When First-Line Fails: Practical Approaches to Treatment-Resistant Depression

[madman]

Are you a healthcare professional looking to deepen your understanding of the latest depression treatment strategies? Join us on The Curbsiders as Dr. Matthew Frankwato and Dr. Paul Nelson Williams welcome back renowned guest Dr. Jesse Gold to discuss advanced topics in managing treatment-resistant depression. This episode provides an essential guide for primary care providers, covering critical screening methods, first-line medications, and innovative alternative therapies to enhance patient care.

In this deep-dive episode, our experts review foundational considerations like ruling out comorbid medical conditions and the importance of pushing medication dosages to an effective level. They also explore the nuances of tapering medications with difficult side effects, such as those from SNRIs like venlafaxine. We also highlight the potential of adjunctive treatments and emerging therapies like transcranial magnetic stimulation (TMS) and ketamine, offering a comprehensive look beyond traditional approaches.

 

[madman]

Thread 'Depression — Advanced Treatments for Treatment-Resistant Depression'

Jun 8, 2024

In this third episode of a four-part Double Take video miniseries on depression from the New England Journal of Medicine, Drs. Sanacora, Nikayin, and Cristancho discuss the role neuroplasticity may play in the pathogenesis of depression and the benefits to patients of advanced therapies for treatment-resistant depression, such as electroconvulsive therapy and transcranial magnetic stimulation. An overview of emerging evidence for the use of ketamine, esketamine, and psilocybin as new or potential treatments is also examined.

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• madman
• depression; diagnosis/advanced treatments
• Replies: 13
• Forum: Mental Health

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[madman]

Thread 'Dr. Roy Perlis on esketamine as an option for treatment-resistant depression.'

Oct 27, 2024

Dr. Roy Perlis is the director of the Center for Quantitative Health at Massachusetts General Hospital and a professor of psychiatry at Harvard Medical School. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. J. Kim and Others. Esketamine for Treatment-Resistant Depression — First FDA-Approved Antidepressant in a New Class. N Engl J Med 2019;381:1-4.

• madman
• depression; mdd; ketamine; esketamine; treatment
• Replies: 0
• Forum: Mental Health

Post in thread 'Ketamine's Role in Medicine: What You Need to Know'

Jan 9, 2025

Ketamine for the Treatment of MDD

https://www.hcplive.com/view/ketamine-for-the-treatment-of-mdd Ryan Oakley, MD, takes a closer look at the recent history of ketamine in depression. He also explores the differences between ketamine and esketamine.

www.excelmale.com

Depression — Advanced Treatments for Treatment-Resistant Depression

In this third episode of a four-part Double Take video miniseries on depression from the New England Journal of Medicine, Drs. Sanacora, Nikayin, and Cristancho discuss the role neuroplasticity may play in the pathogenesis of depression and the benefits to patients of advanced therapies for...

www.excelmale.com

• madman

Thread 'Ketamine: A tale of two enantiomers'

Mar 25, 2021

Abstract

The discovery of the rapid antidepressant effects of the dissociative anaesthetic ketamine, an uncompetitive N-Methyl-D-Aspartate receptor antagonist, is arguably the most important breakthrough in depression research in the last 50 years. Ketamine remains an off-label treatment for treatment-resistant depression with factors that limit widespread use including its dissociative effects and abuse potential. Ketamine is a racemic mixture, composed of equal amounts of (S)-ketamine and (R)-ketamine. An (S)-ketamine nasal spray has been developed...

• madman
• ketamine
• Replies: 9
• Forum: Mental Health

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Thread 'Psilocybin therapy is effective for treatment-resistant depression'

Nov 14, 2021

COMPASS Pathways announces positive topline results from groundbreaking phase IIb trial of investigational COMP360 psilocybin therapy for treatment-resistant depression

The largest randomized, controlled, double-blind psilocybin therapy study ever completed shows rapid and sustained response for patients receiving a single dose of COMP360 psilocybin with psychological support


COMPASS Pathways plc (Nasdaq: CMPS) (“COMPASS”), a mental health care company dedicated to accelerating patient access to evidence-based innovation in mental health, today announced that its...

• madman
• magic mushrooms; psilocybin therapy; depression
• Replies: 35
• Forum: Mental Health

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Thread 'Psilocybin therapy is effective for treating serious depression'

Nov 14, 2021

COMPASS Pathways announces positive topline results from groundbreaking phase IIb trial of investigational COMP360 psilocybin therapy for treatment-resistant depression | COMPASS Pathways plc

Largest randomised, controlled, double-blind psilocybin therapy study ever completed shows rapid and sustained response for patients receiving a single dose of COMP360 psilocybin with psychological support COMPASS management team to host an investor conference call today at 1.00pm UK (8.00am ET)

ir.compasspathways.com

COMPASS Pathways announces positive topline results from groundbreaking phase IIb trial of investigational COMP360 psilocybin therapy for treatment-resistant depression

The largest randomized, controlled, double-blind psilocybin therapy study ever completed shows rapid and sustained response for patients receiving a single dose of COMP360 psilocybin with psychological support


COMPASS Pathways plc (Nasdaq: CMPS) (“COMPASS”), a mental...

• madman
• psilocybin therapy; magic mushrooms; depression
• Replies: 4
• Forum: Mental Health

Thread 'Nitrous Oxide: an emerging novel treatment for treatment-resistant depression'

Aug 17, 2022

Nitrous Oxide: an emerging novel treatment for treatment-resistant depression (2022)
Darin F. Quach, Victoria C. de Leon, Charles R. Conway


ABSTRACT

Stemming from the results of the historic STAR-D trial, it is evident that a significant subset of individuals (20–25%) with major depressive disorder (MDD) do not respond to conventional antidepressant medications. As a result, an emphasis has been placed on the development of novel therapeutics for MDD over the last two decades. Recently, substantial research efforts have been focused on the use of ketamine as an...

• madman
• nitric oxide; ketamine; depression
• Replies: 3
• Forum: When TRT Is Not Enough (ED, Libido, & More)

 

[madman]

Thread 'Ketamine Therapy vs TMS & ECT: Breakthrough Mental Health Treatments and the Future of Interventional Psychiatry'

Oct 24, 2025

In this episode of Better Edge, Brandon Hamm, MD, discusses an evidence-based approach to ketamine therapy, including patient selection, safety protocols and a newly expanded infusion suite. He compares ketamine with TMS and ECT, addresses common misconceptions and highlights training opportunities for residents. The episode also previews emerging treatments like vagus nerve stimulation.




Clinical impact

This conversation underscores ketamine’s growing role as a safe, effective option within a comprehensive interventional psychiatry...

• madman
• depression; mdd; ketamine; esketamine; treatment
• Replies: 1
• Forum: Mental Health