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Abstract
Introduction:
Treatment-resistant depression
(TRD) is a growing concern
with substantial economic
implications. In the United
States alone, TRD affects
30.9% of adults with major
depressive disorder, contributing
significantly to the annual
economic cost of medication-treated
depression.
Objective:
This systematic review aims
to investigate the connection
between excessive day time
sleep (EDS) and/or fatigue
and TRD. It also explores
whether the severity of depression
is linked to EDS and/or fatigue
in TRD patients.
Methods:
Using the PRISMA framework,
we conducted an English-language
search of four databases spanning
2013 to 2023. Eligibility
criteria focused on individuals
aged 15 and above diagnosed
with TRD, EDS, and/or fatigue
assessment in TRD individuals,
and its impacts on quality
of life.
Results:
From 1085 initial records,
three studies met the criteria.
These studies encompassed
24,316 participants, with
diverse findings. One study
suggested EDS predicts suicidal
thoughts in TRD, while another
found no EDS-severity link.
The third study indicated
increased fatigue in TRD.
Conclusions:
While a positive association
between EDS, fatigue, and
TRD is emerging, caution is
warranted due to smaller number
and study diversity, varying
definition of TRD and co-morbid
anxiety. Therefore, future
research, particularly randomized
control trials, is needed
to establish robust conclusions.
Key
words: Excessive daytime
sleepiness; Fatigue; Treatment
resistant depression; Hypersomnolence
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