The Best Alternative Treatment for Treatment Resistant Depression

Although living with depression can be difficult, finding the best treatment option shouldn’t be. While some people can achieve full remission from depression with the help of traditional treatments like antidepressants and talk therapy, this is not the case for everyone. If you’ve tried medication or talk therapy and are experiencing lingering symptoms or unwanted side effects, you’re not alone and it doesn’t mean you can’t feel better. But you should consider other treatment options.

Transcranial Magnetic Stimulation (TMS), IV Ketamine and Spravato are all alternative treatments for depression that can be used alone or in conjunction with other medications and talk therapy to help patients ditch the side effects and feel all the way better.

What is TMS Therapy and How Does it Work?

TMS is an FDA-approved treatment for depression that is covered by most insurance. TMS is drug-free and uses gentle magnetic pulses to stimulate the specific areas of the brain responsible for mood. It is often referred to as physical therapy for the brain.

During TMS treatment, patients recline in a treatment chair and remain awake and alert. A technician positions the TMS magnet over the patient’s head to deliver gentle pulses to specific areas of the brain responsible for depression. Patients report that the magnetic pulses feel like gentle taps on the head. A course of TMS treatment typically involves 5 treatments per week for 6 weeks and then 2 treatments per week for 3 weeks. Each treatment session is about 20 minutes.

TMS is non-invasive, meaning it does not require surgery, and non-systemic, so it does not affect the entire body. And unlike other treatments that stimulate the brain, TMS does not require sedation so patients can drive themselves to and from their TMS appointments and return to their daily routines including work and school immediately after each session.

How Effective is TMS?

The goal of mental health treatment is to achieve full remission. Patients should not tolerate lingering symptoms or unwanted side effects and TMS is twice as effective as traditional antidepressant medication.

Unlike medications which can take 6-8 weeks to exert their full effects, most patients experience improvement in 2 weeks with TMS therapy. For over a decade, over 70% of Neuro Wellness Spa patients have experienced symptom relief with TMS therapy. Only about 15% of patients suffer a depressive recurrence within one year after completing TMS.

What are the Side Effects of TMS?

Although antidepressant medications can work for some people, others struggle with unwanted side effects including GI distress, sleep disturbance weight gain, fatigue, and sexual dysfunction. Unlike medications, which affect the entire body, TMS therapy treats the brain directly. With TMS, there are little to no side effects, with the most common side effect being temporary and mild scalp discomfort during active treatment.

What is Ketamine Therapy and How Does it Work?

Ketamine was first introduced as an FDA-approved anesthetic in the 1960s. It has since been designated by the FDA as a “breakthrough therapy” to treat mood, anxiety, and pain. 

Ketamine works in several ways at the same time including by stimulating brain derived neurotrophic factor (BDNF), resulting in enhanced neuroplasticity. Ketamine is also an NMDA receptor antagonist that interacts with glutamate, the most common excitatory neurotransmitter in the brain. Researchers have observed increased synaptic connections and the growth of neurons. It is this neuronal growth and increase in neuronal activity that has been shown to improve mood and cognition in as little as one hour.

There are two main types of ketamine therapy: intravenous (IV) ketamine therapy and Spravato.

What does IV Ketamine Treatment Involve?

IV ketamine is given as an infusion into the bloodstream. Each IV ketamine infusion lasts about 40 minutes, during which patients wear an eye mask in a dimly lit room with aromatherapy. Ketamine is delivered at a slow and controlled dose under the supervision of a registered nurse where blood pressure, heart rate and oxygen saturation are monitored for the duration of the infusion.  Patients cannot drive home and need to arrange a safe ride. IV ketamine is an off-label use of an FDA approved medication. At the present time, ketamine infusions for mood and chronic pain disorders are cash pay procedures. Typically, an acute course of IV ketamine therapy involves 6-12 infusions over 2-4 weeks.

What is Spravato?

Spravato, also known as Esketamine, is an intranasal treatment given as a nasal spray that is FDA approved for the treatment of adults with treatment resistant depression or suicidal ideation. The team at Neuro Wellness Spa can assist you in determining your specific insurance coverage for Spravato and out-of-pocket costs. Each treatment lasts about two hours during which the patient self-administers the Spravato nasal spray under the supervision of a healthcare provider. After the patient administers the nasal spray, there is a two-hour observation period where they can rest comfortably while blood pressure is monitored. Patients cannot drive home and need to arrange a safe ride. Typically, Spravato is administered twice weekly for four weeks then once weekly for four weeks followed by maintenance treatment which can be once every other week.

How Effective is Ketamine Therapy?

Ketamine’s response rate is more than twice that of traditional antidepressants and ketamine works rapidly, in hours to days compared to weeks with traditional antidepressants. Most patients experience positive results after their first treatment and subsequent treatments help prolong the positive effects.

Ketamine therapy is also particularly beneficial for patients struggling with trauma or chronic pain, especially if comorbid with depression symptoms. Research has shown that ketamine therapy helps patients to disengage from their routine thought patterns, heal unhealthy neural pathways and achieve clarity. Ketamine has also been found to have transformative effects on an individual’s worldview. Ketamine produces a sense of disconnection from one’s ordinary reality and usual self that may induce or enhance feelings of creativity, purpose, perspective, serenity, insight, inspiration, gratitude, empathy, connection with others and the world, openness to new ideas, psychological rebirth, reduced fear of death and traveling outside of one’s self, among others.

Which Alternative Depression Treatment Is Best for Me?

Transcranial Magnetic Stimulation (TMS), IV Ketamine and Spravato are all alternative treatment options for depression that can be life-changing for those experiencing lingering symptoms or unwanted side effects after trying conventional treatments. When working with your provider to determine whether TMS, IV ketamine or Spravato may work well for you, it’s important to consider your specific treatment needs, preferences, and goals. TMS, IV ketamine and Spravato have key differences with regard to indication, insurance coverage, length of treatment, response time and treatment experience. To learn more about these alternative treatments, or to schedule a consultation, contact us with our online form or give us a call at (877) 847-3984.

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    I struggle with depression, OCD or anxiety.

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