If you've been diagnosed with treatment-resistant depression, you might be wondering what happens next. You've already tried some medications. Maybe you've already tried talk therapy, too. They haven't helped. So what now?
"Having treatment-resistant depression is a terrible burden for people," says Ian A. Cook, MD, director of the Depression Research Program at the University of California Los Angeles. "But they really should hold on to some optimism." Success might not come overnight. But with some patience and effort, you and your doctor can find an approach that will help.
Depression poses many dangers, burdening people with hopelessness and raising their risk of suicide. But in attempts to quell the pain, some turn to alcohol, drugs, and other harmful behaviors that endanger them even further, psychologists say.
“There is a strong relationship between depression and high-risk behaviors,” says Pamela Cantor, PhD, a psychologist and lecturer at Harvard Medical School.
“Excessive drinking, drug abuse, unsafe sex, and cutting are all self-injurious behaviors that...
Unfortunately, there's no simple step-by-step plan to tackle treatment-resistant depression. Every case is different. But this article will give you an idea of how your doctor and therapist might think about your treatment. There are three basic approaches for treatment-resistant depression: medications, psychotherapy, and brain stimulation treatments. Here's a guide to the options.
Medications for Treatment-Resistant Depression
If you have treatment-resistant depression, you've already tried some medications. Nonetheless, your doctor -- preferably an expert at treating the condition -- will likely recommend that you try again with a new approach.
You might be skeptical about going onto yet another medication. But keep in mind that there are lots of different drugs available and they work in different ways. Often it takes time -- and trial and error -- to find the right drug at the right dose or in the right combination, says Dean F. MacKinnon, MD, associate professor of psychiatry at the Johns Hopkins Hospital in Baltimore.
Here are your drug options for treatment-resistant depression:
Another new antidepressant, Symbyax, combines the active ingredient in Prozac with an antipsychotic, the active ingredient in Zyprexa. This combination medicine is the first drug approved by the FDA to specifically treat acute treatment-resistant depression.
Older antidepressants. These include tricyclic antidepressants or TCAs (like Elavil and Pamelor) and Monoamine Oxidase Inhibitors or MAOIs (like Nardil and Parnate.) While these drugs can help with treatment-resistant depression, many doctors only turn to them when other antidepressants have failed. They tend to have more severe side effects. MAOIs can cause dangerous interactions with other drugs and foods.