequate response to antidepressant treatment: a randomized, double-blind, placebo-controlled, efficacy trial2012
A randomized, single-blind, comparison of duloxetine with bupropion in the treatment of SSRI-resistant major depression2012
An audit to compare the efficacy of treatment (as indicated by discharge rates and reduction in suicidality) among patients with refractory depression in a Bedfordshire Community Mental Health Team receiving augmentation therapy with either mirtazepine or atypical antipsychotics2011
Improving the antidepressant efficacy of transcranial magnetic stimulation: maximizing the number of stimulations and treatment location in treatment-resistant depression
Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial2011
Citalopram versus desipramine in treatment resistant depression: effect of continuation or switching strategies: a randomized open study2011
Switching antidepressant class does not improve response or remission in treatment-resistant depression2011
Clinically favourable effects of ketamine as an anaesthetic for electroconvulsive therapy: a retrospective study2011
Moderate exercise improves depression parameters in treatment-resistant patients with major depressive disorder2011
A double-blind placebo-controlled trial of lamotrigine as an antidepressant augmentation agent in treatment-refractory unipolar depression2011
Age predicts low-frequency transcranial magnetic stimulation efficacy in major depression2011
Antidepressant effects, of magnetic seizure therapy and electroconvulsive therapy, in treatment-resistant depression2011
A randomized trial of unilateral and bilateral prefrontal cortex transcranial magnetic stimulation in treatment-resistant major depression2011
Effects of 3 different stimulus intensities of ultrabrief stimuli in right unilateral electroconvulsive therapy in major depression: a randomized, double-blind pilot study2011
The use of background EEG activity to determine stimulus timing as a means of improving rTMS efficacy in the treatment of depression: a controlled comparison with standard techniques2010
Deep transcranial magnetic stimulation over the prefrontal cortex: evaluation of antidepressant and cognitive effects in depressive patients2009
S-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for antidepressant nonresponders with major depressive disorder: a double-blind, randomized clinical trial2010
Transcranial low voltage pulsed electromagnetic fields in patients with treatment-resistant depression2010
Is combined treatment more effective than switching to monotherapy in patients with resistant depression? A retrospective study2009
Rapid antidepressant effect of ketamine anesthesia during electroconvulsive therapy of treatment-resistant depression: comparing ketamine and propofol anesthesia2010
Randomized comparison of ultra-brief bifrontal and unilateral electroconvulsive therapy for major depression: cognitive side-effects2010
Clinical benefits and cost effectiveness of vagus nerve stimulation in a long-term treatment of patients with major depression2009
Aripiprazole augmentation in major depressive disorder: a double-blind, placebo-controlled study in patients with inadequate response to antidepressants2009
Influence of prefrontal target region on the efficacy of repetitive transcranial magnetic stimulation in patients with medication-resistant depression: a [(18)F]-fluorodeoxyglucose PET and MRI study2010
Low frequency (1-Hz), right prefrontal repetitive transcranial magnetic stimulation (rTMS) compared with venlafaxine ER in the treatment of resistant depression: a double-blind, single-centre, randomized study2009
Change in emotional processing during a dialectical behavior therapy-based skills group for major depressive disorder2009
A randomized trial of rTMS targeted with MRI based neuro-navigation in treatment-resistant depression2009
A randomized trial of the anti-depressant effects of low- and high-frequency transcranial magnetic stimulation in treatment-resistant depression2009
Randomized comparison of ultra-brief bifrontal and unilateral electroconvulsive therapy for major depression: clinical efficacy2009
Opposite effects of high and low frequency rTMS on mood in depressed patients: relationship to baseline cerebral activity on PET2009
The co-administration of quetiapine or placebo to cognitive-behavior therapy in treatment refractory depression: a preliminary trial2008
Selecting among second-step antidepressant medication monotherapies: predictive value of clinical, demographic, or first-step treatment features2008
Short-term intravenous citalopram augmentation in partial/nonresponders with major depression: a randomized placebo-controlled study2008
Venlafaxine extended release versus citalopram in patients with depression unresponsive to a selective serotonin reuptake inhibitor2008
Adaptation of dialectical behavior therapy skills training group for treatment-resistant depression2008
