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Table 1 Baseline characteristics and outcomes of included studies

From: Systematic review of management for treatment-resistant depression in adolescents

Study

Age (years)

Diagnostic criteria

Baseline score

Female (%)

TRD definition

Trial length (weeks)

Treatment

Response Definition

Measure outcome

Birmaher [34]*

12-18

DSM-III-R

HAMD ≥15

70

Failure to response to at least two antidepressants

10

Amitriptyline, 50–300 mg/d (N = 13); placebo (N = 14)

≥50% reduction in HAMD score

Amitriptyline: 10/13; placebo: 11/14

Boulos [35]

14-18

DSM-III-R

HAMD ≥17

57

Failure to respond to at least two consecutive months with a TCA

6-7

Fluoxetine, 5–40 mg/d (N = 7)

≥50% reduction in HAMD score

Fluoxetine: 2/5

Brent [36]*

(TORDIA)

12-18

DSM-IV

CDRS-R ≥ 40

71

Failure to response to an SSRI regimen for at least eight weeks

12

A second SSRI (N = 85); venlafaxine (N = 83); a second SSRI plus CBT (N = 83); venlafaxine plus CBT (N = 83)

≥50% reduction in CDRS-R score

No CBT: CBT = 68/168:91/166

Ghaziuddin [37]

15-18

DSM III-R

HAMD ≥11

67

Failure to response to an adequate trial of a TCA for at least four weeks

4-16

Fluoxetine, 20–60 mg/d (N = 6)

≥50% reduction in HAMD score

Fluoxetine: 2/6

Kondo [38]

13-18

DSM-IV

CDRS-R ≥40

100

Failure to response to fluoxetine treatment for over eight weeks

8

Augmentation with creatine, 4 g/d (N = 5)

≥50% reduction in CDRS-R score

Creatine: 3/5

Pathak [39]

13-18

DSM-IV-TR

60

Failure to respond to at least an eight-week trial of an SSRI with an adequate dose

Case series (4–16)

Augmentation with quetiapine, 150–800 mg/d (N = 10)

CGI-I of 1 or 2

Quetiapine: 7/10

Ryan [40]

14-19

DSM III

79

Failure to respond to at least a four-week trial of a TCA

Case series (3–16)

Augmentation with lithium, 600–1500 mg/d (N = 14)

CGI-I of 1 or 2

Lithium: 6/14

Strober [41]

13-18

DSM III-R

HAMD-21 ≥ 16

71

Failure to response to imipramine at least six weeks

3

Augmentation with lithium, 900 mg/d (N = 24)

≥50% reduction in HAMD score

Lithium: 2/24

  1. Abbreviations: DSM-III DSM-III-R DSM-IV DSM-IV-TR Diagnostic and Statistical Manual of Mental Disorders III version, III revision version, IV version, IV text revision version, CDRS-R Children Depression Rating Scale-Revised, CGI-S Clinical Global Impressions Severity Subscale, HAMD Hamilton Depression Rating Scale, TRD treatment-resistant depression, SSRI selective serotonin reuptake inhibitor, TCA tricyclic antidepressant, CBT cognitive behavior therapy, CGI-I Clinical Global Impressions Improvement Subscale.
  2. *Randomized controlled trial (RCT).