Are there advanced therapies for major depressive disorder?

Question

Hello doctor,

I am 58 years old and have been dealing with major depressive disorder for many years. I have tried different antidepressants in the past, but none of them have provided lasting relief, and some have caused unpleasant side effects. Lately, I have been feeling stuck and unsure what options are left.

How does a 58-year-old manage depression when multiple antidepressants have all failed?
Are there newer treatments available for people with treatment-resistant depression?
How do doctors decide when to consider options like other advanced therapies?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

An antidepressant can be good for managing major depressive disorder. However, if you have treatment resistant depression, it may not be effective for you.

When an antidepressant does not improve depressive symptoms with the optimal dose and six to eight weeks of duration, we will consider switching the antidepressant. Switching within the same class can also be helpful. If you have had a partial response to your current medication, augmentation strategies can also be tried.

With drug therapy, other things which can be helpful are,

Lifestyle changes are recommended for people with depressive disorder and can be very helpful.
Regular physical exercise.
Social interaction.
Avoiding substance use.
Maintaining a regular sleep–wake cycle.
Engaging in learning new skills are some healthy lifestyle measures that you can adopt.

Doctors can advice you new treatment options which are FDA approved for treatment resistant depression, such as

Ketamine therapy.
Repetitive transcranial magnetic stimulation (rTMS) therapy.
Intensive therapies like electro convulsive therapy (ECT) are safe with good response rates.

Opting for a specific treatment depends on clinical symptoms. When conventional treatment with selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs) does not improve depressive symptoms, then rTMS, ketamine therapy, and ECT sessions are recommended by a psychiatrist.

I hope you find my information useful for you.

Feel free to ask further questions.

Thank you.