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Atypical depression is a chronic syndrome that tends to begin earlier in life than other forms of depression—usually beginning in the teenage years. Similarly, patients with atypical depression are more likely to have anxiety disorders, (such as generalized anxiety disorder, obsessive–compulsive disorder, and social anxiety disorder ...
The risk factors [110] for treatment resistant depression are: the duration of the episode of depression, severity of the episode, if bipolar, lack of improvement in symptoms within the first couple of treatment weeks, anxious or avoidant and borderline comorbidity and old age. Treatment resistant depression is best handled with a combination ...
Patients with depressive symptomology characterized as "atypical," "nonendogenous," and/or "neurotic" respond particularly well to phenelzine. [7] The medication is also useful in patients who do not respond favorably to first and second-line treatments for depression, or are "treatment-resistant."
For treatment-resistant depression, adding on the atypical antipsychotic brexpiprazole for short-term or acute management may be considered. [209] Brexpiprazole may be effective for some people, however, the evidence as of 2023 supporting its use is weak and this medication has potential adverse effects including weight gain and akathisia. [209]
[1] [2] [3] Among TCAs, trimipramine is an atypical agent in that it appears not to do this. [3] In August 2020, esketamine (JNJ-54135419) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of treatment-resistant depression with the added indication for the short-term treatment of suicidal thoughts. [4]
Medium- (7–12 months) and long‐term (longer than 12 months) effects seem similarly beneficial. Psychological therapies, including cognitive behavioral therapy, added to usual care (antidepressants) seem as acceptable as usual care alone and may be used as a first line treatment for mild to moderate treatment resistant depression. [41] [23]