D-10 Refractory depression
Tuesday November 28, 2017 from 10:30 to 11:30

Fiore Lalla, Canada

Medical Director

Psychiatric Services West of Montreal


In order to avoid reistnace, one must have a measure of:

•Compliance measurement or repeated questioning (25% of resistant depression due to this)
•Comorbid drugs, THC, alcohol use: even 2-3 drinks/weekly can create resistance
•Comprehensive labs: including iron studies, testosterone, a.m. cortisol, ferritin, transferrin binding, thyroid studies, and the regular culprits
•Rule out bipolar illness
•Rule out borderline, dependent, and narcissistic personalities
•Role of stress, work problems, secondary gain
•Comorbid diagnoses, especially generalized anxiety disorder
•The use of low dose benzos and/or sleep agents temporarily early on appears to effectively combat much resistance and aid compliance
•Vital role for atypicals as augmentation strategies


As a result of attending this session, participants will be able to:

•Define risk and evaluation factors in psychiatric resistance
•Review the canadian guidelines (CANMAT) in pharmacologically dealing with treatment resistance
•To know which modalities of intervention are more effective
•Review the new modalities, some controversial, in dealing with refractory illness
•Review the risk/benefit factors in augmentation and switching strategies

Recommended Reading Uploads

Lectures by Fiore Lalla

When Session Talk Title Room
10:30 - 11:30
Workshops - D Refractory depression Pointe-aux-Trembles
11:40 - 12:40
Workshops - E Disability at work Fundy

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