 - Lack of therapeutic effects of at least 3 antidepressants selectively blocking serotonin reuptake SSRI at least 12 consecutive weeks at the maximal tolerated dose up to 80 mgday for fluoxetine, 300 mgday for fluvoxamine, 200 mgday for sertraline, 60 mgday for paroxetine, 60mgday for citalopram and 250 mgday for clomipramine prescribed alone and in combination for at least 1 month with: 1 risperidone or olanzapine or aripiprazole or quetiapine, 2 clomipramine 