Various levels of depression exist including mild, moderate and severe, as shown on the illustration,1,2 and these can correspond to scores on the Montgomery–Åsberg Depression Rating Scale (MADRS).3 Of note, remission has been defined as a MADRS score of <9 or <10 in some studies.4
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Major Depressive Disorder (MDD) is a highly prevalent psychiatric condition with significant individual and socio-economic burden. Despite the broad availability of numerous effective therapeutic interventions, up to 30% of patients fail to achieve adequate symptom relief and are classified as having treatment-resistant depression (TRD). TRD represents a significant clinical challenge, affecting approximately 30% of individuals with MDD who fail to respond to at least two adequate antidepressant trials.
Sequential treatment optimization scheme for major depressive disorder generated according to international evidence.
Key steps for managing factors that may confound antidepressant treatment response, including dose, side effects, comorbidities, stressors, adherence, pharmacogenomics, interactions, and treatment algorithms.