european psychiatric association

Evidence-Based Diagnosis and Treatment of Treatment-Resistant Depression – Update and Preview

A webinar by the EPA Section on Psychopharmacology

Major depressive disorder (MDD) affects over 300 million people worldwide. The so-called treatment-resistant depression (TRD) represents a subgroup of this condition, but inconsistent international definitions make it difficult to estimate its exact prevalence.

TRD is not always identified in a timely manner and is often mistakenly attributed to psychosocial factors. Hence, the initial exclusion of the so-called pseudo-resistance is of utmost importance. The EMA defines TRD as the lack of response to two or more consecutive antidepressants from the same or different substance classes, administered at a sufficient dose and for an adequate period of at least four weeks to adherent patients. Accordingly, about one-third of patients with MDD experiences resistance to traditional, predominantly monoaminergic antidepressants. The frequently associated increased mortality and disease burden, reflected in higher suicide rates and frequent comorbidities, underscore the need for timely, individualized, and evidence-based treatment.

In addition to conventional antidepressant psychopharmacotherapy including recommended augmentation and combination strategies, innovative pharmacological developments such as Esketamine nasal spray have already been used very effectively in the clinical routine. Due to its rapid and sustained antidepressant and also anti-suicidal effects, other promising substances targeting glutamatergic or GABAergic systems have increasingly been investigated. Experimental approaches with psychedelics still require further research and its scientifically rigorous interpretation.

While the well-researched electroconvulsive therapy remains the gold standard in the treatment of TRD, other neurostimulation techniques, such as repetitive transcranial magnetic stimulation, vagus nerve stimulation, or deep brain stimulation, can also be individually considered within the treatment algorithm for MDD and TRD.

This webinar will enable the attendees to gain knowledge on the evidence-based diagnostics and treatment of the so-called TRD. Besides the introduction of the clinical phenotype of TRD, a detailed information will be provided for the approved as well as experimental pharmacological and non-pharmacological treatment strategies, as well as their best possibly effective and safe use in TRD according to the recommended therapeutic algorithms.

Registrations are open!

Moderators:

  • Lucie Bartova, Secretary of the EPA Section on Psychopharmacology, Department of Psychiatry and Psychotherapy; Comprehensive Center for Clinical Neurosciences and Mental Health at the Medical University of Vienna, Vienna, Austria
  • Siegfried Kasper, Department of Psychiatry and Psychotherapy; Comprehensive Center for Clinical Neurosciences and Mental Health; Center for Brain Research at the Medical University of Vienna, Vienna, Austria

Speakers:

  • Georg Kranz, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong; Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health at the Medical University of Vienna, Vienna, Austria
  • Pia Baldinger-Melich, Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health at the Medical University of Vienna, Vienna, Austria
  • Christoph Kraus, Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health at the Medical University of Vienna, Vienna, Austria

Webinar details

Title: Evidence-Based Diagnosis and Treatment of Treatment-Resistant Depression – Update and Preview
Date: Monday 27 October 2025
Provisional time: 16:00 – 18:00 CET

PROVISIONAL Programme:

16:00–16:05 | Lucie Bartova – Welcome and Introduction
16:05–16:10 | Sigfried Kasper – Context and Introduction of Speakers
16:10–16:30| Georg Kranz – Presentation (title TBC)
16:30–16:40| Q&A and Discussion
16:40–17:00 | Pia Baldinger-Melich – Presentation (title TBC)
17:00–17:`0| Q&A and Discussion
17:10–17:30| Christoph Kraus – Presentation (title TBC)
17:30–17:45| Q&A and Discussion
17:45– 18:00 | Lucie Bartova & Sigfried Kasper – Wrap-up and conclusions