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Treatment Options for Treatment-Resistant Depression

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Young woman talking about treatment resistant depression treatments with her psychiatrist
Published: October 27, 2022
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Depression is a common mental illness that can affect anyone, regardless of age, race, or gender. It is characterized by feelings of sadness, emptiness, and hopelessness that can last for weeks or months at a time. While most cases of depression can be treated with medication and therapy, some people experience treatment-resistant depression (TRD).

TRD is a relatively common occurrence in clinical practice, with up to 50% to 60% of the patients not achieving adequate response following antidepressant treatment. This occurs when the person does not respond to traditional treatments and needs to explore other options. In this article, we will discuss the options available for those who suffer from treatment-resistant depression.

Pharmacological Options

Changing Medications

One option for addressing treatment-resistant depression is to try a different medication. If you have been taking the same antidepressant for a while and it is not working, your doctor may prescribe a different one. There are many different types of antidepressants available, so it may take some trial and error to find the one that works best for you. This is usually the first option your doctor will recommend before trying other options.

Ketamine Infusions

Ketamine infusions are a newer option that is being studied for the treatment of treatment-resistant depression. While it’s typically used as an anesthetic, ketamine has also been shown to be effective in treating depression. It is usually given as an infusion, which means that it is administered through a vein. Ketamine infusions are not yet widely available, but they show promise as a treatment for treatment-resistant depression. As of right now, ketamine has not been approved by the FDA.

Spravato Nasal Spray

Spravato is a nasal spray that contains the medication esketamine. Unlike ketamine, esketamine is approved by the FDA for the treatment of treatment-resistant depression. Spravato is usually used in conjunction with other antidepressants, and it is thought to work by increasing levels of serotonin and norepinephrine in the brain. If you would like to learn more about Spravato, check out our esketamine treatment page, or our deep-dive blog post on Spravato.

Other Options

Vagus Nerve Stimulation

Vagus nerve stimulation (VNS) is another option that is sometimes used to treat treatment-resistant depression. It involves the implantation of a device that sends electrical impulses to the vagus nerve, which increases activity in the areas of the brain that control our mood. VNS has been shown to be effective in some people, but it is not as widely used as other options due to its invasiveness.

Deep Brain Stimulation

Deep brain stimulation (DBS) is a surgical procedure that is occasionally used to treat treatment-resistant depression, however, it is most commonly utilized for patients with OCD or Parkinson’s. It involves the implantation of a device that sends electrical impulses to specific areas of the brain. DBS has been shown to be effective in some people, but it is not as widely used as other options due to its invasiveness.

Electroconvulsive Therapy

If all else fails, your doctor may recommend electroconvulsive therapy (ECT). ECT is a treatment that uses electrical impulses to stimulate the brain while you’re under general anesthesia. Although it often gets critiqued because of its media portrayal and outdated associations, electroconvulsive therapy is much safer today thanks to decades of research and practice.

It is usually used as a last resort because it can have some side effects, such as confusion and memory loss. However, it has been shown to be effective in treating treatment-resistant depression.

Transcranial Magnetic Stimulation

Transcranial magnetic stimulation (TMS) has become a fairly popular option for treating treatment-resistant depression since it received FDA approval in 2008. It is a completely noninvasive procedure that uses magnetic fields to stimulate certain sections of the brain. TMS gained popularity over the last few years with providers and patients alike as it has been shown to be effective in treating depression with very few side effects. For more information on TMS, check out our TMS treatment page, or our blog post on the pros and cons.

Talk With Your Psychiatrist

As we have seen, there are a number of options available for the treatment of treatment-resistant depression. However, not everyone will respond to the same treatments in the same way. It is important to work with your psychiatrist to find the treatment that is best for you. Everyone’s brain is different, so what works for someone else may not work for you. It may take some trial and error to find the right treatment for you, but it is worth it to find something that works.

BestMind Behavioral Health Specializes in Treating TRD

If you are looking for a way to treat your treatment-resistant depression, BestMind Behavioral Health can help. We offer a variety of options, including medication and alternative therapies, to help you get your life back on track. We accept a variety of insurance plans, so it is easy and affordable to get the care you need. Our team of licensed psychiatrists, certified physician assistants, and advanced registered nurse practitioners are here to help you get the best care possible. If you would like to learn more about our services, please contact us today.