When SSRIs Fail: 3 Additional Approaches To Treating Depression

Posted on: 19 July 2019

Selective serotonin reuptake inhibitors (SSRIs) are often the first-line treatment for depression. However, many people dealing with depression find SSRIs are not effective, and they may spend years trying different ones with no change in symptoms. There are several options beyond the use of SSRIs that can drastically improve depression symptoms.

Different Classes Of Medications

Fortunately, there are several classes of antidepressants and some other classes of medications that may be helpful for depression. Medications that are somewhat related to SSRIs are antidepressants that are reuptake inhibitors for other neurotransmitters, such as dopamine and norepinephrine. Generally, these medications also work on the reuptake of serotonin. Some people find that medications that work on multiple neurotransmitters are more effective than those that only work on serotonin. Monoamine oxidase inhibitors (MAOIs) are an entirely different class of antidepressants that may be more effective in people with "atypical" depression. Another option is the use of certain antipsychotic medications that have been approved as a therapy for depression.

Electroconvulsive Therapy

If you have tried several classes of antidepressants with little or no benefits, your psychiatrist may recommend electroconvulsive therapy (ECT). Many people are apprehensive about the idea of ECT, partly based on the way it was used in decades past. Modern approaches to ECT are fine-tuned to minimize the chance of memory loss. Additionally, you are asleep throughout the procedure so you cannot feel any discomfort. ECT can be performed as a unilateral or bilateral procedure, with unilateral being more common. For ECT to be effective, it is done several times each week for up to three months. Patients continue treatment with medications to prolong any potential benefits and minimize relapse of depressive symptoms. ECT is especially beneficial for people with severe depression and a high risk of suicide.

Ketamine Therapy

A newer treatment that may be helpful for people with treatment-resistant depression is the use of ketamine. Only recently has ketamine been utilized in clinical settings, and it has been found to be an effective pain reliever, too. Since ketamine is not in widespread use, you will need to find a ketamine treatment center that specializes in this treatment. The ketamine is administered via infusion, and most people report benefits quickly, even within hours. How long the effects will last is unique to the individual, but it is not uncommon for patients to feel the benefits for months. Fortunately, when symptoms of depression begin to return, they generally come back slowly, so there is no abrupt change in mood.

SSRIs are so widely used in the treatment of depression that many people may not realize there are other options if they do not work. Trying other classes of medications or more intensive treatments can be the right option to improve depression symptoms.