Treatment of resistant depression is -

Ans. is 'a' i.e., ECT Treatment of depression1) Drugs : - The treatment of major depression usually requires starting pharmacotherapy with antidepressants. Antidepressants are : -i) Tricyclic antidepressants (TCAs) : - Imipramine, Amitriptyline, Trimipramine, Clomipramine, Desipramine, Nortriptyline, Amoxapine, Reboxetine.ii) SSRI (selective serotonin reuptake inhibitors) : - Fluoxetine, Paroxetine, sertaline, Citalopram, Escitalopram. These drugs devoid of side effects seen with TCAs and are safe in elderly.iii) Atypical antidepressants : - Trazodone, Mianserine, Mitrazapine, Venlafaxine, Duloxetine, Tianeptine, Amineptine, Bupropion.Not all patient recover completely after treatment; about 25% cases are refractory to treatment. Recurrence rate is 50% after 1st episode and 90%after 3rd episode.2) ECT (Electroconvulsive therapy) : - Indications of ECT in depression are : -i) Suicidal risk (AIIMS 01,00, AI 94, MAHE 01)ii) Depression with psychotic featureiii) Resistant depressioniv) Severe agitated or stuporous depression with lack of self care.3) Psychotherapy : - Supportive psychotherapy, connitive behavioral psychotherapy.