Treatment Resistant Depression

When you’ve tried standard depression meds but they do not work, you may have Treatment Resistant Depression (TRD). Definitions vary but it means that you have tried 2 to 6 medications with no luck. Fortunately, there are more options for you.

New Medications

In 2019, the FDA approved two new medications that are very different from the standard depression meds. One is brexanolone, which is meant for post-partum depression.

The other is esketamine. This is a drug that has been around for decades as an anesthetic. It has even been used as an anesthetic for animals. Doctors discovered that in low doses, it relieves depression with great success. At first it was only given intravenously. But now, it is available as a nasal spray. You still have to use it in a hospital or doctors office for now. I have heard wonderful things about it.

Other Treatments

ECT (electroconvulsive therapy.) ECT uses electric impulses to trigger controlled seizures in the brain. A series of ECT treatments (usually 6-12 over a few weeks) can often rapidly relieve depression, although some form of continued therapy (either a medicine or else periodic ECT “booster” treatments are usually necessary to prevent relapse.

VNS (vagus nerve stimulation.) Like ECT, this uses electrical stimulation to relieve the symptoms of depression. The difference is that the device is surgically implanted in your body. VNS is FDA-approved for the long-term (not acute) depression of chronic depression that does not respond to at least two antidepressant trials. Its effects may take up to 9 months to appear and studies have shown that a meaningful response seems to occur only in about 1 in 3 people. That doesn’t sound great.

TMS (transcranial magnetic stimulation.) This is a non-invasive approach that’s been approved for treatment-resistant depression. Like VNS and ECT, it uses electrical stimulation to treat depression. Unlike those procedures, TMS poses few side effects. It may be best for seriously depressed people who are mildly resistant to drug therapy. Treatment is done on an outpatient basis four to five days a week for four or more weeks. It is considered safe, but appears to be not as effective as ECT.

There are other experimental treatments out there. Ask your doctor.

I have bipolar II. I feel depressed at times, even though I take meds. I usually ask myself, is this sadness/emptiness/boredom due to a specific reason? Like a romantic breakup or trouble at work? Because it’s normal to feel down when the situation merits it. If I don’t have a reason, and it comes out of nowhere, I’ll call my doctor.

One thing that helped me is that in addition to my Lexapro, we added Abilify which is an anti-psychotic. But in a low dose it acts as a booster to an antidepressant.

Therapy is probably as effective as meds for most people. The problems are finding a good therapist, the cost, dealing with insurance, etc. Also, therapy takes work. It can be very emotional. And time consuming. I’ve been in and out of therapy for over 20 years. I always found that time was my biggest obstacle. So I started therapy with a wonderful woman on See more about this under “Helpful Resources” in my main menu.

If you suffer from depression, don’t give up until you get the help you need. Hugs, ❤️😀💥🙏

8 thoughts on “Treatment Resistant Depression

  1. I agree, therapy is very effective for some (and I was one of the lucky ones). but others need medication to reduce their symptoms before going into therapy. Unfortunately, as we know, ‘once size doesn’t fit all’ in mental health. We just have to keep trying until we find what works for us. Interesting to see you’ve mentioned Transcranial Magnetic Stimulation (TMS) cos, proud mummy moment, my eldest son has been researching TMS for depression for some years and has written many papers. There’s still more research needed to arrive at a positive conclusion.


  2. Thanks for the tips shared on your blog. Something also important I would like to express is that weight loss is not information about going on a dietary fad and trying to get rid of as much weight that you can in a few days. The most effective way to shed weight is by having it gradually and using some basic tips which can make it easier to make the most out of your attempt to slim down. You may realize and be following many of these tips, nevertheless reinforcing expertise never does any damage.


  3. I believe that avoiding packaged foods may be the first step to help lose weight. They may taste excellent, but ready-made foods include very little nutritional value, making you feed on more only to have enough electricity to get through the day. If you’re constantly eating these foods, switching to grain and other complex carbohydrates will aid you to have more vigor while consuming less. Great blog post.


  4. Virtually all of whatever you articulate is supprisingly accurate and it makes me wonder why I had not looked at this in this light before. This piece truly did switch the light on for me as far as this subject goes. But at this time there is actually one factor I am not too cozy with and whilst I attempt to reconcile that with the central idea of the issue, let me see what the rest of your subscribers have to point out.Nicely done.


  5. I was recommended this website by my cousin. I am not sure whether this post is written by him as nobody else know such detailed about my problem. You’re incredible! Thanks!


Comments are closed.