Article: Pharmacotherapeutic approaches to treatment-resistant depression: first, rule out complicating factors and nonadherence to prescribed antidepressant drugs. Then, consider these options for improving the response to treatment.

Depression is a serious medical condition that carries significant morbidity and mortality. The socioeconomic cost of depression is similar to the costs of coronary artery disease (CAD), cancer, and AIDS. (1) In fact, major depressive disorder (MDD) is associated with more disability than many chronic medical illnesses, including CAD, lung diseases, and diabetes. (2,3) The estimated cost of depression in 1990 was about $50 billion, more than half of which involved workplace costs such as losses due to absenteeism and occupational impairment. More workdays are lost owing to depression than to hypertension and CAD combined. Depression also carries a high mortality risk from ...

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