Treatment-Resistant Depression: An Interview with Dr. Prakash Masand

prakash_masand_treatment_resistant_depressionIn this audio interview we discuss with Dr. Prakash Masand the pharmacological management of treatment-resistant depression.

Prakash Masand, M.D., is Founder, Chairman, and CEO of Global Medical Education (GME). Dr. Masand was also Consulting Professor of Psychiatry and Behavioral Sciences at Duke University Medical Center in Durham, NC. He previously served as Director of Therapeutic Area Development, Neurosciences Medicine at the Duke Clinical Research Institute.

His work has been published in peer-reviewed journals including The New England Journal of Medicine, American Journal of Psychiatry, Journal of Clinical Psychiatry, and Journal of Clinical Psychopharmacology. Dr. Masand serves on the editorial boards of the Primary Care Companion to the Journal of Clinical Psychiatry, Annals of Clinical Psychiatry, Current Clinical Pharmacology, and The Open Pharmacology Journal.


We discussed the following topics:

  • Definitions of treatment-resistant depression.
  • The concept of pseudoresistance in treatment-resistant depression: some considerations to keep in mind before labeling a patient as “treatment-resistant”.
  • The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study:
    • Its strenghts and weaknesses
    • Its implications for clinical practice
  • When to switch or augment antidepressants.
  • Evidence base for augmentation strategies: second generation antipsychotics, lithium, T3, lisdexamfetamine, modafinil, methylphenidate, folate and CBT.
  • How long should augmentation therapy be continued in MDD after remission.
  • When to use MAOIs.

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How long should augmentation therapy be continued in MDD after remission?:

Thase – Rush criteria for treatment-resistant depression:

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