Advertisement

Complementary and Alternative Therapies for Treatment-Resistant Depression: A Clinical Perspective

  • Rosalia Sun Young Yoon
  • Nisha Ravindran
  • Arun Ravindran
Chapter

Abstract

Complementary and alternative medicine (CAM) therapies are a group of diverse medical and health systems, practices, and products not currently considered to be part of conventional medicine. These therapies are growing in popularity, with approximately 50% of patients with depressive disorders reported to use some form of alternative treatment. Often perceived as natural and safer alternatives without many of the adverse effects commonly associated with pharmacotherapy, CAM therapies have great potential in the management of treatment-resistant depression (TRD). Many CAM therapies work via mechanisms other than those of antidepressant medications and, as such, may be viable options for patients who have failed to achieve remission with pharmacotherapy and for those who cannot adhere to medications due to intolerable adverse effects. Moreover, augmentation of pharmacotherapy with CAMs can be a practical option for partial responders for whom antidepressant medication doses cannot be increased due to issues of safety and tolerability. However, the evidence on efficacy and safety of different CAM interventions in TRD is limited. The aim of this chapter is to present the available evidence on CAM therapies for TRD, to serve as a guide for the clinician to tailor an alternate therapeutic approach for patients with treatment resistance. Based on the available data on efficacy, safety, and practicality, the most robust evidence is for exercise, mindfulness-based cognitive therapy, and omega-3 fatty acids as adjunctive treatments. There is less evidence on efficacy of yoga, light therapy, and S-adenosyl-L-methionine. Despite current limitations in the availability of studies in TRD, there is a growing body of evidence in support of specific CAMs in TRD, indicating therapeutic potential. As such, CAM therapies as add-on to evidence-based first-line interventions may be considered as part of an integrative approach to the management of treatment resistance.

Keywords

Treatment-resistant depression (TRD) Complementary and alternative medicine (CAM) Mechanism of action Efficacy Safety 

References

  1. 1.
    Alpert JE, Papakostas G, Mischoulon D, et al. S-adenosyl-L-methionine (SAMe) as an adjunct for resistant major depressive disorder: an open trial following partial or nonresponse to selective serotonin reuptake inhibitors or venlafaxine. J Clin Psychopharmacol. 2004;24:661–4.PubMedCrossRefGoogle Scholar
  2. 2.
    Appleton KM, Hayward RC, Gunnell D, et al. Effects of n-3 long-chain polyunsaturated fatty acids on depressed mood: systematic review of published trials. Am J Clin Nutr. 2006;84:1308–16.PubMedCrossRefGoogle Scholar
  3. 3.
    Appleton KM, Sallis HM, Perry R, et al. Omega-3 fatty acids for depression in adults. Cochrane Database Syst Rev. 2015;11:CD004692.Google Scholar
  4. 4.
    Baldessarini RJ. The neuropharmacology of S-adenosyl-L-methionine. Am J Med. 1987;83:95–103.PubMedCrossRefGoogle Scholar
  5. 5.
    Bauer M, Forsthoff A, Baethge C, et al. Lithium augmentation therapy in refractory depression-update 2002. Eur Arch Psychiatry Clin Neurosci. 2003;253:132–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Benedetti F, Colombo C. Sleep deprivation in mood disorders. Neuropsychobiology. 2011;64:141–51.PubMedCrossRefGoogle Scholar
  7. 7.
    Bloch MH, Hannestad J. Omega-3 fatty acids for the treatment of depression: systematic review and meta-analysis. Mol Psychiatry. 2012;17:1272–82.PubMedCrossRefGoogle Scholar
  8. 8.
    Bressa GM. S-adenosyl-L-methionine (SAMe) as antidepressant: meta-analysis of clinical studies. Acta Neurol Scand Suppl. 1994;154:7–14.PubMedCrossRefGoogle Scholar
  9. 9.
    Brook OH, van Hout HP, Stalman WA, de Haan M. Nontricyclic antidepressants: predictors of nonadherence. J Clin Psychopharmacol. 2006;26:643–7.PubMedGoogle Scholar
  10. 10.
    Butler LD, Waelde LC, Hastings TA, et al. Meditation with yoga, group therapy with hypnosis, and psychoeducation for long-term depressed mood: a randomized pilot trial. J Clin Psychol. 2008;64:806–20.PubMedCrossRefGoogle Scholar
  11. 11.
