Clinical Vignette: Management of a Patient with Treatment-Refractory Depression Mr X is a known case of depressive illness for the last 1 year. He has stopped responding after two different groups of antidepressants were tried and has been labelled as a patient of treatment-resistant depression. How will you assess the cause of this resistance? Write the treatment algorithm that you will follow for his management? If you had to start lithium in this case, what protocol would you follow to start it and how will you monitor it? Treatment Options for Refractory Depression