Ketamine, magic mushroom drug used on treatment-resistant depression, along with conventional talk therapy and ECT

Conventional means of treating depression, such as antidepressants and psychotherapy, often fail to improve a patient’s condition

Researchers have been studying ways to tackle treatment-resistant depression (TRD), including by the prescription of psychedelic drugs esketamine and psilocybin

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Depression doesn’t always respond to regular treatment; and experts are looking at psychedelic drugs such as esketamine (available in a spray, above) and psilocybin, and electroconvulsive and magnetic therapies, as alternative treatments. Photo: Shutterstock

Published: 6:15pm, 16 Jan 2024Updated: 8:43am, 18 Jan 2024

A diagnosis of treatment-resistant depression (TRD) sounds like the end of the road. Fortunately, it’s not.

“Depression, even if it proves to be stubborn, is a very treatable condition,” says psychiatrist and psychotherapist Dr Mazda Adli, head of the affective disorders research division at Charité University Hospital in Berlin, Germany.

So if your doctor says your depression is “treatment-resistant”, it doesn’t mean nothing more can be done for you. The term is used when adequate dosages of at least two different antidepressants, administered for four to six weeks, don’t improve your symptoms.

“It’s very important to make clear that ‘treatment-resistant’ doesn’t mean you aren’t treatable, but that your depression is simply refractory to treatment,” meaning it is not responding, Adli says.

“Depression, even if it proves to be stubborn, is a very treatable condition,” says Dr Mazda Adli, head of the affective disorders research division at Charité University Hospital in Berlin, Germany

He says about a third of patients with major depressive disorders don’t respond to initial treatment with two antidepressants.

“Patients, their relatives, and the doctors then need plenty of staying power and patience with treatment,” says Adli. There are many ways to help people with depression, he adds, even when medications – and perhaps a first go at psychotherapy, or “talk therapy” – have little effect at the outset.