| Treatment nonresponse (e.g., significant residual depressive symptoms). A response that is poor enough that a change in the treatment plan is callede for (e.g., failure to evidence at least a 50% reduction in the HRS- D score (or equivalent scale). |
| Treatment response. A response that is good enough that a change in the treatment plan is not usually called for (e.g., at least a 50% reduction in HRS-D score). |
| Remission. Attainment of a virtually asymptomatic status (e.g., HRS-D {ewc MVIMG, MVIMAGE,!lesseq.bmp} 7) for at least 2 consecutive weeks. |
| Recovery. Remission for {ewc MVIMG, MVIMAGE,!greateq.bmp} 6 consecutive months. |
| Relative treatment resistance. Nonresponse to an adequate dose of a potentially effective medication for an adequate length of time. |
| Absolute treatment resistance. Failure to respond to a maximal trial of a single treatment for an extended period of time (e.g., IMI at 300 mg/d for 6 weeks). |
| Treatment refractory depression (TRD). Treatment nonresponse (i.e., persistence of significant depressive symptoms) despite at least two treatment trials with drugs from different pharmacological classes, each used in an adequate dose for an adequate time period. |
| Adequate dose. An oral dose that is close to the manufacturer's recommended maximal dose. Adequate dose may be smaller for elderly patients. |
| Adequate length of treatment. At least 4 consecutive weeks of treatment, during which the patient has had an adequate dose for at least 3 weeks. |
| Medication intolerance. Inability to achieve or maintain an adequate therapeutic dose of an antidepressant drug due to idiosyncratic reactions or side effects. |
Adapted from These et al. (109).
published 2000