Priming stimulation enhances the effectiveness of low-frequency right prefrontal cortex transcranial magnetic stimulation in major depression2008
Depressed patients perception of the efficacy of electroconvulsive therapy and venlafaxine therapy2007
Risperidone for treatment-refractory major depressive disorder: a randomized trial2007
Placebo-controlled study of relapse prevention with risperidone augmentation in older patients with resistant depression2008
A randomized, single-blind, comparison of venlafaxine with paroxetine in elderly patients suffering from resistant depression2007
A functional magnetic resonance imaging study of the effects of low frequency right prefrontal transcranial magnetic stimulation in depression2007
Lithium augmentation compared with phenelzine in treatment-resistant depression in the elderly: an open, randomized, controlled trial2007
Efficacy and tolerability of adjunctive ziprasidone in treatment-resistant depression: a randomized, open-label, pilot study2007
Lithium versus lamotrigine augmentation in treatment resistant unipolar depression: a randomized, open-label study2007
A randomized, double-blind comparison of olanzapine/fluoxetine combination, olanzapine, and fluoxetine in treatment-resistant major depressive disorder2007
Quetiapine augmentation of treatment-resistant depression: a comparison with lithium2007
Clinical efficacy and cognitive side effects of bifrontal versus right unilateral electroconvulsive therapy (ECT): a short-term randomised controlled trial in pharmaco-resistant major depression2007
Lithium and triiodothyronine augmentation of antidepressants2006
A randomized, double-blind, placebo-controlled trial of augmentation with an extended release formulation of methylphenidate in outpatients with treatment-resistant depression2006
A randomized trial of low-frequency right-prefrontal-cortex transcranial magnetic stimulation as augmentation in treatment-resistant major depression2006
Concomitant use of vagus nerve stimulation and electroconvulsive therapy for treatment-resistant depression2006
Tranylcypromine versus venlafaxine plus mirtazapine following three failed antidepressant medication trials for depression: a STAR*D report
A comparison of lithium and T(3) augmentation following two failed medication treatments for depression: a STAR*D report2006
Daily and spaced treatment with transcranial magnetic stimulation in major depression: a pilot study2006
A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression2006
A comparison of mirtazapine and nortriptyline following two consecutive failed medication treatments for depressed outpatients: a STAR*D report2006
Memory, attention, and executive functions before and after sine and pulse wave electroconvulsive therapies for treatment-resistant major depression2006
Effects of risperidone augmentation in patients with treatment-resistant depression: Results of open-label treatment followed by double-blind continuation2006
A randomized, double-blind comparison of olanzapine/fluoxetine combination, olanzapine, fluoxetine, and venlafaxine in treatment-resistant depression2006
Treatment with venlafaxine extended release after SSRI nonresponse or intolerance: a randomized comparison of standard- and higher-dosing strategies2006
Imipramine is effective in preventing relapse in electroconvulsive therapy-responsive depressed inpatients with prior pharmacotherapy treatment failure: a randomized, placebo-controlled trial2006
Treatment-resistant bipolar depression: a STEP-BD equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone2006
A description of next-step switching versus augmentation practices for outpatients with treatment-resistant major depressive disorder enrolled in an academic specialty clinic2005
Olanzapine/fluoxetine combination for treatment-resistant depression: a controlled study of SSRI and nortriptyline resistance2005
Transcranial magnetic stimulation in treatment-resistant depressed patients: a double-blind, placebo-controlled trial2005
A one-year comparison of vagus nerve stimulation with treatment as usual for treatment-resistant depression
Vagus nerve stimulation for treatment-resistant depression: a randomized, controlled acute phase trial2005
Distinctive neurocognitive effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy in major depression2005
Repetitive transcranial magnetic stimulation (rTMS) at high and low frequency: an efficacious therapy for major drug-resistant depression?2005
Accelerated intermittent theta burst stimulation treatment in medication-resistant major depression: A fast road to remission?2016
Cognitive behavioral analysis system of psychotherapy and brief supportive psychotherapy for augmentation of antidepressant nonresponse in chronic depression: The REVAMP trial2009
Combination rapid transcranial magnetic stimulation in treatment refractory depression2006
Deep brain stimulation of the ventral anterior limb of the internal capsule for treatment-resistant depression: A randomized clinical trial2016