    Cano M, Cardoner N, Urretavizcaya M, et al. Modulation of limbic and prefrontal connectivity by electroconvulsive therapy in treatment-resistant depression: a preliminary study. Brain Stimul. 2016;9:65–71.PubMedCrossRefGoogle Scholar
  12. 12.
    Carpenter DJ. St John’s wort and S-adenosyl methionine as “natural” alternatives to conventional antidepressants in the era of suicidality boxed warning: what is the evidence for clinically relevant benefit? Altern Med Rev. 2011;16:17–39.PubMedGoogle Scholar
  13. 13.
    Chiesa A, Serretti A. Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Res. 2011;187:441–53.PubMedCrossRefGoogle Scholar
  14. 14.
    Chiesa A, Castagner V, Adrisano C, et al. Mindfulness-based cognitive therapy vs. psycho-education for patients with major depression who did not achieve remission following antidepressant treatment. Psychiatry Res. 2015;226:474–83.PubMedCrossRefGoogle Scholar
  15. 15.
    Chojnacka M, Antosik-Wójcińska AZ, Dominiak M, et al. A sham-controlled randomized trial of adjunctive light therapy for non-seasonal depression. J Affect Disord. 2016;203:1–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Cladder-Micus MB, Vrijsen JN, Becker ES, et al. A randomized controlled trial of mindfulness-based cognitive therapy (MBCT) versus treatment-as-usual (TAU) for chronic, treatment-resistant depression: study protocol. BMC Psychiatry. 2015;15:275.PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Cooney GM, Dwan K, Greig CA, et al. Exercise for depression. Cochrane Database Syst Rev. 2013;12:CD004366.Google Scholar
  18. 18.
    Cramer H, Lauche R, Langhorst J, Dobos G. Yoga for depression: a systematic review and meta-analysis. Depress Anxiety. 2013;30:1068–83.PubMedCrossRefGoogle Scholar
  19. 19.
    Cramer H, Anheyer D, Lauche R, Dobos G. A systematic review of yoga for major depressive disorder. J Affect Disord. 2017;213:70–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Dallaspezia S, Benedetti F. Chronobiological therapy for mood disorders. Expert Rev Neurother. 2011;11:961–70.PubMedCrossRefGoogle Scholar
  21. 21.
    Dawson R, Lavori PW, Coryell WH, et al. Course of treatment received by depressed patients. J Psychiatr Res. 1999;33:233–42.PubMedCrossRefGoogle Scholar
  22. 22.
    De Berardis D, Orsolini L, Serroni N, et al. A comprehensive review on the efficacy of S-adenosyl-L-methionine in major depressive disorder. CNS Neurol Disord Drug Targets. 2016;15:35–44.PubMedCrossRefGoogle Scholar
  23. 23.
    Delion S, Chalon S, Herault J, et al. Chronic dietary alpha-linolenic acid deficiency alters dopaminergic and seronotonergic neurotransmission in rats. J Nutr. 1994;124:2466–75.PubMedCrossRefGoogle Scholar
  24. 24.
    Delion S, Chalon S, Guilloteau D, et al. Alpha-linolenic acid deficiency alters age-related changes of dopaminergic and serotonergic neurotransmission in the rat frontal cortex. J Neurochem. 1996;66:1582–91.PubMedCrossRefGoogle Scholar
  25. 25.
    Desai R, Tailor A, Bhatt T. Effects of yoga on brain waves and structural activation: a review. Complement Ther Clin Pract. 2015;21:112–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Echizenya M, Suda H, Takeshima M, et al. Total sleep deprivation followed by sleep phase advance and bright light therapy in drug-resistant mood disorders. J Affect Disord. 2013;144:28–33.PubMedCrossRefGoogle Scholar
  27. 27.
    Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA. 1998;280:1569–75.PubMedCrossRefGoogle Scholar
  28. 28.
    Eisendrath SJ, Delucchi K, Bitner R, et al. Mindfulness-based cognitive therapy for treatment-resistant depression: a pilot study. Psychother Psychosom. 2008;77:319–20.PubMedCrossRefGoogle Scholar
  29. 29.
    Eisendrath SJ, Gillung E, Delucchi KL, et al. A randomized controlled trial of mindfulness-based cognitive therapy for treatment-resistant depression. Psychother Psychosom. 2016;85:99–110.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Fava M, Rush AJ, Wisniewski SR, et al. A comparison of mirtazapine and nortriptyline following two consecutive failed medication treatments for depressed outpatients: a STAR*D report. Am J Psychiatry. 2006;163:1161–72.PubMedCrossRefGoogle Scholar
  31. 31.
