This work would give an overall and up-to-date vision of psychopharmacological and physical strategies of treatment for resistant depression.A PubMed search was done using the keywords "resistant depression treatment", "electroconvulsive therapy", "antidepressants", and the inclusion criteria of adult samples, English, French or Italian languages.Lots of psycho-pharmacological and physical treatment strategies for resistant depression exist; anyway there is no consensus about their indications and efficacy, which appears still unsatisfactory.Further research should move towards the identification of specific clinical picture of treatment resistant depression to develop more efficacious and selective treatment protocols.