Staging Method for Treatment-Resistant Depression

 

Parameters:

(1) number of adequate trails of an antidepressant that the patient has not responded to

(2) number of these trials that were optimized

(3) electroconvulsive therapy (ECT)

Parameter	Finding	Points
number of adequate trials with an antidepressant that were optimized	(number)	(number) * 1.5
number of adequate trials with an antidepressant that were not optimized	(number)	(number)
ECT therapy	not given	0
	given	3

 

total number of adequate trials =

= (number optimized) + (number not optimized)

 

where:

• An adequate trial involves an adequate dose of an antidepressant for at least 6 weeks.

• Optimization involves attentions to duration, dose and augmentation.

• The total number of adequate trials indicates the number of different types of antidepressants that the patient has received.

 

total score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: dependent on the number of trials

• The higher the score the better the documentation of therapy resistance.