What is treatment-resistant depression?
Treatment-resistant depression (TRD) generally describes depression that hasn't improved enough after two or more antidepressant medications taken at adequate doses for an adequate length of time. If that sounds like your experience, it doesn't mean nothing will help — it means it may be worth exploring an approach that works differently in the brain.
Living with TRD can be exhausting and isolating. Many of the people we see have tried several medications, done the therapy, and still feel stuck. A consultation is a chance to talk that through with a medical provider and understand whether IV ketamine is a reasonable next step.
A mechanism that bypasses the antidepressant pathway
When depression doesn't respond to standard antidepressants, it may be because those medications rely on the same serotonin and norepinephrine pathways that haven't worked for you. Ketamine acts on a completely different system — the brain's glutamate pathway, specifically NMDA receptors — which is why it can produce a response even after multiple antidepressants have not.
Bypasses prior failures
Because ketamine's mechanism is unrelated to serotonin-based antidepressants, a history of non-response doesn't predict a ketamine outcome.
Rapid onset in some patients
Some people with TRD notice measurable shifts within hours to days — a meaningful difference when months of waiting on other medications have yielded little.
Continued alongside existing care
Many patients keep their current medications in place during ketamine therapy; any changes are made only with their prescriber and our provider.
What treatment looks like for TRD patients
TRD protocols differ in important ways from a first-line depression evaluation. Your provider will review your antidepressant history — medications tried, doses, duration, and reasons for stopping — before recommending a plan. This history shapes the conversation about whether IV ketamine is appropriate and what the treatment course may involve.
Many patients begin with a short series of infusions, with response assessed closely throughout. Maintenance sessions may be discussed depending on your progress. Ketamine is not a cure for treatment-resistant depression; for most people it is one part of a care plan that continues to include psychotherapy and coordination with existing providers.
Treatment-Resistant Depression FAQs
Depression doesn't have to be the last word.
Begin with a consultation. We'll review your history, answer your questions, and help you decide if IV ketamine therapy is right for you.
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Consultations are scheduled privately by phone and email — no online intake form.
Medical disclaimer. This page is for educational purposes only and does not provide medical advice, diagnosis, or treatment. Ketamine is used off-label for mental health conditions, is not appropriate for everyone, and individual results vary. Candidacy is determined only after a clinical evaluation by a licensed medical provider. If you are in crisis or thinking about harming yourself, call or text 988 or go to the nearest emergency room.