Why Some Depression Doesn't Respond to Antidepressants — and What Doctors Try Next
The Times ran a broad explainer on treatment-resistant depression — roughly defined as not improving by half after two different antidepressants, which describes an estimated 31% of people treated for depression in the US. Yale's Gerard Sanacora and UC Davis's Debra Kahn walk through what's tried next: TMS (patients on TMS plus an antidepressant were 2.8x as likely to reach remission as sham TMS plus antidepressant, per a 2023 meta-analysis of 19 trials), esketamine/Spravato (52.5% response vs. about 31% on placebo in its approval trial), lithium, and combination approaches. Psilocybin, ibogaine, and 5-MeO-DMT get one line — "also being studied" — which is a useful reminder of where psychedelics actually sit in mainstream medical coverage right now: a footnote to ketamine and neuromodulation, not yet a headline treatment.
Read at The New York Times