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We do not have one agreed-upon definition of TRD. We also do not have agreement on different “stages” of TRD.
I can give you my opinion of what TRD should mean, but if the definition is not widely agreed on, it is best that we SPECIFY what treatments the depression has not responded to.
Probably, we can’t have one clear-cut definition of TRD. Instead, we may use the various definitions of different “stages” of TRD.
Stage 1: “Failure” of two adequate trials of antidepressants or psychotherapy from different classes (either in combination or succession) in the current episode (Conway et al., 2017).
Stage 2: “Failure” of three adequate trials of antidepressants or psychotherapy from different classes (either in combination or succession) in the current episode (Conway et al., 2017).
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