Major depressive disorder refractory

Thus, although few controlled studies have been performed in well-characterized treatment-resistant populations, further studies using these techniques would prove useful in determining the role of these interventions in the treatment of refractory major depressive disorder. 

A classical augmentation strategy for treatment-refractory depression Specifically, may be useful for treatment of cognitive dysfunction and fatigue as residual symptoms of major depressive disorder unresponsive to multiple prior treatments... 

Well accepted for use in schizophrenia and bipolar disorder, including difficult cases Documented utility in treatment-refractory cases, especially at higher doses Documented efficacy as augmenting agent to SSRIs (especially fluoxetine) in nonpsychotic treatment-resistant major depressive disorder Documented efficacy in bipolar depression, especially in combination with fluoxetine... 

Electroconvulsive therapy (ECT) is probably the most effective treatment for major depressive disorder (MDD) with psychotic features, with average response rates of 70-90%, compared with only about 40% for regular antidepressant medications. The response rates for MDD without psychosis are comparable between regular medications and ECT (about 70-75%). ECT is usually given to patients whose condition is refractory to or who are intolerant of antidepressant medication. 

Electroconvulsive therapy remains the gold standard for the treatment of major depression and a variety of other psychiatric and neurologic disorders (97). Because of the effectiveness and resurgence of ECT, more patients are considered to be good candidates for this treatment option. Overall, these patients are medication refractory and elderly and, thus, are more sensitive to polypharmacy. Additionally, these patients tend to have more coexisting medical problems. 

Kelly TF, Lieberman DZ. Long term augmentation with T3 in refractory major depression. J Affect Disord 2009 115 (1-2) 230-3. 

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