Treatment Resistant Depression and Lithium

Found a link to this story at Brain Blogger.

Dr. Shock MD PhD reports an interesting finding about the genetics possibly linked to treatment resistant depression: “Patients with the s/s genotype who according to the literature seem to be at risk for a less favorable response to antidepressant monotherapy might particularly benefit from augmentation strategies. …. early lithium augmentation in these patients (with the s/s genotype) could be a promising strategy and might help to reduce the occurrence of treatment resistance in depressive disorders.”

Although the definition of treatment resistant depression is not always clear, there are several options for treatment resistant depression resulting in 9 possible steps for treatment resistant depression. I am convinced that especially lithium addition is a very effective treatment strategy if an antidepressant fails and should be preferred above more experimental addition strategies such as atypical antipsychotics. Lithium addition can result in a response rate up to 50% in treatment resistant depression and has been studied in many RCT’s, reviews and meta analysis.

Individuals with the short allelic form of this variant showed an increased risk of depression compared to those carrying the long allele but only when exposed to adverse life events or maltreatment.

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