Talk:Treatment-resistant depression

message: Electroconvulsive therapy is actually has more potential for collateral damage than Vagus Nerve Stimulation.  It can lead to permanent brain damage (mostly memory related).  Vagus Nerve Stimulation is only invasive in that it involves a foreign object being implanted in the body.
This is true. I have changed the article to say "more invasive" procedures such as vagus nerve, rather than "more extreme." ECT is about as extreme as it gets as far as therapy goes. I have also added transcranial magnetic stimulation, which is invasive in neither of the ways that these other two treatments are and actually seems to be one of the best options at the moment for those who are looking into these types of treatments.--Gloriamarie 18:13, 11 September 2007 (UTC)
thread_title: Untitled

message: I always called it thus and this is what I have most commonly seen it referred to in literature as. Input? Happy with rename? Cheers, Casliber (talk · contribs) 02:26, 31 July 2008 (UTC)
thread_title:  Proposal to rename this [[Treatment-resistant depression]] 

message: Yes, it's a more common term than refractory depression in the literature, but it's also a term created by aping medical descriptions such as "extensively drug-resistant tuberculosis".  However, there's no pathogen so it's effectively ascribing it to a fault in the patient.   To be honest (although not acknowledged), a far better title would "psychiatrists without a clue wasting people's time with quack treatments" syndrome.  --79.75.13.219 (talk) 16:35, 15 October 2008 (UTC)
replies: text: What is the point of your comment? Its not helpful and very insulting. I'm suffering from treatment resistant depression myself and as far as this article is concerned it could use a lot more information. It blows my mind that in the 4 years I've been frequenting Wikipedia no psychiatrists have taken the time to add more substance to this article. Mramz88 (talk) 09:22, 5 August 2010 (UTC)
thread_title:  Stupid term 

message: We don't need government-sponsored paternalistic tripe about how drug abuse can be involved with stimulants here - what is the point of adding it...? it is self-evident (we already make things emphatically clear by pointing out no one who is addictively-prone or cardiologically-unsound should consider this possibility, like good Boy Scouts...) The propaganda-flavored moralism (moralism is ethics in its lowest state) is also insulting and marginalizing to those individuals who actually benefit from psychostimulant medicines after all else has failed them... My mother has Multiple Sclerosis, folks, with co-morbid MDD, the brain stimulation did NOTHING! Life without stimulants would be like living death for her - so let's make such people feel even worse, right? GEEZ. Yeah, let's make them feel more miserable as if pathological demonized automatic born criminals in need of DEA stormtroop guardianship because NECESSARILY unethical (right?) as what is a poison to others, is a boon to some...
PARACELSUS: ALL IS A TOXIN: DOSE DETERMINES THE POISONOUSNESS  — Preceding unsigned comment added by 2602:304:B34B:A940:F051:AB0F:3A76:DE48 (talk) 18:39, 18 June 2015 (UTC)
thread_title:  This is an Encyclopedia 

message: Pseudoresistant depression is distinct from Treatment-Resistant Depression (TRD). People with TRD are diagnosed as such because they aren't responding adequately to accepted treatments and modalities. Pseudoresistance to depression is, as it sounds, "pseudo" meaning what presents as "resistance" is actually inadequate treatment. The second sentence explains this and thus contradicts the preceding sentence. To summarize: not responding adequately to treatment and receiving inadequate treatment are not the same thing and presenting them as occasionally synonymous confuses the topic by implying that people with TRD are merely receiving inadequate treatment and aren't resistant to treatment at all. Therefore, I do not think the following references to "Pseudoresistant Depression" (PRD) in the opening paragraph should be in this article at all and would be more appropriate on a page about PRD specifically. 
People with treatment-resistant depression who do not adequately respond to antidepressant treatment are sometimes referred to as pseudoresistant. (3) Some factors that contribute to inadequate treatment are: early discontinuation of treatment, insufficient dosage of medication, patient noncompliance, misdiagnosis, and concurrent psychiatric disorders.(3)
(3) Treatment-resistant depression - PubMed (nih.gov) - sourced from the abstract of a paper, it is merely the opinion of the author that TRD is usually someone's fault.  Belial Lovett (talk) 21:15, 18 October 2022 (UTC)
replies: text: I agree. I removed that sentence (diff), in part because most readers would not understand its meaning, but most importantly because the "pseudo" term is not prominent in the literature on this topic. Mark D Worthen PsyD (talk) [he/him] 19:12, 11 December 2022 (UTC)
thread_title:  Treatment-Resistant Depression ≠ Pseudo-Resistance to depression. 

message: Not yet fit for inclusion, but this research is very interesting: BH4 deficiency and cerebral folate deficiency found in some patients with TRD in a replication study by Lisa Pan et al: PMID 36330595. Cheers, --CopperKettle (talk) 05:21, 9 December 2022 (UTC)
replies: text: I agree that's fascinating research and consistent with the modest efficacy of treatment augmentation with L-methylfolate (levomefolic acid). Mark D Worthen PsyD (talk) [he/him] 19:25, 11 December 2022 (UTC)
thread_title:  Very interesting research; thus far no secondary sources 

message: In this edit (diff), I changed a sentence from: "Inadequate response has traditionally been defined as no clinical response whatsoever (e.g. no improvement in depressive symptoms). However, many clinicians consider a response inadequate if the person does not achieve full remission of symptoms" to: "Inadequate response has most commonly been defined as less than 50% reduction in depressive symptoms following treatment with at least one antidepressant medication, although definitions vary widely." The previous sentence lacked a page number in the 2010 reference, and is not valid when reads contemporary reliable sources such as the now-cited 2022 reference. Mark D Worthen PsyD (talk) [he/him] 19:31, 11 December 2022 (UTC)
replies: text: More edits (diff), explained in the edit summaries. I used one reliable source twice in the lead section, which is not ideal, so additional reliable sources should be added as we can. The epidemiological section lacked a reference. It's an important section when we can develop it. // Note that psychiatric disorders are medical disorders. If we write something like, "medical conditions and psychiatric disorders" we perpetuate mind-body dualism. // Keep in mind that "treatment-resistant depression" is not a condition, or stated a bit differently, it is not a depression subtype. Mark D Worthen PsyD (talk) [he/him] 20:12, 11 December 2022 (UTC)
thread_title:  Lead section improvements