Improvement in quality of life with left prefrontal transcranial magnetic stimulation in patients with pharmacoresistant major depression: Acute and six month outcomes2014
Influence of prefrontal target region on the efficacy of repetitive transcranial magnetic stimulation in patients with medication-resistant depression: A [?F]-fluorodeoxyglucose PET and MRI study2010
Long-term effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: Follow-up of the CoBalT randomised controlled trial2016
Low-vs high-frequency repetitive transcranial magnetic stimulation as an add-on treatment for refractory depression2012
Repetitive transcranial magnetic stimulation in patients with drug-resistant major depression: A six-month clinical follow-up study2015
A randomized double-blind crossover trial of deep brain stimulation of the subcallosal cingulate gyrus in patients with treatment-resistant depression: A pilot study of relapse prevention2015
A randomized-controlled trial of bilateral rTMS for treatment-resistant depression2008
Serum BDNF as a peripheral biomarker of treatment-resistant depression and the rapid antidepressant response: A comparison of ketamine and ECT2015
A randomized controlled trial of cognitive behavioural therapy as an adjunct to pharmacotherapy in primary care based patients with treatment resistant depression: A pilot study2008
Unilateral and bilateral MRI-targeted repetitive transcranial magnetic stimulation for treatmentresistant depression: A randomized controlled study2016
A negative double-blind controlled trial of sequential bilateral rTMS in the treatment of bipolar depression2016
Ninety-six hour ketamine infusion with co-administered clonidine for treatment-resistant depression: A pilot randomised controlled trial2016
Ketamine Anesthesia, Efficacy of Electroconvulsive Therapy, and Cognitive Functions in Treatment-Resistant Depression2016
Can Medication Free, Treatment-Resistant, Depressed Patients Who Initially Respond to TMS Be Maintained off Medications? A Prospective, 12-Month Multisite Randomized Pilot Study2016
A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression2016
Improvements in psychosocial functioning and health-related quality of life following exercise augmentation in patients with treatment response but nonremitted major depressive disorder: Results from the tread study2016
Intravenous Esketamine in Adult Treatment-Resistant Depression: A Double-Blind, Double-Randomization, Placebo-Controlled Study2015
Pragmatic randomized controlled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: The Tavistock Adult Depression Study (TADS)2015
Augmentative repetitive Transcranial Magnetic Stimulation (rTMS) in the acute treatment of poor responder depressed patients: a comparison study between high and low frequency stimulation2015
Does the presence of accompanying symptom clusters differentiate the comparative effectiveness of second-line medication strategies for treating depression?2011
Switching to duloxetine from selective serotonin reuptake inhibitor antidepressants: a multicenter trial comparing 2 switching techniques
Do suicidal thoughts or behaviors recur during a second antidepressant treatment trial?2012
Cognitive therapy versus medication in augmentation and switch strategies as second-step treatments: a STAR*D report2007
What predicts attrition in second step medication treatments for depression?: a STAR*D Report2009
Venlafaxine extended release versus conventional antidepressants in the remission of depressive disorders after previous antidepressant failure: ARGOS study2005
Venlafaxine or a second SSRI: Switching after treatment failure with an SSRI among depressed inpatients: a retrospective analysis2011
The efficacy and safety of aripiprazole as adjunctive therapy in major depressive disorder: a multicenter, randomized, double-blind, placebo-controlled study2007
Extended-release quetiapine fumarate (quetiapine XR) as adjunctive therapy in major depressive disorder (MDD) in patients with an inadequate response to ongoing antidepressant treatment: a multicentre, randomized, double-blind, placebo-controlled study2010
Transcranial magnetic stimulation in the treatment of major depressive disorder: a comprehensive summary of safety experience from acute exposure, extended exposure, and during reintroduction treatment2008
Aripiprazole augmentation to antidepressant therapy in Japanese patients with major depressive disorder: a randomized, double-blind, placebo-controlled study (ADMIRE study)2013
The efficacy and safety of aripiprazole as adjunctive therapy in major depressive disorder: a second multicenter, randomized, double-blind, placebo-controlled study2008
A randomized controlled trial with 4-month follow-up of adjunctive repetitive transcranial magnetic stimulation of the left prefrontal cortex for depression2008
Comparing outcomes of adjunctive treatment in depression: aripiprazole versus bupropion2014
