Depression, Depressionen

Table_2

Tables 2 and 3 present the treatment histories (lifetime, during the current episode, and during VNS) of all patients. Over their lifetimes, patients averaged 18.4 ± 7.2 (range = 6-‐38) antidepressant and mood disorder treatments, of which 10.3 ± 3.7 (range = 4‐-18) were antidepressant medication trials. Altogether, 63% had received ECT in their lifetime, whereas 57% had received ECT during the current MDE. Ten (33%) had received ECT within 2 years of study entry. Of the 19 patients who had ever received ECT, seven had no response (no or minimal symptom reduction), three had partial responses (only modest Symptom reduction), eight had transient responses (substantial symptom reduction lasting <2 months), and one had a sustained response.

All patients met or exceeded eligibility criteria by failing at least two robust treatment trials in the current MDE according to the ATHF. To qualify, the agent had to be used at doses with established efficacy for a sufficient period (eg., at least 4 weeks) to establish that the agent was ineffective. During the current MDE, 30% had failed two treatments, 7% had failed three, 20% had failed four, and 43% had failed five or more well-documented treatments that met ATHF criteria. Tables 2 and 3 reveal, in fact, that many more treatment attempts were made, often in combinations, for the current MDE. As a group, the patients were remarkably treatment resistant-resulting in prolonged, severe, and disabling illness.