Psychiatr. praxi. 2025;26(2):83-86 | DOI: 10.36290/psy.2025.015

Treatment of pharmacoresistant states in psychiatry. Part 2: Treatment-resistant depression

prof. MUDr. Eva Češková, CSc.
Psychiatrická klinika LF MU a FN Brno
KPN LF Ostravská univerzita
Odd. psychiatrie FN Ostrava

The paper is focused on pharmacotherapy of treatment-resistant depression and presents the treatment possibilities, e.g. switch to another antidepressant, augmentation and combination of antidepressants. In more details the augmentation with the first (ketamine, esketamine) and the second generation (esmethadone) of uncompetitive NMDA receptors antagonists, so called rapid acting antidepressants is described. Further, there are mentioned some substances used before psychopharmacological era (opioids, psilocybin) and alternative approaches (nutraceuticals, probiotics), which have certain potential to reduce severe depressive symptoms.

Keywords: treatment-resistant depression, switch of antidepressants, augmentation, combination of antidepressants, antagonists of NMDA receptors, psilocybin, opioids, nutraceuticals.

Accepted: June 9, 2025; Published: July 4, 2025  Show citation

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Češková E. Treatment of pharmacoresistant states in psychiatry. Part 2: Treatment-resistant depression. Psychiatr. praxi. 2025;26(2):83-86. doi: 10.36290/psy.2025.015.
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