Please click here to log in with you RCPsych web account details; you will be redirected back to CPD Online.If you have forgotten your College web account details, you will be able to reset them here.
Please click here to log in if your institution has a subscription to CPD Online with Athens access.
Please click here to log in if you are subscribed through Medicom Netherlands.
If you having troubles signing in with the options above, please try this alternative login route.
by Professor Philip J.
Last updated: June 2019
Depressed patients referred to psychiatrists have nearly always
failed to respond to first-line treatment with antidepressant
medication. Subsequent care by the psychiatric team will involve a
comprehensive care package; however, for most patients
the adjustment of antidepressant medication will
also play an important role.
The use of medication in treatment-resistant
depression has benefited from the availability of an increasing
number of antidepressant drugs. However, the evidence base for
treating resistant depression is modest. Furthermore, it is
difficult to produce treatment algorithms that can be broadly
applicable; each patient must be treated as an individual and a
collaborative approach pursued.
The pharmacological approach to
treatment-resistant depression (TRD) is a vast subject area and one
that we could not possibly cover in depth here. The aim of
this module is to provide an overview of the subject. We start with
relatively simple interventions such as switching within and
between antidepressant classes, and move on to treatment
combinations with both antidepressants and adjuncts such as
lithium. The roles of electroconvulsive therapy (ECT) and
cognitive-behaviour therapy (CBT) are also considered.
We hope that this module will help
general adult and old-age psychiatrists gain confidence in the
innovative use of pharmacological treatment in resistant
depression, and thereby help patients with this debilitating
condition to achieve better outcomes.
If you like this module, you may also be
and psychosexual dysfunction: Part 1 – diagnosis
by Dr Ursula Werneke
Pharmacological management of anxiety disorders
by Dr Zia Nadeem and Dr Allan Scott
Pharmacological management of mania by Dr
Karine A.N. Macritchie and Professor Allan H. Young
causes and consequences by Dr V R Badrakalimuthu
Treating depression in later life by
Professor Robert Baldwin, Dr Deepak K Sachdeva and Dr Amit
Related Advances articles
Download take-home notes to print and