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Treatment Resistant Depression

What is Treatment Resistant Depression?

Treatment-resistant depression (TRD) is a form of major depressive disorder (MDD) characterized by the failure of at least two different initial antidepressant treatments to effectively alleviate symptoms during a depressive episode. These treatments need to be administered at appropriate doses and for a sufficient duration (typically six to eight weeks) before a healthcare professional can diagnose TRD.

What are the symptoms of TRD?

People with treatment-resistant depression (TRD) have the same symptoms as people with major depressive disorder, like depressed mood, sleep disturbances and appetite changes. But people with TRD are more likely to have:

:•More severe symptoms

•Depressive episodes that last longer

•Anhedonia (reduced ability to experience pleasure)

•A higher number of lifetime depressive episodes


•Suicidal ideation and behavior

How is TRD diagnosed?

Most healthcare providers diagnose TRD if your depression symptoms haven’t improved after trying at least two antidepressant medications. If you have tried at least two antidepressant medications for a total trial of at least 6-8 weeks, your provider will assess, review and discuss the next steps for treatment.

How is TRD treated?

Here at Excel Psychiatry, we are a certified treatment center for Spravato. Spravato is the only FDA approved nasal spray used to treat patients with major depressive disorder or treatment resistant depression. It is used in conjunction with an antidepressant.

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