Product Details

This product includes instant access to the PDF/eBook and 12-CME Post-Test. Print copies will ship by the end of November 2025.

When Your Clinical Expertise Meets Complex Cases
Treatment-resistant depression challenges even the most experienced clinicians. When patients don’t respond to first- and second-line treatments, the path forward requires sophisticated clinical reasoning, familiarity with advanced interventions, and a systematic approach to complex case management. This practical resource bridges the gap between research literature and clinical application, offering experienced psychiatrists a structured approach to patients who haven’t responded to conventional treatments.

Effective tools for your most challenging cases.

Browse free sample pages, including the table of contents, introduction, figures, and index.

Inside this book, you’ll find:

• A comprehensive framework for evaluating and defining treatment resistance, including diagnostic reconsideration and comorbidity assessment
• Evidence-based strategies for optimizing pharmacotherapy: augmentation, combination, and switching protocols backed by current research
• Practical guidance on advanced somatic treatments including ECT, TMS, ketamine/ esketamine, and emerging neuromodulation therapies
• Integration of psychotherapeutic approaches for treatment-resistant populations
• How to identify and address contributing factors: medical comorbidities, substance use, trauma, and medication interactions
• Pharmacogenomic testing and personalized medicine approaches: when to use them and how to interpret results
• Case studies illustrating decision-making in complex clinical scenarios
•  Strategies for maintaining therapeutic alliance and managing patient and family expectations through prolonged treatment courses
• Updates on pipeline treatments and future directions in the field

About the Author
Chris Aiken is the editor-in-chief of The Carlat Psychiatry Report, the mood disorders section editor of Psychiatric Times, and an adjunct assistant professor of psychiatry at New York University and Wake Forest Schools of Medicine. He has authored numerous books and peer-reviewed articles in psychiatry, including Prescribing Psychotropics (2022) and the upcoming Complementary and Alternative Medicine Fact Book. He began his career as a research assistant at the National Institute of Mental Health and completed his training at Yale, Cornell, and Duke medical centers. He has directed neuromodulation and esketamine centers in North Carolina, and his current practice, Psych Partners, integrates pharmacotherapy and psychotherapy.

Table of Contents

• Section I: Introduction

• Chapter 1: What is “Difficult-to-Treat” Depression?

• Chapter 2: A Primer on “Regular” Depression

• Section II: Assessment and Diagnosis

• Common Causes of Treatment Resistance

• Chapter 3: Misdiagnosis

• Chapter 4: Optimal Use of Assessment Tools

• Personalized Treatment for Depressive Subtypes

• Chapter 5: Bipolar Depression

• Chapter 6: Depression with Mixed Features

• Chapter 7: Psychotic Depression

• Chapter 8: Vascular Depression

• Chapter 9: Inflammatory Depression

• Chapter 10: Trauma and Depression

• Chapter 11: Other Subtypes of Depression

• Section III: Treatment

• Psychosocial Treatment

• Chapter 12: The Psychology of Depression

• Chapter 13: Working with Chronic Depression

• Chapter 14: Therapy and Lifestyle

• Biological Treatment

• Chapter 15: When Antidepressants Don’t Work

• Chapter 16: Monoamine Oxidase Inhibitors (MAOIs)

• Chapter 17: Tricyclics

• Pharmacologic Augmentation

• Chapter 18: Overview of Pharmacologic Augmentation

• First-Line Augmentation Strategies

• Chapter 19: Lithium

• Chapter 20: Antipsychotics

• Chapter 21: Pramipexole

• Second-Line Augmentation Strategies

• Chapter 22: Thyroid

• Chapter 23: Celecoxib

• Third-Line Augmentation Strategies

• Chapter 24: Amantadine

• Chapter 25: D-Cycloserine

• Chapter 26: Minocycline

• Rapid-Acting Medications

• Chapter 27: Overview of Rapid-Acting Medications

• Chapter 28: Alprazolam and the Benzodiazepines

• Chapter 29: Eszopiclone

• Chapter 30: Auvelity

• Chapter 31: The Ketamines

• Chapter 32: Pindolol

• Chapter 33: Zuranolone

• Chapter 34: Psychedelics

• Natural Therapies and Deficiency States

• Chapter 35: Overview of Natural Therapies and Deficiency States

• Chapter 36: Light Therapy

• Chapter 37: Folate, L-Methylfolate, and SAMe

• Chapter 38: Vitamin D

• Chapter 39: Omega–3 Fatty Acids

• Chapter 40: Probiotics

• Neuromodulation

• Chapter 41: Overview of Neuromodulation

• Chapter 42: Transcranial Magnetic Stimulation (TMS)

• Chapter 43: Electroconvulsive Therapy (ECT)

• Other Treatments

• Chapter 44: Reproductive Hormones

• Deprescribing

• Chapter 45: Overview of Deprescribing

• Chapter 46: Deprescribing Extra Antidepressants

• Chapter 47: Deprescribing Benzodiazepines, Stimulants, and Anticonvulsants

• Conclusion

• Chapter 48: Getting Well and Staying Well

• Appendix

• Treatment Menus

• Index

______________

Carlat CME Institute maintains responsibility for this program and its content. Carlat CME Institute designates this enduring material educational activity for a maximum of twelve (12) AMA PRA Category 1 Credits^TM. Physicians or psychologists should claim credit commensurate only with the extent of their participation in the activity