    Freeman MP, Hibbeln JR, Wisner KL, et al. Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. J Clin Psychiatry. 2006;67:1954–67.PubMedCrossRefGoogle Scholar
  32. 32.
    Galper DI, Trivedi MH, Barlow CE, et al. Inverse association between physical inactivity and mental health in men and women. Med Sci Sports Exerc. 2006;38:173–8.PubMedCrossRefGoogle Scholar
  33. 33.
    Gaynes BN, Dusetzina SB, Ellis AR, et al. Treating depression after initial treatment failure: directly comparing switch and augmenting strategies in STAR*D. J Clin Psychopharmacol. 2012;32:114–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Giedke H, Klingberg S, Schwarzler F, Schweinberg M. Direct comparison of total sleep deprivation and late partial sleep deprivation in the treatment of major depression. J Affect Disord. 2003;76:85–93.PubMedCrossRefGoogle Scholar
  35. 35.
    Golden RN, Gaynes BN, Ekstrom RD, et al. The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. Am J Psychiatry. 2005;162:656–62.PubMedCrossRefGoogle Scholar
  36. 36.
    Grosso G, Pajak A, Marventano S, et al. Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials. PLoS One. 2014;9:e96905.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Güzel Özdemir P, Boysan M, Smolensky MH, et al. Comparison of venlafaxine alone versus venlafaxine plus bright light therapy combination for severe major depressive disorder. J Clin Psychiatry. 2015;76Ñ:e645–54.CrossRefGoogle Scholar
  38. 38.
    Josefsson M, Lindwall M, Archer T. Physical exercise intervention in depressive disorders: meta-analysis and systematic review. Scand J Med Sci Sports. 2014;24:259–72.PubMedCrossRefGoogle Scholar
  39. 39.
    Hibbeln JR, Salem N Jr. Dietary polyunsaturated fatty acids and depression: when cholesterol does not satisfy. Am J Clin Nutr. 1995;62:1–9.PubMedCrossRefGoogle Scholar
  40. 40.
    Ho SC, Jacob SA, Tangiisuran B. Barriers and facilitators of adherence to antidepressants among outpatients with major depressive disorder: a qualitative study. PLoS One. 2017;12:e0179290.PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Höfer P, Schosser A, Calati R, et al. The impact of serotonin receptor 1A and 2A gene polymorphisms and interactions on suicide attempt and suicide risk in depressed patients with insufficient response to treatment—a European multicentre study. Int Clin Psychopharmacol. 2016;31:1–7.PubMedCrossRefGoogle Scholar
  42. 42.
    Kautto M, Kampman O, Mononon N, et al. Serotonin transporter (5-HTTLPR) and norepinephrine transporter (NET) gene polymorphisms: susceptibility and treatment response of electroconvulsive therapy in treatment resistant depression. Neurosci Lett. 2015;590:116–20.PubMedCrossRefGoogle Scholar
  43. 43.
    Kennedy SH, Lam RW, McIntyre RS, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: section 3. Pharmacological treatments. Can J Psychiatr. 2016;61:540–60.CrossRefGoogle Scholar
  44. 44.
    Kenny MA, Williams JMG. Treatment-resistant depressed patients show a good response to mindfulness-based cognitive therapy. Behav Res Ther. 2007;45:617–25.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Khoury B, Lecomte T, Fortin G, et al. Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev. 2013;33:763–71.PubMedCrossRefGoogle Scholar
  46. 46.
    Knubben K, Reischies FM, Adli M, et al. A randomized, controlled study on the effects of short-term endurance training programme in patients with major depression. Br J Sports Med. 2007;41:29–33.PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Lam RW, Levitt AJ, Levitan RD, et al. The Can-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder. Am J Psychiatry. 2006;163:805–12.PubMedCrossRefGoogle Scholar
  48. 48.
    Levkovitz Y, Alpert JE, Brintz CE, et al. Effects of S-adenosylmethionine augmentation of serotonin-reuptake inhibitor antidepressants on cognitive symptoms of major depressive disorder. J Affect Disord. 2012;136:1174–8.PubMedCrossRefGoogle Scholar
  49. 49.
    Lin PY, Su KP. A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids. J Clin Psychiatry. 2007;68:1056–61.PubMedCrossRefGoogle Scholar
  50. 50.
    Lam RW, Levitt AJ, Levitan RD, et al. Efficacy of bright light treatment, fluoxetine, and the combination in patients with nonseasonal major depressive disorder – a randomized clinical trial. JAMA Psychiat. 2016;73:56–63.CrossRefGoogle Scholar
  51. 51.
