Drug-resistant depression. When the grain doesn’t get us out of the hole – Zdrowie Wprost

Depressed mood, sleep disturbances, inability to feel cheerful, pessimistic and sometimes suicidal are some of the symptoms of depression. The patient goes to a psychiatrist, receives medication, often has sessions with a therapist … and there is no or little improvement. This type of response to treatment isn’t uncommon — psychiatrists say they’re dealing with a patient with drug-resistant depression.

Drug-resistant depression

It is not rare at all. “The first antidepressant treatment used during a particular episode only guarantees remission in 20-30% of patients. Patient. About 30-40 percent. Patients do not respond to it (during a particular episode) in 70-80% complete improvement (remission) is not observed. , 20% do not recover within two years, and 10%. Chronic depressive state persists despite numerous therapeutic interventions “- wrote the professor. Stanisław Pużyński in Commentary to Review Article on Drug-Resistant Depression by Researchers: Berlim and Turecki (Reprinted in Polish by the Medycyna Praktyczna website).

One drug company that has just started the “Back from Depression” campaign reports that estimates are In Poland, the problem of drug-resistant depression may affect up to 600,000 people.

It must also be emphasized that psychiatrists are aware of the fact that some patients are too fast to be classified as ‘treatment-resistant’. “We sometimes deal with ‘pseudo-drug resistance’, where the lack of an intended therapeutic effect results from inadequate drug therapy, interactions between medications given to the patient, or misdiagnosis of depression. It has been shown that about 60 percent of ‘drug-resistant’ patients actually belong to The group of people with resistance to pseudo-drugs, more than half of whom were treated with very small doses of drugs, which, moreover, patients often took infrequently ”- comments the professor. Pużyński.

The main relationship between the patient and the doctor

In treating any disease, one of the most important things is the doctor’s professionalism on the one hand, and the patient’s confidence in him on the other. It can be different. Perhaps the situation is more complicated in the field of psychiatry – mental disorders, turning to specialists when faced with such problems – is still a stigma.

– Consultation with a specialist is postponed by patients for the next week, month or year – the professor regrets. Janusz Heitzmann, former director of the Institute of Psychiatry and Neurology.

There are also harmful myths about antidepressants – for example, that they are addictive (not true, sleeping pills have a strong addictive potential), and that they change personality (not true, personality does not change). No wonder that if the patient does not dispel his doubts with the doctor, or if the doctor does not adequately explain to the patient the meaning and method of treatment, he may take medicines irregularly, reduce doses, etc.

“The prerequisite for effective treatment with antidepressants is an appropriate (“appropriate”) treatment regimen. This appropriate treatment consists in the selection of the appropriate drug, the determination of the therapeutic dose (…) after the possible determination of the concentration of the drug in the blood, and the use of drugs in therapeutic doses for an appropriate period (on least 6-8 weeks). In addition, the physical condition and comorbidities should be evaluated, the drugs used in the treatment of these diseases and possible interactions between them should be analyzed. It is necessary to take into account the psychological factors that maintain depression and provide therapeutic assistance to the patient. It is very important to ensure that The patient takes medications in accordance with the recommendations ”- emphasizes the professor. Pużyński.

Drug-resistant depression: causes

It should be noted that inappropriate treatment of depression increases the risk of developing drug-resistant depression. Other causes include chronic diseases. a. Piotr Gałecki, national consultant psychiatrist. He noted that people with systemic diseases such as diabetes, rheumatoid arthritis and Hashimoto’s disease are at risk of developing drug-resistant depression.

“Such an illness is also a risk factor for a depressive episode, which would have nothing to do with psychological stressors from the environment, such as the experience of loss, or with the personality traits of such a person. Such a depressive episode would result from an exacerbation of the underlying disease, rheumatoid arthritis or Hashimoto’s or another disease of this kind.

Psychiatrists assure that in such a situation it is necessary to treat these diseases well and pay special attention to hygiene of life, that is, a good rest.

It should also be noted that, despite everything, depression can be treated, even if it is resistant to drugs. The reward is remission and thus natural coordination, intellectual ability, ability to enjoy and restful sleep. Only life.

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