ESTRATEGIA COMUNITARIA PARA LA DEPRESIÓN RESISTENTE AL TRATAMIENTO FARMACOLÓGICO: REVISIÓN BIBLIOGRÁFICA

Abstract

Introduction: Treatment-resistant depression is a serious disorder that does not respond to several antidepressants, affecting quality of life and increasing the risk of suicide. Studies have been conducted with the use of ketamine and esketamine. Multidisciplinary management is required, combining pharmacological, psychological, and electroconvulsive approaches. Objective: To determine a comprehensive community strategy that provides support and effective treatment for people with depression who are resistant to pharmacological treatment. Methods: A literature review was conducted in PubMed, Cochrane, Science Direct, and Elsevier using the terms "depression," "resistance," "treatment," "psychotherapy," and "pharmacotherapy." Of 100 articles published between 2019 and 2024, 22 relevant articles on current therapeutic options for treatment-resistant depression were selected, using DeCS/MeSH terms such as "Treatment-resistant depression," "medicine," "drugs," and "psychotherapy." Results: Treatment-resistant depression is defined as a lack of response to two or more antidepressant treatments. It affects up to 30% of patients with major depression. The lack of a precise definition hampers research, the development of new therapies, and clinical treatment. Treatment strategies include combinations of antidepressants, esketamine, brain stimulation therapies, psychotherapy, and multidisciplinary approaches. Conclusions: Treatment-resistant depression negatively impacts quality of life and carries a high risk of suicide. It is associated with sociodemographic factors and comorbidities, and its management requires a multidisciplinary approach that includes pharmacotherapy, psychotherapy, and neurostimulation. Community support plays a fundamental role.