    Malhi GS, Byrow Y. Is treatment-resistant depression a useful concept? Evid Based Ment Health. 2016;19:1–3.PubMedCrossRefGoogle Scholar
  52. 52.
    Mårtensson B, Pettersson A, Berglund L, et al. Bright white light therapy in depression: a critical review of the evidence. J Affect Disord. 2015;182:1–7.PubMedCrossRefGoogle Scholar
  53. 53.
    Martiny K, Refsgaard E, Lund V, et al. A 9-week randomized trial comparing a chronotherapeutic intervention (wake and light therapy) to exercise in major depressive disorder patients treated with duloxetine. J Clin Psychiatry. 2012;73:1234–42.PubMedCrossRefGoogle Scholar
  54. 54.
    Mather AS, Rodriguez C, Guthrie MF, et al. Effects of exercise on depressive symptoms in older adults with poorly responsive depressive disorder: randomized controlled trial. Br J Psychiatry. 2002;180:411–5.PubMedCrossRefGoogle Scholar
  55. 55.
    McIntyre RS, Filteau MJ, Martin L, et al. Treatment-resistant depression: definitions, review of the evidence, and algorithmic approach. J Affect Disord. 2014;156:1–7.PubMedCrossRefGoogle Scholar
  56. 56.
    McNamara RK, Strimpfel J, Jandacek R, et al. Detection and treatment of long-chain omega-3 fatty acid deficiency in adolescents with SSRI-resistant major depressive disorder. Pharma Nutrition. 2014;2:38–46.CrossRefGoogle Scholar
  57. 57.
    Miller IW, Keitner GI, Whisman MA, et al. Depressed patients with dysfunctional families: description and course of illness. J Abnorm Psychol. 1992;101:637–46.PubMedCrossRefGoogle Scholar
  58. 58.
    Mota-Pereira J, Silverio J, Carvalho S, et al. Moderate exercise improves depression parameters in treatment-resistant patients with major depressive disorder. J Psychiatr Res. 2011a;45:1005–11.PubMedCrossRefGoogle Scholar
  59. 59.
    Mota-Pereira J, Carvalho S, Silverio J, et al. Moderate physical exercise and quality of life in patients with treatment-resistant major depressive disorder. J Psychiatr Res. 2011b;45:1657–9.PubMedCrossRefGoogle Scholar
  60. 60.
    Mrazek DA, Hornberger JC, Altar CA, Degtiar I. A review of the clinical, economic, and societal burden of treatment-resistant depression: 1996-2003. Psychiatr Serv. 2014;65:977–87.PubMedCrossRefGoogle Scholar
  61. 61.
    National Center for Complementary and Alternative Medicine. 2002. What is complementary and alternative medicine? National Institutes of Health. Available at [http:nncam.nih.gov/health/whatiscam/#su1].
  62. 62.
    Nemeroff CB. Prevalence and management of treatment-resistant depression. J Clin Psychiatry. 2007;68:17–25.PubMedCrossRefGoogle Scholar
  63. 63.
    Nemets B, Stahl Z, Belmaker RH. Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. Am J Psychiatry. 2002;159:477–9.PubMedCrossRefGoogle Scholar
  64. 64.
    Niederhofer, Klitzing V. Bright light treatment as add-on therapy for depression in 28 adolescents: a randomized trial. Prim Care Companion CNS Disord. 2011;13:PCC.11m01194.PubMedPubMedCentralGoogle Scholar
  65. 65.
    Noaghiul S, Hibbeln JR. Cross-national comparisons od seafood consumption and rates of bipolar disorders. Am J Psychiatry. 2003;160:2222–7.PubMedCrossRefGoogle Scholar
  66. 66.
    Nyström MB, Neely G, Hassmén P, et al. Treating major depression with physical activity: a systematic overview with recommendations. Cogn Behav Ther. 2015;44:341–52.PubMedCrossRefGoogle Scholar
  67. 67.
    Oldham MA, Ciraulo DA. Bright light therapy for depression: a review of its effects on chronobiology and the autonomic nervous system. Chronobiol Int. 2014;31:305–19.PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Papakostas GI, Petersen TJ, Farabaugh AH, et al. Psychiatric comorbidity as a predictor of clinical response to nortriptyline in treatment-resistant major depressive disorder. J Clin Psychiatry. 2003;64:1357–61.PubMedCrossRefGoogle Scholar
  69. 69.
