Sun. Oct 13, 2019 10:30 AM - 12:10 PM Room 1 (Main Hall)

Organizer / Chair: Siegfried KASPER (Department of Psychiatry and Psychotherapy Medical University Vienna, Austria), Co-chair: Shigeto YAMAWAKI (Center for Brain, Mind and KANSEI Sciences Research, Hiroshima University, Japan), Discussant: ‌Toshifumi KISHIMOTO (Department of Psychiatry, Nara Medical University, Japan)

The challenge for management of major depressive disorder (MDD) is currently focussed on treatment-resistant depression (TRD). This group presents many challenges for patients, physicians as well as in the research community. This symposium aims to evaluate the current status of the field of TRD and reflects the main findings available in the literature, mostly obtained by the colleagues presenting in this symposium. A staging model that distinguishes between “non-responders” (patients who failed to respond to one form of treatment, a condition which is now termed “insufficient response, “treatment resistant depression” (TRD patients that failed to respond to two or more adequate antidepressant trials), as well as “chronic resistant depression” (CRD, patients being treated with several antidepressants for more than 12 months) seems to be of validity for both researchers as well as for clinical practice. One potential way of improving treatment of TRD is through the use of predictive biomarkers, most likely including genetic parameters in combination with clinical variables. The advent of new treatments may also help by focusing on neurotransmitters other than serotonin, e.g. the glutamatergic system with ketamine demonstrating efficacy data in TRD as well as in depressed patients with suicidality. Furthermore, pharmacological strategies such as the use of a combination therapy with lithium, atypical antipsychotics and other pharmacological agents can improve outcomes, and techniques such as deep brain stimulation and vagus nerve stimulation have shown promising results. Despite consistent advances in the pharmacotherapy of mood disorders in the last decade, high rates of TRD are still a challenging aspect of overall management.
The information obtained in the proposed symposium will be helpful in trying to identify depressed patients who are likely to respond for antidepressant treatment as well as in finding potential drug targets for treatment resistant depression which are promising to develop the next generation of psychotherapeutic agents.