Definition of treatment-resistant depression – Asia Pacific perspectives

C. H. Ng; T. Kato; C. Han; G. Wang; M. Trivedi; V. Ramesh; D. Shao; S. Gala; S. Narayanan; W. Tan; Y. Feng; S. Kasper

doi:10.1016/j.jad.2018.11.038

Definition of treatment-resistant depression – Asia Pacific perspectives

C. H. Ng, T. Kato, C. Han, G. Wang, M. Trivedi, V. Ramesh, D. Shao, S. Gala, S. Narayanan, W. Tan, Y. Feng, S. Kasper

Research output: Contribution to journal › Review article › peer-review

40 Citations (Scopus)

Abstract

Background: The lack of uniformity in the definition of treatment resistant depression (TRD) within the Asia-Pacific (APAC) region may have implications for patient management. We aimed to characterize the most commonly used TRD definition in selected APAC countries. Methods: A systematic literature review of TRD definitions in APAC countries was conducted in Medline and Embase (2010–2016) and conference proceedings (2014 and 2016). TRD guidelines (APAC, Europe regional, US, or international) were also searched. An expert-panel explored APAC nuances in TRD definitions to achieve consensus for a regional-level definition. Results: Ten guidelines and 89 studies qualified for study inclusion. Among the studies, variations were observed in definitions regarding: number of antidepressants failed (range: ≥1 to ≥3), classes of antidepressants (same or different; 59% did not specify class), duration of previous treatments (range: 4–12 weeks), dosage adequacy, and consideration of adherence (yes/no; 88% of studies did not consider adherence). No TRD-specific guidelines were identified. The emerging consensus from the literature review and panel discussion was that TRD is most commonly defined as failure to ≥2 antidepressant therapies given at adequate doses, for 6–8 weeks during a major depressive episode. Limitations: Few studies provided definitions of TRD used in daily clinical practice, and a limited number of countries were represented in the included studies and expert panel. Conclusion: Attaining consensus on TRD definition may promote accurate, and possibly early detection of patients with TRD to enable appropriate intervention that may impact patient outcomes and quality of life.

Original language	English
Pages (from-to)	626-636
Number of pages	11
Journal	Journal of Affective Disorders
Volume	245
DOIs	https://doi.org/10.1016/j.jad.2018.11.038
Publication status	Published - 2019 Feb 15

Bibliographical note

Funding Information:
Madhukar Trivedi reports personal fees for consultations/advisory board participation from Alkeremes Inc, Akili Interactive, Allergan Pharmaceuticals, Arcadia Pharmaceuticals, Avanir Pharmaceuticals, Brintellix Global, Bristol Myers Squibb, Caudex, Cerecor, Forest Pharmaceuticals, Global Medical Education, Inc., Health Research Associates, Johnson & Johnson Pharmaceutical Research and Development, Lilly Research Laboratories, Lundbeck Research USA, Medscape, Merck & Co., Inc., Mitsubishi Pharma, MSI Methylation Sciences – Phamlab, Inc., Navitor, Otsuka America Pharmaceutical Inc., One Carbon Therapeutics, Pfizer Inc. and Takeda Global Research. He reports receiving royalties from Janssen Research and Development, LLC, and grants from the Agency for Healthcare Research and Quality, Cancer Prevention and Research Institute of Texas, National Institute for Mental Health, National Institute of Drug Abuse, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Advancing Translational Sciences, Johnson & Johnson, and PCORI. Dr Triveldi has author agreements with Janssen Asia Pacific and Oxford University Press and has received honoraria from the American Psychiatric Association.

