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What to Do if Antidepressants Aren’t Working

  • June 14, 2019
  • By Grace

Antidepressants are commonly prescribed to treat both mild and severe depression. In some cases, antidepressants may not work for certain individuals. This may be due to the depression being resistant to drugs or the body being unable to effectively digest and process the antidepressant medication. There are several alternative methods that can help when antidepressant medication is not working to effectively treat depression including transcranial magnetic stimulation, electroconvulsive therapy, vagus nerve stimulation, talk therapy, inpatient hospitalization, and other methods that are currently experimental.

Transcranial magnetic stimulation (TMS) is a treatment that has been approved by the United States Food and Drug Administration for use individuals with treatment-resistant depression. TMS is a non-invasive treatment that uses electrical stimulation in an outpatient setting to treat depression that is treatment resistant. Non-invasive depression treatment options like TMS are typically used with individuals who are mildly resistant to antidepressant drugs. Transcranial magnetic stimulation treatments are conducted approximately four or five days a week over the course of a month to five weeks.

Electroconvulsive therapy (ECT) is a treatment that uses electricity to cause controlled seizures. In general, electroconvulsive therapy is used in cases that involve severe depression that is not treatable through other methods or treatments. ECT is administered over the course of six to twelve weeks and is typically able to relieve depressive symptoms very quickly. ECT usually needs to be followed up through medication or more electroconvulsive therapy treatments over time in order to prevent a relapse into depression.

Vagus nerve stimulation uses electrical currents to relieve depressive symptoms through a device that is implanted in the body. Vagus nerve stimulation is an extremely invasive procedure and requires major surgery in order to place the implant. Vagus nerve stimulation is approved by the United States Food and Drug Administration for the long term treatment of treatment-resistant depression and chronic depression. The depression must be non-responsive to at least two trials of antidepressant medications in order to qualify for vagus nerve stimulation treatment. The effects of Vagus nerve stimulation may not be effective until nine months after the first treatment. Further, according to studies, meaningful effects of vagus nerve stimulation may only occur in one out of three people who receive the implant.

Talk therapy, including cognitive behavioral therapy, may be able to help individuals experiencing ongoing bouts of extreme grief and other hallmark signs of depression. The methods of talk therapy and cognitive behavioral therapy focus on thoughts and behavior that contribute to depression. There is also a huge focus on concrete goals that the individual must meet in order to overcome issues that are contributing to their depression.

In some cases, individuals with treatment-resistant depression may need inpatient treatment in a hospital that specializes in treating severe depression. Inpatient hospitalization is typically the first-line treatment for individuals who have severe depression that may be a harm to themselves or others. It is important to consider all factors when making a decision about whether to undergo treatment on an outpatient basis or enter an inpatient facility due to treatment-resistant depression.

Experimental methods of treating depression that is not resolved by medication are currently being researched by mental health professionals. Some examples of methods that are currently under scientific investigation include magnetic seizure therapy and deep brain stimulation. These methods are currently being tested through experimental medical trials with individuals who have treatment-resistant depression. If you are interested in joining a clinical trial, you should speak to your doctor for more information.

By Grace, June 14, 2019
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