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Medicines for Depression continued...

For depression that's hard to treat, doctors sometimes pair an antidepressant with another prescription medicine, such as:

All antidepressants carry a boxed warning about increased risks of suicidal thinking and behavior in children, teens, and young adults 18-24 years old. If you start taking an antidepressant and begin having troubling thoughts, tell your doctor and loved ones right away.

Working with your doctor, you can weigh the risks and benefits of treatment and find the medication and dose that work best for you.

ECT (Electroconvulsive Therapy) for Depression

This is a safe and effective treatment for people with depression that's resistant to multiple medications. It's typically recommended when depression symptoms are especially severe or when people haven't been helped by medicines or therapy.

In ECT, the patient is put to sleep under general anesthesia and the doctor then applies a small electric current to cause a brief controlled seizure. A course of ECT-induced seizures, done over a few weeks, seems to affect areas of the brain involved in controlling mood. It may sound scary, but during the procedure, a person receives anesthesia and a muscle relaxant, so they're asleep and won't feel anything.

ECT tends to work very quickly. It also works well -- about 70%-90% of people who receive it show improvement. The most common side effect is temporary memory loss.

You might have up to 12 sessions or more over a few weeks. Some people get further treatment with ECT to prevent depression from returning.

Transcranial Magnetic Stimulation (TMS) for Depression

TMS is another nondrug approach for depression that's mildly resistant to drug treatment. Unlike ECT, it uses an electromagnetic device held to the forehead to induce a much smaller electric current in the region of the brain that controls mood -- without causing a seizure or loss of consciousness.

TMS works best in people who haven't been helped by one, but not necessarily two or more, antidepressant treatments. Also, unlike ECT, TMS doesn't require sedation, and is given on an outpatient basis. Side effects, if any, are minimal. They might include discomfort at the site where the magnet is placed and mild headache.