Journal Article

Clinical guidelines for the management of treatment-resistant depression: French recommendations from experts, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental

Moliere, F., Dorey, J.-M., Bougerol, T., Camus, V., Yrondi, A., Haesebaert, F., Doumy, O., Leboyer, M., Courtet, P., Vaiva, G., Charpeaud, T., Richieri, R., Holtzmann, J., Lançon, C., Stephan, F., Alaïli, N., Destouches, S., Lefebvre, M., Bennabi, D., Nieto, I., Llorca, P.-M., Lancrenon, S., Bellivier, F., El-Hage, W., Genty, J.-B., Aouizerate, B., Haffen, E., Schmitt, L., Rabu, C., Walter, M.

2019

Overview

Background Clear guidance for successive antidepressant pharmacological treatments for non-responders in major depression is not well established. Method Based on the RAND/UCLA Appropriateness Method, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental developed expert consensus guidelines for the management of treatment-resistant depression. The expert guidelines combine scientific evidence and expert clinicians’ opinions to produce recommendations for treatment-resistant depression. A written survey comprising 118 questions related to highly-detailed clinical presentations was completed on a risk-benefit scale ranging from 0 to 9 by 36 psychiatrist experts in the field of major depression and its treatments. Key-recommendations are provided by the scientific committee after data analysis and interpretation of the results of the survey. Results The scope of these guidelines encompasses the assessment of pharmacological resistance and situations at risk of resistance, as well as the pharmacological and psychological strategies in major depression. Conclusion The expert consensus guidelines will contribute to facilitate treatment decisions for clinicians involved in the daily assessment and management of treatment-resistant depression across a number of common and complex clinical situations.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Antidepressants / Antidepressive Agents / Antidepressive Agents - therapeutic use / Associations / Biological Psychiatry / Biological Psychiatry - methods / Biological Psychiatry - standards / Care and treatment / Clinical medicine / Clinical practice guidelines / Data analysis / Depression (Mood disorder) / Depressive Disorder, Major - epidemiology / Depressive Disorder, Major - psychology / Depressive Disorder, Major - therapy / Depressive Disorder, Treatment-Resistant / Depressive Disorder, Treatment-Resistant - epidemiology / Depressive Disorder, Treatment-Resistant - psychology / Depressive Disorder, Treatment-Resistant - therapy / Drug resistance / Drug therapy / Evidence-based medicine / Expert consensus guidelines / Expert evidence / Expert Testimony / Expert Testimony - methods / Expert Testimony - standards / Female / Foundations / Foundations - standards / France / France - epidemiology / Human health and pathology / Humans / Information management / Life Sciences / Major Depressive Disorder / Male / Management / Medicine / Medicine & Public Health / Mental depression / Mood disorders / Neuropsychology / Participation / Patient outcomes / Patients / Pharmacotherapy / Practice guidelines (Medicine) / Practice Guidelines as Topic / Practice Guidelines as Topic - standards / Psychiatrics and mental health / Psychiatrists / Psychiatry / Psychiatry - methods / Psychiatry - standards / Psychopharmacology / Psychopharmacology - methods / Psychopharmacology - standards / Psychotherapy / Questionnaires / Research Article / Treatment resistance / Treatment resistant depression