Thread by @rcpsych

Welcoming Prof Hamish McAllister-Williams - @HamishMcAW to the virtual stage this morning to talk about: When depression is proving difficult to treat #RCPsychIC #Depression

Is there a need to define treatment-resistant depression? #RCPsychIC #Depression

Standard is 6-week antidepressant, however sometimes 8-week trial before classed as failed. Psychotherapy is often not taken into account

#RCPsychIC #Depression

Treatment comes from the Latin word "curatio" which means to manage the illness #RCPsychIC #Depression

Within 5 years 88% of people were treated for depression #RCPsychIC #Depression

2 year follow up #RCPsychIC #Depression

If the first treatment doesn't work....we need to ask, were they diagnosed correctly?

#RCPsychIC #Depression

Thank you Koen for you informative talk.

A nice illustration to end his presentation...and a quote on what Koen uses to describe fighting depression

#RCPsychIC #Depression

Welcome David Baldwin to #RCPsychIC

Published about a month ago - 14 antidepressants were analysed

#RCPsychIC #Depression

The most effective came out as phenelzine. From this study, it should be prioritised in future trials of PTSD although there has been some hesitancy on this

#RCPsychIC #Depression

Star D studied. Response rate was 12.1% to Tranylcypromine

Side effects:
Increased anxiety
Insomnia

Also has amphetamine-like reaction in high doses

#RCPsychIC #Depression

MAOIs are not advised as good treatments for depression #RCPsychIC #Depression #MAOIs

Need to apply 2-3 week washout period and carry on the restrictive diet after stopping phenelzine #RCPsychIC #Depression #Antidepressants

@HamishMcAW Thank you to David Baldwin on your talk about MAOIs

Is there a future for MAOIs?

#RCPsychIC #Depression

Effect of duration of untreated depression on outcomes

After 4 weeks there should be some improvement from the treatment. if there is no improvement from 6-8 weeks then something else needs to be taken into consideration.

#RCPsychIC #Depression

Significant benefits using Esketamine, that are having TRD

#RCPsychIC #Depression

Modafinil augmentation: meta analysis

#RCPsychIC #Depression

@HamishMcAW

Different time scales for the use of Esketamine nasal spray

#RCPsychIC #Depression

@HamishMcAW

May need to consider other treatment trials.

Regular reconsideration to treatments, every 6 months.

#RCPsychIC #Depression

Thank you to @HamishMcAW David and Koen for your talks on treatment-resistant depression.

We hope you found this session informative and useful

#RCPsychIC #Depression