Publisher Copyright:
© 2018

Keywords

Asia-pacific
Consensus
Definition
Expert panel
Systematic literature review
Treatment resistant depression

ASJC Scopus subject areas

Clinical Psychology
Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.jad.2018.11.038

Cite this

@article{5ce09aae88014cb48b5ded62a9f0d30c,

title = "Definition of treatment-resistant depression – Asia Pacific perspectives",

abstract = "Background: The lack of uniformity in the definition of treatment resistant depression (TRD) within the Asia-Pacific (APAC) region may have implications for patient management. We aimed to characterize the most commonly used TRD definition in selected APAC countries. Methods: A systematic literature review of TRD definitions in APAC countries was conducted in Medline and Embase (2010–2016) and conference proceedings (2014 and 2016). TRD guidelines (APAC, Europe regional, US, or international) were also searched. An expert-panel explored APAC nuances in TRD definitions to achieve consensus for a regional-level definition. Results: Ten guidelines and 89 studies qualified for study inclusion. Among the studies, variations were observed in definitions regarding: number of antidepressants failed (range: ≥1 to ≥3), classes of antidepressants (same or different; 59% did not specify class), duration of previous treatments (range: 4–12 weeks), dosage adequacy, and consideration of adherence (yes/no; 88% of studies did not consider adherence). No TRD-specific guidelines were identified. The emerging consensus from the literature review and panel discussion was that TRD is most commonly defined as failure to ≥2 antidepressant therapies given at adequate doses, for 6–8 weeks during a major depressive episode. Limitations: Few studies provided definitions of TRD used in daily clinical practice, and a limited number of countries were represented in the included studies and expert panel. Conclusion: Attaining consensus on TRD definition may promote accurate, and possibly early detection of patients with TRD to enable appropriate intervention that may impact patient outcomes and quality of life.",

keywords = "Asia-pacific, Consensus, Definition, Expert panel, Systematic literature review, Treatment resistant depression",

author = "Ng, {C. H.} and T. Kato and C. Han and G. Wang and M. Trivedi and V. Ramesh and D. Shao and S. Gala and S. Narayanan and W. Tan and Y. Feng and S. Kasper",

note = "Funding Information: Madhukar Trivedi reports personal fees for consultations/advisory board participation from Alkeremes Inc, Akili Interactive, Allergan Pharmaceuticals, Arcadia Pharmaceuticals, Avanir Pharmaceuticals, Brintellix Global, Bristol Myers Squibb, Caudex, Cerecor, Forest Pharmaceuticals, Global Medical Education, Inc., Health Research Associates, Johnson & Johnson Pharmaceutical Research and Development, Lilly Research Laboratories, Lundbeck Research USA, Medscape, Merck & Co., Inc., Mitsubishi Pharma, MSI Methylation Sciences – Phamlab, Inc., Navitor, Otsuka America Pharmaceutical Inc., One Carbon Therapeutics, Pfizer Inc. and Takeda Global Research. He reports receiving royalties from Janssen Research and Development, LLC, and grants from the Agency for Healthcare Research and Quality, Cancer Prevention and Research Institute of Texas, National Institute for Mental Health, National Institute of Drug Abuse, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Advancing Translational Sciences, Johnson & Johnson, and PCORI. Dr Triveldi has author agreements with Janssen Asia Pacific and Oxford University Press and has received honoraria from the American Psychiatric Association. Publisher Copyright: {\textcopyright} 2018",

year = "2019",

month = feb,

day = "15",

doi = "10.1016/j.jad.2018.11.038",

language = "English",

volume = "245",

pages = "626--636",

journal = "Journal of Affective Disorders",

issn = "0165-0327",

publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Definition of treatment-resistant depression – Asia Pacific perspectives

AU - Ng, C. H.

AU - Kato, T.

AU - Han, C.

AU - Wang, G.

AU - Trivedi, M.

AU - Ramesh, V.

AU - Shao, D.

AU - Gala, S.

AU - Narayanan, S.

AU - Tan, W.

AU - Feng, Y.

AU - Kasper, S.

