Antidepressants are a common way of treating depression. While this class of drugs can be effective for some people, other people may not realize the full benefits of this treatment and may be treatment-resistant.  Perhaps you have struggled or know other people who have utilized traditional treatments without much success and feel hopeless about your treatment. 

There are several classes of antidepressants that include:

  • Selective serotonin reuptake inhibitors (i.e. Fluoxetine, Citalopram, Sertraline, Paroxetine, and Escitalopram)
  • Serotonin and norepinephrine reuptake inhibitors  (i.e. Venlafaxine, Duloxetine)
  • Bupropion- increases activity in the brain and has been effective for smoke cessation.
  • Older antidepressants (i.e.  Tricyclics, Tetracyclics, and Monamine Oxidase Inhibitors (MAOIs). 

Antidepressants have been effective for many people and been game changers in treating depression for many individuals.   As with any medications, there are both benefits and adverse effects of utilizing pharmacology. ( is a great resource for obtaining useful information.

So, what happens if you are in the subgroup of individuals who do not respond to traditional treatment such as antidepressants?  What are your options?  There are other options for treating depression that may be resistant to traditional treatment such as electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation, or ketamine treatment.

Electroconvulsive therapy (ECT) is treatment that is used to treat depression that has not responded to traditional treatment. Electroconvulsive therapy involves placing the individuals under anesthesia to electrically stimulate the brain.

Transcranial Magnetic Stimulation (TMS) is a noninvasive treatment that utilizes magnetic fields to stimulate certain regions of the brain.

Vagus Nerve Stimulation (VNS) was originally developed to treat seizure disorder but has been useful in treating depression. An electrical pulse generator is placed under the skin and sends electrical pulses to the vagus nerve.   The vagus nerve is an integral part of the autonomic nervous system and is important in regulating metabolic homeostasis (Howland, 2014). 

Ketamine is an anesthetic that has been used to treat depression.  Ketamine enables the cortex to develop new connections which helps individuals develop new positive thoughts and behaviors (Yale, 2022).

These are just some treatments to consider for treatment-resistant depression and there is no “one size fits all”. What works for one person, may not work for another.  Of course, there are other perspectives or holistic approaches to consider when developing a treatment plan for treating depression and an integrated approach appears to yield the best outcomes.   For more information on these treatments, please review the sources noted below.

NCBI. (2020).  Depression: How effective are antidepressants:  Retrieved from 

NIH MedlinePlus (2020).  Commonly prescribed antidepressants and how they work.

American Psychiatric Association. (n.d.) What is electroconvulsive therapy (ECT)?

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Yale Medicine (2022). Treating Depression: An Expert Discusses Risks, Benefits of Ketamine.

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