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Treatment Resistant Depression


Up to one-third of adults with major depression continue to have depression symptoms—such as persistent feelings of sadness, sleep disturbances, low energy and thoughts of death or suicide—that don’t respond to treatment.

One of the largest studies in depression 'The Sequenced Treatment Alternatives to Relieve depression (STAR-D) showed that the likelihood of response and remission progressively decreases as patients fail each antidepressant. Current antidepressants have limited efficacy and may patients discontinue their antidepressants due to lack of efficacy or side effects. 


What is TRD ?

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TRD is depression which has not responded to treatment with ≥2 different antidepressants prescribed in adequate dosage for adequate duration (6-8 weeks)- and further trials of traditional antidepressants are unlikely to help

Treatment options 


There are few treatment options for patients with TRD

1. Transcranial magnetic Stimulation

2. Esketamine (Spravato)

3. ECT- Electroconvulsive therapy

At Synapse Behavioral Health, we specialize in treating patients with TRD with a thorough evaluation including rating scales, neuropsychological testing, genetic testing and through treatment modalities like cognitive therapy, TMS and Spravato


Best Practices Treatment Guideline for Depression

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