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 |