[Management of treatment-resistant depression (author's transl)]

Abstract

An intensive course of drug treatment--combination of a major tranquilliser with two antidepressants--was used in 46 patients with endogenous depression and 31 with exhaustion depression, all of which had proved refractory to other forms of treatment. After one week intramuscular injection of the major tranquilliser, in order to relax the patient, intravenous infusion of the two antidepressants, clomipramine and maprotiline, was performed daily for 10-20 days, while the major tranquilliser was given orally during this period. Complete remission after 4-6 weeks was achieved in 70% of patients with endogenous depression and 48% with exhaustive depression. It is stressed that careful diagnosis and treatment by drug and psychotherapy are preconditions for the successful management of otherwise resistant depressions.