Advanced Depression Options and Neurostimulation (ADDON) Clinic
For an appointment with Washington University depression specialists, please call
(314) 286-1700. Please note that a physician referral is needed.
The Department of Psychiatry at Washington University has established a referral
clinic for those suffering from treatment resistant depression.
Mission of Clinic
It is estimated that as many as 2-3 million people in the United States suffer from
a more severe form of depression known as treatment resistant depression (TRD).
We have established this clinic at Washington University with two primary missions:
To provide a thorough and comprehensive evaluation of individuals suffering
from TRD, so as to provide guidance/input into the TRD patient’s care going forward.
Often in the treatment of TRD, patients will have been on a wide and extensive array
of medications with little opportunity to get a comprehensive overview of what treatments/treatment
combinations the patient has been on. This clinic is designed to take a “big picture”
view of the patient’s treatment, with a careful review of the patient’s psychiatric
medical record, detailed review of their history, and recommendations to the referring
physician regarding future treatments.
Using cutting edge treatments and knowledge, to explore the biological and psychological
basis of TRD and how this relates to treatment outcomes. Very little
is known about TRD. We have little understanding of the biological, physiological,
anatomical, and psychological nature of this horrible form of depression. The staff
at the ADDON clinic is committed to better understanding this illness so as to be
able to provide better treatments to help those with this daunting illness. With
this in mind, we are undertaking studies to assess the impact of genetics, endocrinology,
family history, brain function (using brain imaging), psychology, and pharmacology
Referrals To the ADDON Clinic
Because the ADDON Clinic functions on a consultative basis, all patients must currently
be receiving care by a treating physician (psychiatrist or primary care). We do
not accept new patients for followup care. In order to be seen in the clinic,
patients must be referred directly, in writing, to the clinic by their treating
physician. To receive a phone screen for determination of appropriateness of the
clinic, please call 314-286-1700.
What Happens in the Clinic Evaluation?
Once accepted into the clinic, the TRD patient will be asked to forward their complete
psychiatric medical record for careful review. Doctors in the clinic will carefully
and comprehensively review the record to determine which treatments have been attempted,
what response/nonresponse to these treatments was, which treatments have not been
attempted and which would be most appropriate as the next step. On the day of your
evaluation, the patient undergoes a one hour interview with the clinic doctors to
further detail their treatment history. A brief physical examination is performed.
After these occur, the doctors in the clinic will meet to discuss your situation
and you will be called back to meet with the ADDON clinic doctors for a preliminary
evaluation summary. Finally, the ADDON clinic will provide a written copy of your
evaluation, complete with specific recommendations intended to guide your referring
physician on “next steps” in treatment.
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