Treatment of Refractory Depression & High Dose Tricyclics
Refractory depression is a disabling and incurable condition in which depressed individuals do not improve with medication. The use of high dose tricyclic antidepressants to increase treatment response is a controversial topic within the psychiatric community. Ongoing research endeavors continues to establish safety and efficacy, but concerns about side effects and other complications persist among professionals.
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Definition
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The U.S. Department of Health and Human Services defines refractory depression as a condition which fails to improve after two biological treatment efforts have been applied.
Prevelance
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Washington University Physicians estimates severe refractory depression occurs in 5 percent of all depression sufferers.
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Tricyclic Antidepressants
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The Mayo Clinic states that tricyclic antidepressants prevent the reabsorption of dopamine, norepinephrine and serotonin which are mood enhancing neurotransmitters.
High Doses
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Results of research shared by the U.S. National Library of Medicine indicate high dose tricyclic medication increases therapeutic benefits in depression that is unresponsive to moderate doses.
Tolerability
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The National Institutes of Health report more than half of participants in a study of high dose tricyclic antidepressant therapy were unable to complete treatment when depressive symptoms increased or side effects became unmanageable.
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