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Accumulating data suggest that treatment-resistant depression is heterogeneous and therefore this heterogeneity may notify interventions. Furthermore, these data declare that substantially more nuance is needed in evaluating the 'adequacy' of prior treatments whether or not they are psychotherapeutic or psychopharmacologic. Last, adjunctive treatments that focus on neuromodulation, glutamatergic, GABAergic, and inflammatory pathways remain poorly grasped in youth with treatmen