Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Depression Health Center

Font Size

Treatment-Resistant Depression Care

There is no universally agreed upon approach to controlling treatment-resistant depression, also referred to as TRD. Your treatment will depend on your doctor's expertice as well as your own needs, concerns, and medical history.

Recommended Related to Depression

Could You Be Depressed and Not Know It?

"Could you be depressed and not know it?" This sounds like a ridiculous question. After all, wouldn't you know if you were depressed? Possibly not. Depression can take hold gradually, without a person realizing that depressive thoughts and feelings are increasingly dominating her perspective - and her life. Many people assume that depression is easily identifiable, manifesting itself as persistent sadness that doesn't lift. In fact, symptoms of depression can take a variety of forms. Chances are...

Read the Could You Be Depressed and Not Know It? article > >

But while the details may vary, most doctors follow the same basic pattern. Here is a rough outline of how your doctor might treat your depression. If you have treatment-resistant depression, your depression has already typically failed to respond to two or more treatments, usually one or more antidepressants and/or psychotherapy. At that point, your doctor may suggest other options.

  • Other antidepressants. If one type of antidepressant hasn't worked -- or has caused unpleasant side effects -- your doctor may suggest that you try another. This might be a new depression medicine in the same class of drugs or one in a different class. Again, you may need to stay on this medicine up to eight weeks to see its full effects. You'll then need to stay on it for at least several months, depending on your doctor's recommendations. If this second one doesn't work, your doctor may try a combination of depression medicines. Your doctor may also recommend older drugs for depression, such as MAOIs or tricyclics.
  • Augmentation with other drugs. If standard treatments aren't working, your doctor may add other medicines to your antidepressants. The combination can work in cases where antidepressants on their own did not. Types of drugs might include anti-anxiety drugs, anticonvulsants, antipsychotics, lithium, thyroid hormones, and others. Your doctor may want to try a number of different drugs in different combinations. One drawback is that the more medications you take, the greater potential for side effects.
  • ECT (electroconvulsive therapy). Although sometimes used as an initial treatment for people with severe, life-threatening depression, ECT is usually reserved for people with serious depression that can't be controlled with other treatments. It uses an electrical impulse to trigger a brief controlled seizure in the brain while the patient is asleep under general anesthesia. This treatment can rapidly relieve depression, although its effects often fade unless "maintenance" ECT treatments are continued or an effective medicine is used to prevent relapse.
  • TMS (transcranial magnetic stimulation). In 2008, the FDA approved a TMS device for treating severely depressed adults for whom one antidepressant has failed to work. TMS creates a magnetic field to induce a much smaller electric current in a specific part of the brain without causing a seizure or loss of consciousness. An electromagnetic coil is set against the forehead to induce the current.
  • VNS (vagus nerve stimulation). VNS is a surgical procedure used in people with serious depression that hasn't responded to other treatments. Through a pacemaker-like device implanted under the collarbone, VNS delivers regular electrical impulses to the vagus nerve in the neck, one of the nerves that relays information to and from the brain.
  • Other techniques. Researchers are working on therapies to tackle treatment-resistant depression, such as MST (magnetic seizure therapy) and DBS (deep brain stimulation).

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on August 21, 2014

Today on WebMD

Differences between feeling depressed and feeling blue.
jk rowling
Famous people who've struggled with persistent sadness.
depressed man sitting on hallway floor
Learn the truth about this serious illness.
Sad woman looking out of the window
Tips to stay the treatment course.
unhappy teen boy
Health Check
jk rowling
Pills with smiley faces
Teen girl huddled outside house
Depressed man sitting in hospital hallway
antidepressants slideshow
pill bottle
Winding path