
Why Antidepressants Stop Working — And What to Try Next

Depression is a complex condition, and finding the right treatment can feel like hit-or-miss. You may be on an antidepressant and have felt some much-needed relief, only to find that over the last several months, it just doesn’t work like it used to.
If you’re feeling anxious about that, there are options for you, including newer therapies like ketamine infusion, which we offer under the expert care of Michael Gentile, MD, at Wyckoff Wellness Center, here in Wyckoff, New Jersey.
When antidepressants lose their effectiveness
This unfortunate situation is called antidepressant tolerance. It occurs when your brain gets used to the medication, and the positive effects begin to wear off. It may happen due to:
- Shifts in your brain chemistry, reducing the medication’s impact
- Interference from underlying conditions
- A change in or deepening of your depression
If you’re facing antidepressant tolerance, Dr. Gentile may suggest:
- Increasing the dosage (if it’s safe to do so)
- Changing to a different type of antidepressant
- Using psychopharmacology to combine medications to improve overall effectiveness
- Adding psychotherapy and lifestyle strategies to boost outcomes
If those don’t make a difference for you, Dr. Gentile assesses you to determine if you have the type of depression that doesn’t respond to traditional treatment.
Treatment-resistant depression
If you’ve tried two different types of antidepressants and neither worked well or for long (6-8 weeks), you may have treatment‑resistant depression (TRD). It can feel overwhelming and all-consuming and significantly affect your quality of life.
But even with its discouraging name and all the medications you’ve already tried, there’s hope and help for TRD.
Enter fast-acting and effective ketamine infusion therapy. Ketamine is an N-methyl-D-aspartate (NMDA)/glutamate receptor antagonist, working with your brain’s glutamate system, not its serotonin, like traditional antidepressants.
Some of the benefits of ketamine infusion therapy are:
- Rapid effect
- Significant relief
- Reduction in suicidal ideation and thoughts of self-harm within hours
Under the care of a skilled psychiatrist like Dr. Gentile, ketamine infusions are safe.
Ketamine infusions: What to expect
You lean back in a cozy chair in a quiet room while the ketamine enters your system via an IV. Through a process called neuroplasticity, ketamine helps your brain rewire when it's stuck in repetitive thought patterns.
During your sessions here at Wyckoff Wellness Center, and while a shift is happening in your brain, you might temporarily feel disconnected from yourself or like you’re in a dream instead of your real life.
Side effects are typically mild and include an elevated heart rate, dizziness, a floating sensation, and nausea. Dr. Gentile stays with you to monitor your vital signs and mental state before and after your infusions, and he talks through the experience with you when it’s complete.
Don’t lose hope
If you feel like nothing’s working, don’t lose hope. Turn to Dr. Gentile for compassionate, skilled TRD care with supervised ketamine infusion therapy. Call our office now or request an in-person or virtual consultation online.
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