The origin and progression of neuropsychiatric and physical disorders share multiple risk factors, which act along common biological pathways to produce overlapping outcomes as illustrated on the image.
Pathways of activated immune–inflammatory stress, oxidative stress and nitrosative stress appear to underlie many psychiatric disorders and physical diseases, including MDD.1,2,3
MDD=major depressive disorder
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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.