Treatment Resistant Depression

What is treatment-resistant depression?

Treatment-resistant depression (TRD) is a form of major depressive disorder that doesn’t respond to traditional treatments like antidepressant medications and talk therapy. If you have TRD, it means you’ve often tried two or more different types of antidepressants and taken them for a sufficient period at the right dosage, without significant improvement in your symptoms.

This form of depression can be particularly frustrating and emotionally exhausting, as it can impact your relationships, work, and overall quality of life. TRD doesn’t mean recovery is impossible; rather, it indicates you may need more specialized or advanced approaches.

How is treatment-resistant depression diagnosed?

TRD is typically diagnosed after you’ve tried at least two different antidepressants from different classes, without achieving adequate relief from symptoms. Dr. Gentile gathers information about the following:

• Previous medications
• Dosages
• Treatment duration
• Side effects

He will also want to know if you had therapy. Dr. Gentile takes a close look at your history to be sure he can rule out other conditions that can mimic depression or interfere with treatment, such as thyroid problems, medication side effects, or undiagnosed bipolar disorder. An accurate diagnosis ensures he can develop the most effective treatment strategy.

How is treatment-resistant depression treated?

At Wyckoff Wellness Center, Dr. Gentile offers ketamine to treat TRD. Ketamine was once used mainly as an anesthetic but is now recognized as a powerful option for people with treatment-resistant depression.

When administered at low doses through intravenous (IV) infusions or other forms like intranasal esketamine (Spravato®), ketamine can rapidly relieve depressive symptoms, sometimes within hours or days.

Unlike traditional antidepressants that work by altering serotonin or norepinephrine levels, ketamine targets the brain’s glutamate system and N-methyl-D-aspartate (NMDA) receptors. This helps stimulate the growth of new neural connections and may help “reset” areas of the brain involved in mood regulation.

Ketamine’s fast-acting nature is especially helpful if you have severe depression or suicidal thoughts, where waiting weeks for a standard antidepressant to work isn't an option. While not a cure, ketamine infusions can provide relief when other treatments have failed and may be used alongside therapy or other medications as part of a comprehensive care plan.

Under Dr. Gentile’s supervision, ketamine can be a life-changing option for managing treatment-resistant depression.

You don’t have to suffer from treatment-resistant depression. Contact Wyckoff Wellness Center to learn more about ketamine infusions as an effective treatment. Call or book online today.