    Papakostas GI. Managing partial response or nonresponse: switching, augmentation, and combination strategies for major depressive disorder. J Clin Psychiatry. 2009a;70:16–25.PubMedCrossRefGoogle Scholar
  70. 70.
    Papakostas GI. The role of S-adenosyl methionine in the treatment of depression. J Clin Psychiatry. 2009b;70:18–22.PubMedCrossRefGoogle Scholar
  71. 71.
    Papakostas GI, Mischoulon D, Shyu I, et al. S-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for antidepressant nonresponders with major depressive disorder: a double-blind, randomized clinical trial. Am J Psychiatry. 2010;167:942–8.Google Scholar
  72. 72.
    Peet M, Horrobin DF. A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Arch Gen Psychiatry. 2002;59:913–9.PubMedCrossRefGoogle Scholar
  73. 73.
    Peng HJ, Zheng HR, Ning YP, et al. Abnormalities of cortical-limbic-cerebellar white matter networks may contribute to treatment-resistant depression: a diffusion tensor imaging study. BMC Psychiatry. 2013;13:72.PubMedPubMedCentralCrossRefGoogle Scholar
  74. 74.
    Perera S, Eisen R, Bhatt M, et al. Light therapy for non-seasonal depression: systematic review and meta-analysis. B J Psych Open. 2016;2:116–26.CrossRefGoogle Scholar
  75. 75.
    Piet J, Hougaard E. The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic ​review and meta-analysis. Clin Psychol Rev. 2011;31:1032–40.Google Scholar
  76. 76.
    Pilu A, Sorba M, Hardoy MC, et al. Efficacy of physical activity in the adjunctive treatment of major depressive disorders: preliminary results. Clin Pract Epidemiol Ment Health. 2007;3:8.PubMedPubMedCentralCrossRefGoogle Scholar
  77. 77.
    Prasko J, Brunovsky M, Latalova K, et al. Augmentation of antidepressants with bright light therapy in patients with comorbid depression and borderline personality disorder. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010;154:355–61.PubMedCrossRefGoogle Scholar
  78. 78.
    Prien R, Kupfer D. Continuation drug therapy for major depressive episodes: how long should it be maintained? Am J Psychiatry. 1986;143:18–23.PubMedCrossRefGoogle Scholar
  79. 79.
    Qureshi NA, Al-Bedah AM. Mood disorders and complementary and alternative medicine: a literature review. Neuropsychiatr Dis Treat. 2013;9:639–58.PubMedPubMedCentralCrossRefGoogle Scholar
  80. 80.
    Ravindran AV, Balneaves LG, Faulkner G, et al. Canadian network for mood and anxiety treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: section 5. Complementary and alternative medicine treatments. Can J Psychiatr. 2016;61(9):576–87.Google Scholar
  81. 81.
    Reynolds CF, Smith GS, Dew MA, et al. Accelerating symptom-reduction in late-life depression: a double-blind, randomized, placebo-controlled trial of sleep deprivation. Am J Geriatr Psychiatry. 2005;13:353–8.PubMedCrossRefGoogle Scholar
  82. 82.
    Rao NP, Varambally S, Gangadhar BN. Yoga school of thought and psychiatry: therapeutic potential. Indian J Psychiatry. 2013;55:S145–9.PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Rohan KJ, Mahon JN, Evans M, et al. Randomized trial of cognitive-behavioral versus light therapy for seasonal affective disorder: acute outcomes. Am J Psychiatry. 2015;172:862–9.PubMedCrossRefGoogle Scholar
  84. 84.
    Rosenbaum JF, Fava M, Falk WE, et al. The antidepressant potential of oral S-adenosyl-I-methionine. Acta Psychiatr Scand. 1990;81:432–6.PubMedCrossRefGoogle Scholar
  85. 85.
    Rosenbaum S, Tiedermann A, Sherrington C. Physical activity interventions for people with mental illness: a systematic review and meta-analysis. J Clin Psychiatry. 2014;75:964–74.PubMedCrossRefGoogle Scholar
  86. 86.
    Rush AJ, Trivedi MH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163:1905–17.PubMedCrossRefGoogle Scholar
  87. 87.
    Sarris J, Kavanagh DJ, Byrne G. Adjuvant use of nutritional and herbal medicines with antidepressants, mood stabilizers and benzodiazepines. J Psychiatr Res. 2010;44:32–41.PubMedCrossRefGoogle Scholar
  88. 88.
