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  1. Pharmacological choices after one antidepressant fails : a survey of UK psychiatrists.

    Article - En anglais


    At least 30% of depressed patients fail to respond to adequate first-line anti-depressant medication.

    Several pharmacological strategies have been suggested to treat such refractory depression.

    There has been no survey of United Kingdom psychiatrists'treatment preferences for refractory depression.

    This study was carried out to determine both experience and preference of various strategies for management of refractory depression.


    A total of 300 fellows, members and inceptors of the Royal College of Psychiatrists were randomly selected and approached by postal questionnaire.

    They were asked to comment on management of a detailed clinical vignette of a case of depression with initial treatment failure.


    The response rate was 63% (n=175).

    The most popular treatment choices were increasing dosage of tricyclic medication and change of medication to SSRI.

    The most rarely selected were augmentation with triiodothyronine (T3) and augmentation with tryptophan or MAOIs.

    Treatment choice was significantly influenced by previous experience.

    A large number (39%) of psychiatrists were not confident in treating refractory depression.


    Surprisingly few psychiatrists chose to use the best proven pharmacological treatments such as augmentation with lithium or T3. (...)

    Mots-clés Pascal : Etat dépressif, Trouble humeur, Chimiothérapie, Antidépresseur, Résistance traitement, Prescription médicale, Choix, Association médicamenteuse, Psychiatre, Personnel sanitaire, Enquête, Royaume Uni, Europe, Homme

    Mots-clés Pascal anglais : Depression, Mood disorder, Chemotherapy, Antidepressant agent, Negative therapeutic reaction, Medical prescription, Choice, Drug combination, Psychiatrist, Health staff, Survey, United Kingdom, Europe, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0306237

    Code Inist : 002B02B02. Création : 15/07/1997.