Clinical guidelines for the management of treatment-resistant depression: French recommendations from experts, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental

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Bennabi, D. | Charpeaud, T. | Yrondi, A. | Genty, J.-B. | Destouches, S. | Lancrenon, S. | Alaïli, N. | Bellivier, F. | Bougerol, T. | Camus, V. | Dorey, J.-M. | Doumy, O. | Haesebaert, F. | Holtzmann, J. | Lançon, C. | Lefebvre, M., . | Moliere, F. | Nieto, I. | Rabu, C. | Richieri, R. | Schmitt, L. | Stephan, F. | Vaiva, G. | Walter, M. | Leboyer, M. | El-Hage, Wissam | Llorca, P.-M. | Courtet, P. | Aouizerate, Bruno | Haffen, E.

Edité par CCSD ; BioMed Central -

International audience. Background: Clear guidance for successive antidepressant pharmacological treatments for non-responders in major depression is not well established.Method: Based on the RAND/UCLA Appropriateness Method, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental developed expert consensus guidelines for the management of treatment-resistant depression. The expert guidelines combine scientific evidence and expert clinicians’ opinions to produce recommendations for treatment-resistant depression. A written survey comprising 118 questions related to highly-detailed clinical presentations was completed on a risk-benefit scale ranging from 0 to 9 by 36 psychiatrist experts in the field of major depression and its treatments. Key-recommendations are provided by the scientific committee after data analysis and interpretation of the results of the survey.Results: The scope of these guidelines encompasses the assessment of pharmacological resistance and situations at risk of resistance, as well as the pharmacological and psychological strategies in major depression.Conclusion: The expert consensus guidelines will contribute to facilitate treatment decisions for clinicians involved in the daily assessment and management of treatment-resistant depression across a number of common and complex clinical situations.

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