Treatment Resistant Depression

Treatment resistant depression (TRD) has been variably defined over the past 20 years. The term has most recently been used to describe persistent depressive symptoms even after two or more different antidepressants have been used at adequate doses for an adequate amount of time. I personally feel that the term can be misleading, sounding like a with TRD has a special “more difficult to treat than usual” kind of depression, when it is more likely a result of our treatment limitations. In other words, I see it as a term that has evolved from our expanding range of effective treatment options, such as TMS and Spravato, and who should qualify for them.