Are Antidepressants Doing Enough?

How to know when it’s time to try a new treatment plan for depression

In the United States alone, it’s estimated that 17+ million individuals have suffered at least one major depressive episode. A number that high can be difficult to visualize or fully grasp, but think of it this way: that’s more than eight times the population of Manhattan, New York City’s most densely populated borough, and what most people picture when they think of the ‘Big Apple’. Depression is widely experienced by Americans on a large scale, and while depression probably looks different for you and for your neighbor, you may be on the same treatment plan. Medication is the most commonly used treatment for depression, and 13%  (nearly 45 million people) of the entire United States population takes at least one anti-depressant, and those numbers are likely to rise amid and following the impact of COVID-19. However, depression is not black and white, and neither should be the treatment provided.

depressionWhile many people experience the positive benefits of an antidepressant, up to 30% of those with major depression do not show improvement, or experience minimal positive effects often coupled with a high rate of relapse into a depressive episode. In STAR-D,  the largest clinical trial conducted that studied the effectiveness of a multi-tiered approach to treating major depressive disorder (MDD), it was demonstrated that a phased treatment plan consisting of both pharmacology and cognitive therapy is most likely to prevent remission in depressed patients, with remission rates of 50% during the early phases of treatment. However, for those individuals who required a third or fourth-phase treatment with various anti-depressants, the likelihood of remission significantly decreased to less than 10%. The trial sheds light on the fact that for many individuals with major depressive disorder,  continual treatment through anti-depressants can be a flawed approach toward achieving remission from chronic depression, as the disorder can be treatment-resistant for a large number of individuals.

So how, then, do you know if an antidepressant is the right treatment option for you? There are a number of variables that impact an individual’s unique response to medication, but anti-depressants may not be working if you’ve experienced the following:

  • A clinician has diagnosed you with major depressive disorder – a depression that lasts more than two weeks.
  • You have taken an antidepressant (such as Zoloft, Lexapro, Prozac, Paxil) for more than six weeks with no improvement in depressive symptoms.
  • You have increased the dosage of your SSRI with minimal improvements to your depression.
  • Your treatment includes both medication and cognitive therapy, but you frequently relapse or have yet to achieve remission.
  • You are experiencing negative side effects to taking medication that outweigh the potential benefits (uncommon but severe side effects include increased suicidal ideation, overwhelming fatigue, heightened anxiety, and presence of a sleep disorder such as insomnia or significant oversleeping).

As the rate of depression continues to rise, so has the number of treatment options available. One such option is TMS, or Transcranial Magnetic Stimulation therapy, a non-invasive treatment that is particularly effective for individuals who face the above challenges with antidepressants. TMS therapy uses gentle magnetic pulses at targeted areas of the brain to stimulate cells into activity, which can produce long-lasting results and greatly reduce depressive symptoms. At The TMS Collaborative, 80% of our patients have experienced the benefits of TMS therapy and have regained feelings of happiness and well-being. Unlike antidepressants, TMS therapy has minimal side effects and a specific timeline for treatment – a complete treatment consists of 36 sessions, each lasting less than 20 minutes and with little to no effect on the rest of your day. TMS therapy is covered by most insurance plans, and is a safe option for individuals who have tried anti-depressants with little success.

The team at TMS Collaborative is here to help guide you through the process of pursuing TMS therapy for treatment of depression. We are happy to work with you and provide an assessment on whether TMS is the right next step in your treatment plan after you’ve tried medication. To learn more about how we can work with you, simply fill out the form below or reach out to us at [email protected] / (603) 988-2561.