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Summary: Objectives Why Holistic? ~ 30% to 40% of patients with major depressive disorder (MDD) do not respond sufficiently to usual antidepressant treatment ~ Even under optimal treatment conditions, only one-third of patients achieve remission ~ Among patients who fail to respond to two pharmacologic interventions, remission rates with the next antidepressant are as low as 12% ~ A patient becomes less likely to respond clinically with each additional nonresponse to antidepressant treatment