Refractory Depression Current Strategies and Future Directions Edited by Willem A. Nolen Psychiatric Centre Bloemendaal, The Hague, The Netherlands Joseph Zohar The Chaim Sheba Medical Center, Israel Steven P. Roose New York State Psychiatric Institute, New York, USA Jay D. Amsterdam Department of Psychiatry, University of Pennsylvania, USA As many as 30 per cent of depressed patients fail to respond to conventional antidepressant therapy, and 15 per cent may develop a chronic unremitting depression. A variety of pharmacological, biochemical and clinical factors may contribute to this situation. However, even after making allowances for these variables, a substantial number of patients remain refractory to treatment. This text offers the clinician a broad insight into the problem of refractory depression, providing new information on the adequacy of standard treatments and the major alternatives as well as reviews of a number of other possible alternatives for those patients remaining depressed. Finally, some future directions and developments are presented which may soon lead to a better understanding of the problem of refractory depression. Written by an international field of authors, the book will be of value to all researchers and clinicians in the field of psychiatry.