Ziprasidone Augmentation of Escitalopram for Major Depressive Disorder: Efficacy Results From a Randomized, Double-Blind, Placebo-Controlled Study2015
Osmotic-release oral system methylphenidate augmentation of antidepressant monotherapy in major depressive disorder: results of a double-blind, randomized, placebo-controlled trial2008
Predictors of response to adjunctive osmotic-release methylphenidate or placebo in patients with major depressive disorder: effects of apathy/anhedonia and fatigue2014
Evidence why paroxetine dose escalation is not effective in major depressive disorder: a randomized controlled trial with assessment of serotonin transporter occupancy2009
Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression
Effect of concomitant pharmacotherapy on electroconvulsive therapy outcomes: short-term efficacy and adverse effects2009
Medication augmentation after the failure of SSRIs for depression2006
Exercise as an augmentation treatment for nonremitted major depressive disorder: a randomized, parallel dose comparison2011
A Double-Blind, Randomized, Placebo-Controlled, Dose-Frequency Study of Intravenous Ketamine in Patients With Treatment-Resistant Depression2016
Tachyphylaxis after repeated antidepressant drug exposure in patients with recurrent major depressive disorder2009
Anxiety impairs depression remission in partial responders during extended treatment in late-life2010
A randomized, placebo-controlled trial of risperidone augmentation for patients with difficult-to-treat unipolar, non-psychotic major depression2009
Improving physical quality of life with group physical activity in the adjunctive treatment of major depressive disorder2008
Treating depression to remission in older adults: a controlled evaluation of combined escitalopram with interpersonal psychotherapy versus escitalopram with depression care management2010
Oral SAMe in persistent treatment-refractory bipolar depression: a double-blind, randomized clinical trial2014
Efficacy and safety of deep transcranial magnetic stimulation for major depression: a prospective multicenter randomized controlled trial2015
A randomized add-on trial of an N-methyl-D-aspartate antagonist in treatment-resistant bipolar depression2010
Efficacy of physical activity in the adjunctive treatment of major depressive disorders: preliminary results2007
Dysfunctional attitudes as a moderator of pharmacotherapy and psychotherapy for chronic depression2013
Social problem solving and depressive symptoms over time: a randomized clinical trial of cognitive-behavioral analysis system of psychotherapy, brief supportive psychotherapy, and pharmacotherapy2011
Affect Following First Exercise Session as a Predictor of Treatment Response in Depression2016
Efficacy of aripiprazole augmentation in Japanese patients with major depressive disorder: a subgroup analysis and Montgomery-Asberg Depression Rating Scale and Hamilton Rating Scale for Depression item analyses of the Aripiprazole Depression Multicenter Efficacy study2015
A 5-Year Observational Study of Patients With Treatment-Resistant Depression Treated With Vagus Nerve Stimulation or Treatment as Usual: Comparison of Response, Remission, and Suicidality2017
Effect of Antidepressant Switching vs Augmentation on Remission Among Patients With Major Depressive Disorder Unresponsive to Antidepressant Treatment: The VAST-D Randomized Clinical Trial2017
A Breathing-Based Meditation Intervention for Patients With Major Depressive Disorder Following Inadequate Response to Antidepressants: A Randomized Pilot Study2017
Cognitive outcome after ventral capsule/ventral striatum stimulation for treatment-resistant major depression2017
Ziprasidone Augmentation of Escitalopram for Major Depressive Disorder: Cardiac, Endocrine, Metabolic, and Motoric Effects in a Randomized, Double-Blind, Placebo-Controlled Study2017
Placebo-controlled pilot trial testing dose titration and intravenous, intramuscular and subcutaneous routes for ketamine in depression2016
Levothyroxine effects on depressive symptoms and limbic glucose metabolism in bipolar disorder: a randomized, placebo-controlled positron emission tomography study2016
A randomised controlled trial of Intensive Short-Term Dynamic Psychotherapy for treatment resistant depression: the Halifax Depression Study2017
Effect of antipsychotic pharmacotherapy on clinical outcomes of intermittent theta-burst stimulation for refractory depression2017
Two Versus One High-Frequency Repetitive Transcranial Magnetic Stimulation Session per Day for Treatment-Resistant Depression: A Randomized Sham-Controlled Trial2017
Pilot Randomized Controlled Trial of Titrated Subcutaneous Ketamine in Older Patients with Treatment-Resistant Depression2017
Episodic memory following deep brain stimulation of the ventral anterior limb of the internal capsule and electroconvulsive therapy2017

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