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. 2019 Aug 28;19(1):262.
doi: 10.1186/s12888-019-2237-x.

Clinical guidelines for the management of treatment-resistant depression: French recommendations from experts, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental

D Bennabi  1   2 , T Charpeaud  3 , A Yrondi  4 , J-B Genty  5 , S Destouches  5 , S Lancrenon  5 , N Alaïli  6 , F Bellivier  6 , T Bougerol  7 , V Camus  8 , J-M Dorey  9   10   11 , O Doumy  12 , F Haesebaert  13 , J Holtzmann  7 , C Lançon  14 , M Lefebvre  13 , F Moliere  15 , I Nieto  6 , C Rabu  16 , R Richieri  14 , L Schmitt  4 , F Stephan  17 , G Vaiva  18 , M Walter  17 , M Leboyer  16 , W El-Hage  8 , P-M Llorca  3 , P Courtet  15 , B Aouizerate  9   10   11 , E Haffen  19
Affiliations

Clinical guidelines for the management of treatment-resistant depression: French recommendations from experts, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental

D Bennabi et al. BMC Psychiatry. .

Abstract

Background: Clear guidance for successive antidepressant pharmacological treatments for non-responders in major depression is not well established.

Method: Based on the RAND/UCLA Appropriateness Method, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental developed expert consensus guidelines for the management of treatment-resistant depression. The expert guidelines combine scientific evidence and expert clinicians' opinions to produce recommendations for treatment-resistant depression. A written survey comprising 118 questions related to highly-detailed clinical presentations was completed on a risk-benefit scale ranging from 0 to 9 by 36 psychiatrist experts in the field of major depression and its treatments. Key-recommendations are provided by the scientific committee after data analysis and interpretation of the results of the survey.

Results: The scope of these guidelines encompasses the assessment of pharmacological resistance and situations at risk of resistance, as well as the pharmacological and psychological strategies in major depression.

Conclusion: The expert consensus guidelines will contribute to facilitate treatment decisions for clinicians involved in the daily assessment and management of treatment-resistant depression across a number of common and complex clinical situations.

Keywords: Antidepressants; Expert consensus guidelines; Major depressive disorder; Pharmacotherapy; Treatment resistant depression.

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Conflict of interest statement

No financial support was received for this study and there are no potential conflicts of interest to declare. Regarding financial support unrelated to the present article, we disclose that N. Alaïli has benefited from financial support for conferences and has been scientific responsible and experimenter for preclinical studies from Servier laboratories.

B. Aouizerate has perceived honoraria to communicate at conferences from Laboratories AstraZeneca, Lundbeck and Janssen. V. Camus has benefited from honoraria and financial support for conferences from Laboratories Otsuka, Novartis, Lundbeck, Servier, Janssen and has been experimenter for studies from Janssen and Lilly.

T. Charpeaud has benefited from honoraria and financial support for conferences from Laboratories AstraZeneca, Janssen and Lundbeck and has been experimenter for studies from Janssen. P. Courtet has benefited from honoraria and financial support for conferences, training action and for participation in experts groups from Servier and Janssen. O. Doumy has benefited from honoraria and financial support for conferences from Lilly, AstraZeneca, Servier, Lundbeck and Janssen. JM. Dorey has benefited from honoraria for conferences from Lundbeck. W. El-Hage has benefited from honoraria and financial support for conferences, training action and for participation in experts groups from Lundbeck, Janssen, and Otsuka.

F. Haesebaert has benefited from financial support for conferences, grant from BMS and AstraZeneca, training grant from Servier and a research grant from « Fonds de Recherche du Québec - Nature et Technologie (#200123) » and has been experimenter for studies from Janssen. E. Haffen has benefited from honoraria and financial support for conferences, training action and for participation in experts groups from AstraZeneca, BMS, Euthérapie u e Servier, Janssen, Livanova, Lundbeck, Otsuka and has been experimenter for studies from Janssen. J. Holtzmann has benefited from honoraria and financial support for conferences from Lundbeck, Servier has been experimenter for studies from Janssen. C. Lançon has benefited from honoraria and financial support for training action from Lundbeck. P.-M. Llorca has benefited from honoraria and financial support for conferences, training action and for participation in experts groups from Janssen, EISAI, Lundbeck, Otsuka, Allergan.

F. Moliere has benefited from honoraria for conferences from Lundbeck, Otsuka. G. Vaiva has benefited from honoraria and financial support for conferences, training action and for participation in experts groups from Janssen and Otsuka. A. Yrondi has benefited from honoraria and financial support for conferences from Lundbeck, Janssen, AstraZeneca; for participation in experts groups from Lundbeck and has participated in reseach studies from Lundbeck.

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