N1 - Funding Information: Madhukar Trivedi reports personal fees for consultations/advisory board participation from Alkeremes Inc, Akili Interactive, Allergan Pharmaceuticals, Arcadia Pharmaceuticals, Avanir Pharmaceuticals, Brintellix Global, Bristol Myers Squibb, Caudex, Cerecor, Forest Pharmaceuticals, Global Medical Education, Inc., Health Research Associates, Johnson & Johnson Pharmaceutical Research and Development, Lilly Research Laboratories, Lundbeck Research USA, Medscape, Merck & Co., Inc., Mitsubishi Pharma, MSI Methylation Sciences – Phamlab, Inc., Navitor, Otsuka America Pharmaceutical Inc., One Carbon Therapeutics, Pfizer Inc. and Takeda Global Research. He reports receiving royalties from Janssen Research and Development, LLC, and grants from the Agency for Healthcare Research and Quality, Cancer Prevention and Research Institute of Texas, National Institute for Mental Health, National Institute of Drug Abuse, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Advancing Translational Sciences, Johnson & Johnson, and PCORI. Dr Triveldi has author agreements with Janssen Asia Pacific and Oxford University Press and has received honoraria from the American Psychiatric Association. Publisher Copyright: © 2018

PY - 2019/2/15

Y1 - 2019/2/15

N2 - Background: The lack of uniformity in the definition of treatment resistant depression (TRD) within the Asia-Pacific (APAC) region may have implications for patient management. We aimed to characterize the most commonly used TRD definition in selected APAC countries. Methods: A systematic literature review of TRD definitions in APAC countries was conducted in Medline and Embase (2010–2016) and conference proceedings (2014 and 2016). TRD guidelines (APAC, Europe regional, US, or international) were also searched. An expert-panel explored APAC nuances in TRD definitions to achieve consensus for a regional-level definition. Results: Ten guidelines and 89 studies qualified for study inclusion. Among the studies, variations were observed in definitions regarding: number of antidepressants failed (range: ≥1 to ≥3), classes of antidepressants (same or different; 59% did not specify class), duration of previous treatments (range: 4–12 weeks), dosage adequacy, and consideration of adherence (yes/no; 88% of studies did not consider adherence). No TRD-specific guidelines were identified. The emerging consensus from the literature review and panel discussion was that TRD is most commonly defined as failure to ≥2 antidepressant therapies given at adequate doses, for 6–8 weeks during a major depressive episode. Limitations: Few studies provided definitions of TRD used in daily clinical practice, and a limited number of countries were represented in the included studies and expert panel. Conclusion: Attaining consensus on TRD definition may promote accurate, and possibly early detection of patients with TRD to enable appropriate intervention that may impact patient outcomes and quality of life.

AB - Background: The lack of uniformity in the definition of treatment resistant depression (TRD) within the Asia-Pacific (APAC) region may have implications for patient management. We aimed to characterize the most commonly used TRD definition in selected APAC countries. Methods: A systematic literature review of TRD definitions in APAC countries was conducted in Medline and Embase (2010–2016) and conference proceedings (2014 and 2016). TRD guidelines (APAC, Europe regional, US, or international) were also searched. An expert-panel explored APAC nuances in TRD definitions to achieve consensus for a regional-level definition. Results: Ten guidelines and 89 studies qualified for study inclusion. Among the studies, variations were observed in definitions regarding: number of antidepressants failed (range: ≥1 to ≥3), classes of antidepressants (same or different; 59% did not specify class), duration of previous treatments (range: 4–12 weeks), dosage adequacy, and consideration of adherence (yes/no; 88% of studies did not consider adherence). No TRD-specific guidelines were identified. The emerging consensus from the literature review and panel discussion was that TRD is most commonly defined as failure to ≥2 antidepressant therapies given at adequate doses, for 6–8 weeks during a major depressive episode. Limitations: Few studies provided definitions of TRD used in daily clinical practice, and a limited number of countries were represented in the included studies and expert panel. Conclusion: Attaining consensus on TRD definition may promote accurate, and possibly early detection of patients with TRD to enable appropriate intervention that may impact patient outcomes and quality of life.

KW - Asia-pacific

KW - Consensus

KW - Definition

KW - Expert panel

KW - Systematic literature review

KW - Treatment resistant depression

UR - http://www.scopus.com/inward/record.url?scp=85056454693&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2018.11.038

DO - 10.1016/j.jad.2018.11.038

M3 - Review article

C2 - 30445388

AN - SCOPUS:85056454693

SN - 0165-0327

VL - 245

SP - 626

EP - 636

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Definition of treatment-resistant depression – Asia Pacific perspectives

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this