    Segal Z, Williams JM, Teasdale J. Mindfulness-based cognitive therapy for depression. New York: The Guilford press; 2002.Google Scholar
  89. 89.
    Shapiro D, Cook IA, Davydov DM, et al. Yoga as a complementary treatment for depression: effects of traits and moods on treatment outcome. Evid Based Complement Alternat Med. 2007;4:493–502.PubMedPubMedCentralCrossRefGoogle Scholar
  90. 90.
    Sharma A, Barrett MS, Cucchiara AJ, et al. A breathing-based meditation intervention for patients with major depressive disorder following inadequate response to antidepressants: a randomized pilot study. J Clin Psychiatry. 2017;78:e59–63.PubMedPubMedCentralCrossRefGoogle Scholar
  91. 91.
    Silveira H, Moraes H, Oliveira N. Physical exercise and clinically depressed patients: a systematic review and meta-analysis. Neuropsychobiology. 2013;67:61–8.PubMedCrossRefGoogle Scholar
  92. 92.
    Souery D, Oswald P, Massat I, et al. Clinical factors associated with treatment resistance in major depressive disorder: results from a European multicenter study. J Clin Psychiatry. 2007;68:1062–70.PubMedCrossRefGoogle Scholar
  93. 93.
    Stephens I. Medical yoga therapy. Child Aust. 2017;4:12.CrossRefGoogle Scholar
  94. 94.
    Strauss C, Cavanagh K, Oliver A, Pettman D. Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomized controlled trials. PLoS One. 2014;9:e96110.PubMedPubMedCentralCrossRefGoogle Scholar
  95. 95.
    Streeter CC, Gerbarg PL, Saper RB, et al. Effects of yoga on autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Med Hypotheses. 2012;78:571–9.PubMedCrossRefGoogle Scholar
  96. 96.
    Su KP, Huang SY, Chiu CC, Shen WW. Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial. Eur Neuropsychopharmacol. 2003;13:267–71.PubMedCrossRefGoogle Scholar
  97. 97.
    Sublette ME, Ellis SP, Geant AL, et al. Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. J Clin Psychiatry. 2011;72:1577–84.PubMedPubMedCentralCrossRefGoogle Scholar
  98. 98.
    Sundborn LT, Bingefors K. The influence of symptoms of anxiety and depression on medication nonadherence and its causes: a population based survey of prescription drug users in Sweden. Patient Prefer Adherence. 2013;7:805–11.CrossRefGoogle Scholar
  99. 99.
    Thase ME, Kupfer DJ. Characteristics of treatment-resistant depression. In: Zohar J, Belmaker R, editors. Treating resistant depression. New York: PMA Publishing; 1987. p. 23–45.Google Scholar
  100. 100.
    Tindle HA, Davis RB, Phillips RS, et al. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med. 2005;11:42–9.PubMedGoogle Scholar
  101. 101.
    Trivedi MH, Rush AJ, Wisniewski SR, et al. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006a;163:28–40.PubMedCrossRefGoogle Scholar
  102. 102.
    Trivedi MH, Greer TL, Grannemann BD, et al. Exercise as an augmentation strategy for treatment of major depression. J Psychiatr Pract. 2006b;12:205–13.PubMedCrossRefGoogle Scholar
  103. 103.
    Tuunainen A, Kripke DF, Endo T. Light therapy for non-seasonal depression. Cochrane Database Syst Rev. 2004;2:CD004050.Google Scholar
  104. 104.
    Wirz-Justice A, Bader A, Frisch U, et al. A randomized, double-blind, placebo-controlled study of light therapy for antepartum depression. J Clin Psychiatry. 2011;72:986–93.PubMedCrossRefGoogle Scholar
  105. 105.
    World Health Organization. The World Health Report – 2001: mental health: new understanding, New Hope. Geneva: World Health Organization; 2011.Google Scholar
  106. 106.
    Yamamura T, Okamoto Y, Okada G, et al. Association of thalamic hyperactivity with treatment-resistant depression and poor response in early treatment for major depression: a resting-state fMRI study using fractional amplitude of low-frequency fluctuations. Transl Psychiatry. 2016;6:e754.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Rosalia Sun Young Yoon
    • 1
    • 2
  • Nisha Ravindran
    • 1
    • 2
  • Arun Ravindran
    • 1
    • 2
  1. 1.Department of PsychiatryUniversity of TorontoTorontoCanada
  2. 2.Centre for Addiction and Mental Health, Mood and AnxietyTorontoCanada

Personalised recommendations