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Birmingham, UK – A new study published in the British Journal of Psychiatry has revealed that almost half of patients diagnosed with depression could be classified as having treatment-resistant depression (TRD), meaning they do not respond to multiple antidepressant medications.
The research, conducted by academics from the University of Birmingham and Birmingham and Solihull Mental Health NHS Foundation Trust, analyzed electronic health records and conducted patient interviews. The findings indicate that 48% of patients with a depression diagnosis had tried at least two different antidepressants, while 37% had tried four or more.
TRD is typically defined as depression that fails to respond effectively after a patient has tried two separate antidepressant treatments. The study highlights the lack of clear guidelines for managing this condition.
Patient interviews revealed a pervasive “sense of hopelessness” among those struggling with TRD, with many expressing frustration over the “one size fits all” approach to treatment.
“This paper highlights how widespread treatment-resistant depression is among those who are diagnosed with depression,” said Kiranpreet Gill, Ph.D. researcher from the School of Psychology at the University of Birmingham and the study’s corresponding author. “With nearly half of all patients not responding to multiple drug options, we need better treatment options to be able to support patients for whom first-line antidepressant medications don’t make a difference.”
The study also found that patients with TRD have a significantly higher risk of developing other psychiatric disorders, such as anxiety and personality disorders, as well as physical health issues like cardiovascular disease. Data analysis indicated a 35% higher odds of personality disorder and a 46% higher odds of cardiovascular disease in this patient group.
Professor Steven Marwaha, Clinical Professorial Fellow at the Institute for Mental Health at the University of Birmingham and co-author of the study, emphasized the need for improved care pathways. “This study is important as the data demonstrates people with TRD are at a higher risk of a range of poorer outcomes, and that we need better defined care pathways for helping this population, and are in urgent need of developing and testing new treatments for this group.”
The research is part of the Mental Health Mission Midlands Translational Center, which aims to improve treatments for TRD, particularly in young, diverse, and underserved populations. The center focuses on accelerating the development and delivery of evidence-based interventions to reduce disparities in mental health care.
The study’s authors stress the urgent need for increased awareness and improved treatment options for those with TRD, recognizing the detrimental impact of treatment failure on patients’ mental well-being.
More information: Kiranpreet Gill et al, Examining the needs, outcomes and current treatment pathways of 2461 people with treatment-resistant depression: mixed-methods study, The British Journal of Psychiatry (2025). DOI: 10.1192/bjp.2024.275
Journal information: British Journal of Psychiatry
Disclaimer: This article is based on the provided study and is intended for informational purposes only. It does not constitute medical advice. Individuals experiencing symptoms of depression should consult with a qualified healthcare professional for diagnosis and treatment. Mental health conditions are complex, and treatment outcomes can vary. The information presented here should not replace professional medical guidance.
