Treatment Refractory Depression Specialist

Sandhya Prashad, M.D. -  - Psychiatry - Depression Specialist

Houston Deep TMS Therapy & Ketamine

Sandhya Prashad, M.D.

Psychiatry - Depression Specialist located in Bellaire, TX

It’s estimated that about one-third of patients diagnosed with depression develop treatment refractory depression when antidepressants fail to improve their symptoms. Sandhya Prashad, MD, at Houston Deep TMS Therapy has extensive experience helping patients overcome refractory depression. Dr. Prashad offers safe, effective, and innovative therapies such as ketamine infusions and transcranial magnetic stimulation. You don’t need to continue suffering from treatment-refractory depression. Call the office in Bellaire, Texas, or book an appointment online.

Treatment Refractory Depression Q & A

What is treatment-refractory depression?

When your depression is treated with antidepressants, but your symptoms don’t improve, you may have treatment refractory depression. However, you’ll need to go through at least two trials of antidepressant treatment before your depression is considered refractory to treatment.

The number of trials is determined by Dr. Prashad and based on each patient’s symptoms and the degree of improvement they achieve if any.

There are many types of antidepressants and combinations of medications. Individual patients respond differently to each medication. Even the dose needed to achieve symptom relief varies with each person.

You need to take the right dose of the right medication for an adequate amount of time to see if it will help your depression. This process usually requires time and some trial-and-error before Dr. Prashad determines that you’re treatment-resistant to antidepressants.

What increases your risk of developing treatment-refractory depression?

Major depression is a complex disorder affected by many different variables, from your genetics to stressful life events to substance abuse. There’s no way to predict how you’ll respond to antidepressant medications. However, these factors may increase your risk of being resistant to medications:

  • Severe depression
  • Depressive episodes that last a long time
  • Being diagnosed with multiple psychiatric disorders
  • Certain types of depression

Treatment resistance occurs more often in some types of depression, such as bipolar depression.

How is refractory depression treated?

Dr. Prashad begins by prescribing varying types and doses of antidepressants. She may also recommend adding psychotherapy to your treatment. Most patients get better and longer-lasting symptom relief by combining medication with therapy.  

In some cases, Dr. Prashad may recommend genetic testing, which reveals how your body metabolizes medications. With this information, she can determine your optimal dose without as much trial and error.

As a specialist in helping patients with depression, Dr. Prashad offers two innovative therapies proven to successfully improve treatment refractory depression:

Ketamine infusions

Ketamine is an anesthetic medication that’s highly effective for treating refractory depression. Low doses of intravenous ketamine balance brain chemicals that regulate depression. After IV infusion, ketamine acts quickly, with most patients seeing some symptoms improve within one day.

For optimal results, Dr. Prashad recommends a full course of treatment: six infusions during the first two weeks followed by maintenance treatments. The frequency of your maintenance treatments depends on your response to the medication.

Deep transcranial magnetic stimulation (dTMS)

When magnetic impulses are directly targeted to regions of the brain that regulate mood, they increase electrical activity and improve symptoms of depression. Dr. Prashad uses the BrainsWay® dTMS system, which is FDA-cleared as a safe and effective treatment for refractory depression.

If your depression symptoms continue despite taking antidepressants, call Houston Deep TMS Therapy or book an appointment online.