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About 30% of people with depression do not respond to an antidepressant at the recommended dose and can be described as having treatment-refractory depression. Aims To summarise the findings from all randomised controlled trials (RCTs) that have assessed the efficacy of a pharmacological or psychological intervention for treatment-refractory depression. Method We used a systematic search strategy to identify RCTs that included adults aged 18–75 years with a diagnosis of unipolar depression thatdoi:10.1192/bjp.181.4.284 pmid:12356654 fatcat:5ckkt74ydrao5ou65h4wrmyjxy