What Actually Works For Treatment Resistant Depression?

[@marcoslagomarsino4688]

I’m currently doing spravato treatments (esketamine nasal spray) monitored in a doctors office and I believe having some good success!

[@ShrinksInSneakers]

Thats awesome, ketamine had some really good data recently showing at the 3 month mark outcomes are similar to ECT. The major question is how long should someone take it for and the effects do not seem to last as long as we would like with respect to depression and suicidaility. Hope this helps

[@vwvqr]

Duloxetine, lithium, olanzapine and mirtazapine for me. Spend almost the entire day asleep. Been this way for 3+ years. Lost count of how may hospitalisations i've had for suicidal ideation/attempts. But much to my surprise, my 'dysthimia' is mild, so nothing more can be done. I'm so glad I don't constantly dream of dying and that i'm attention seeking and not actually depressed.

[@Alexander_W]

I feel the same as you and have had similar experiences with treatment resistant depression, along with treatment resistant OCD. I also suffer from addiction. It is a living hell.

[@Clowncentral101]

Shocked to see that antipsychotics work so well for some people for depression

[@ShrinksInSneakers]

It’s been well established for a long time but obviously side effects are the problem. This is why they are not considered first line

[@AlexSerrell]

Seroquel, Abilify, lithium carbonate and thyroid hormone, pfft. it has been shown that D2 blocking drugs don’t help most Americans w/ TRD. I’d think the frequency of incidents of muscular movement disorders post market like dystonia, tardive dyskinesia, akathisia, Parkinsonism would discourage usage of neuroleptics in depression.

[@SusanBunchOfNumbers]

Thank you for doing this video :).

[@ShrinksInSneakers]

No problem thanks for watching

[@gurukiran4567]

Wow i thought California Rocket Fuel would work

[@ifrankensteinsmonster]

Don't know why SSRIs and SNRIs even work... They're the worst!

[@questioneverything1776]

Was Mindfulness CBT included, walking outside, and exercise because I can gtd you these beat all typical drugs except for IV Ketamine and psylicibin

[@ShrinksInSneakers]

This was a medication trial, studies of psychotherapy in TRD have not proven to be as helpful as we would like. Is psychotherapy a good thing, yes, will it cure TRD, no. The same goes for diet and exercise, both great things to add to any mental or physical health treatment, has either been proven to cure TRD, no. Likewise ketamine and psylicibin do not cure depression. The research on psychedelics is still in the early stages and there has been no indication from early studies that it's disease modifying in the case of depression. In short all the things you talked about are worthwhile and should be incorporated into depression treatment. As far as them beating medications in TRD that has not been proven scientifically

[@Limitbreak-yc7su]

Can you please tell me all things that treat major depression please

[@nenadcubric2663]

Ketamine

[@nenadcubric2663]

Olanzapine, Risperidone

[@benjamintausheck6368]

Can you do one on what to do if clozapine isn't working?

[@ShrinksInSneakers]

I can. First get a blood level and make sure it's therapeutic for clozapine thats always my first step. I think the next steps are considering neuro modulation newer TMS protocols or ECT if clozapine has been tried at an adequate dose and duration

[@ifrankensteinsmonster]

​@@ShrinksInSneakersIs Clozapine also used for Depression as an adjunct?... I know the side effects are too much to be used, but does being the best antipsychotic also gives it good or great efficacy for Depression?

[@coupdefoudre5352]

I use clonazapine with Prozac. Tried everything including ECT and Ketamine, only thing that helps are the Clonazapine with the Prozac.

[@questioneverything1776]

I thought seroquel was basically an antihistamine in its mechanism of action. Rarely I see that it works well for depression but it does contribute well to obesity

[@ShrinksInSneakers]

It's not an antihistamine, hydroxyzine and diphenhydramine are. Does it work for depression? It works very well and has been approved by the FDA for both adjunctive treatment in major depression and bipolar I and II depression, Yes it has metabolic side effects including weight gain and the decision to use it should be considered and discussed at length.

[@evrenki1]

Ritalin adult 40mg works!

[@ShrinksInSneakers]

it can be option I wouldn't say first line but it's not out the question if other options aren't effective

[@lui8885]

What about cbd oil?

[@cannibalcatgirl]

CBd made mine significantly worse. Like completely overwhelming sense of dread. I speak only for myself though

[@lui8885]

​@@cannibalcatgirl Thanks for sharing your experience. Are you talking about cbd isolate or full spectrum cbd oil?

[@cannibalcatgirl]

@@lui8885 it was a cbd gummy. I cant remember what kind exactly

[@cadaankudhiigleh]

Be aware cbd oil it did my anxiety 100 worse

[@cannibalcatgirl]

Update: I have found the green crack strain to be the most friendly with my high anxiety and it doesnt cause me paranoia or disphoria like the others have. If anything it helps even everything out

[@Gotinha123]

Nothing

[@bqureshi21]

Mushrooms