[French Society for Biological Psychiatry and Neuropsychopharmacology and Fondation FondaMental task force: Formal Consensus for the management of treatment-resistant depression].
L'Encéphale. 2017-09-01; 43(4): S1-S24
DOI: 10.1016/s0013-7006(17)30155-0
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1. Encephale. 2017 Sep;43(4S):S1-S24. doi: 10.1016/S0013-7006(17)30155-0.
[French Society for Biological Psychiatry and Neuropsychopharmacology and
Fondation FondaMental task force: Formal Consensus for the management of
treatment-resistant depression].
[Article in French]
Charpeaud T(1), Genty JB(2), Destouches S(3), Yrondi A(4), Lancrenon S(3),
Alaïli N(5), Bellivier F(5), Bennabi D(6), Bougerol T(7), Camus V(8), D’amato
T(9), Doumy O(10), Haesebaert F(9), Holtzmann J(7), Lançon C(11), Lefebvre M(9),
Moliere F(12), Nieto I(5), Richieri R(9), Schmitt L(4), Stephan F(13), Vaiva
G(14), Walter M(13), Leboyer M(15), El-Hage W(8), Haffen E(6), Llorca PM(2),
Courtet P(12), Aouizerate B(10).
Author information:
(1)CHU de Clermont-Ferrand, centre expert dépression résistante FondaMental,
service de psychiatrie de l’adulte B, 63003 Clermont-Ferrand, France. Electronic
address: .
(2)CHU de Clermont-Ferrand, centre expert dépression résistante FondaMental,
service de psychiatrie de l’adulte B, 63003 Clermont-Ferrand, France.
(3)SYLIA-STAT, 10, boulevard du Maréchal-Joffre, 92340 Bourg-la-Reine, France.
(4)CHRU de Toulouse, hôpital Purpan, centre expert dépression résistante
FondaMental, service de psychiatrie de l’adulte, 31059 Toulouse, France.
(5)Hôpital Fernand-Widal, centre expert dépression résistante FondaMental,
service de psychiatrie adulte, 75010 Paris, France.
(6)CHU de Besançon, centre expert dépression résistante FondaMental, service de
psychiatrie de l’adulte, 25030 Besançon Cedex, France.
(7)CHU de Grenoble, hôpital nord, centre expert dépression résistante
FondaMental, service de psychiatrie de l’adulte, CS 10217, 38043 Grenoble Cedex
9, France.
(8)CHU de Tours, clinique psychiatrique universitaire, centre expert dépression
résistante FondaMental, 37044 Tours Cedex 9, France.
(9)Centre hospitalier Le Vinatier, centre expert dépression résistante
FondaMental, service universitaire de psychiatrie adulte, BP 300 39, 69678 Bron
Cedex, France.
(10)CH Charles-Perrens, pôle de psychiatrie générale et universitaire, centre
expert dépression résistante FondaMental, 33076 Bordeaux Cedex, France.
(11)CHU La Conception, pôle psychiatrie centre, centre expert dépression
résistante FondaMental, 13005 Marseille, France.
(12)CHRU Lapeyronie, centre expert dépression résistante FondaMental,
département des urgences et post-urgences psychiatriques, 34295 Montpellier
Cedex 5, France.
(13)CHU de Brest, hôpital de Bohars, centre expert dépression résistante
FondaMental, service de psychiatrie de l’adulte, 29820 Bohars, France.
(14)CHRU de Lille, hôpital Fontan 1, centre expert dépression résistante
FondaMental, service de psychiatrie adulte, 59037 Lille Cedex, France.
(15)Hôpital Chenevier-Henri-Mondor, pôle de psychiatrie des hôpitaux
universitaires, centre expert dépression résistante FondaMental, 94000 Créteil,
France.
Major depression represents among the most frequent psychiatric disorders in the
general population with an estimated lifetime prevalence of 16-17%. It is
characterized by high levels of comorbidities with other psychiatric conditions
or somatic diseases as well as a recurrent or chronic course in 50 to 80% of the
cases leading to negative repercussions on the daily functioning, with an
impaired quality of life, and to severe direct/indirect costs. Large cohort
studies have supported that failure of a first-line antidepressant treatment is
observed in more than 60% of patients. In this case, several treatment
strategies have been proposed by classical evidence-based guidelines from
internationally recognized scientific societies, referring primarily on: I) the
switch to another antidepressant of the same or different class; II) the
combination with another antidepressant of complementary pharmacological
profile; III) the addition of a wide range of pharmacological agents intending
to potentiate the therapeutic effects of the ongoing antidepressant medication;
IV) the association with appropriate psychological therapies; and, V) the use of
non-invasive brain stimulation techniques. However, although based on the most
recently available data and rigorous methodology, standard guidelines have the
significant disadvantage of not covering a large variety of clinical conditions,
while currently observed in everyday clinical practice. From these
considerations, formalized recommendations by a large panel of French experts in
the management of depressed patients have been developed under the shared
sponsorship of the French Association of Biological Psychiatry and
Neuropsychopharmacology (AFPBN) and the Fondation FondaMental. These French
recommendations are presented in this special issue in order to provide relevant
information about the treatment choices to make, depending particularly on the
clinical response to previous treatment lines or the complexity of clinical
situations (clinical features, specific populations, psychiatric comorbidities,
etc.). Thus, the present approach will be especially helpful for the clinicians
enabling to substantially facilitate and guide their clinical decision when
confronted to difficult-to-treat forms of major depression in the daily clinical
practice. This will be expected to significantly improve the poor prognosis of
the treatment-resistant depression thereby lowering the clinical, functional and
costly impact owing directly to the disease.
© 2017 L’Encéphale, Paris.
DOI: 10.1016/S0013-7006(17)30155-0
PMID: 28822460 [Indexed for MEDLINE]