Two antidepressants didn’t work? There’s a treatment made for exactly that.
Doctors call it treatment-resistant depression, and it simply means the usual medications haven’t helped enough yet. It’s common, it’s not your fault, and it’s exactly who Spravato is FDA-approved for: a treatment that works on a different system in the brain from the ones you’ve tried.
Two antidepressants that didn’t help enough.
Treatment-resistant depression (TRD) is major depression that hasn’t responded well enough to at least two antidepressants.
Not sure whether yours count? That’s something we go through with you at your evaluation.
Not because you didn’t try hard enough.
Most antidepressants work on the same few brain chemicals, mainly serotonin and norepinephrine. If that route doesn’t work for your depression, trying another drug that takes the same route often doesn’t either.
That’s why the next step is usually a treatment that works differently, not just another prescription of the same kind.
The options after two antidepressants.
| Option | How it works | Worth knowing |
|---|---|---|
| Spravato (esketamine) | Nasal spray acting on glutamate, a different system from most antidepressants | FDA-approved for TRD; given in certified offices; covered by most insurance |
| Adding a second medication | An add-on such as an antipsychotic or lithium alongside your antidepressant | Common next step; some add-ons cause weight gain or other long-term side effects |
| TMS | Magnetic pulses to the brain, daily sessions over several weeks | No medication; a daily schedule at first |
| IV ketamine | Ketamine infusions | Off-label for depression; usually self-pay |
| ECT | Electroconvulsive therapy under anesthesia | Highly effective for severe depression; memory side effects are a concern for some |
Two antidepressants didn’t work? That’s why you qualify.
See exactly what qualifies, and what rules Spravato out, before you call.
Name, date of birth and insurer. We check your plan and call you back. No commitment.
Check my coverageRegister once, and our team starts your insurance check and reaches out to schedule your evaluation.
Request an evaluationIt beat a standard add-on head to head.
In the ESCAPE-TRD trial, people with treatment-resistant depression did better on Spravato than on quetiapine, a common add-on medication: 55.7% were in remission at 32 weeks, against 36.3%, and fewer stopped because of side effects (4.5% against 10.1%).1
Our team has given more than 30,000 Spravato treatments across four New Jersey offices. How well it works · Am I a candidate?
What people ask about treatment-resistant depression.
What is treatment-resistant depression?
Major depression that hasn’t responded well enough to at least two antidepressants.
Is treatment-resistant depression permanent?
No. It means the first treatments didn’t work, not that nothing will. Treatments that work differently, like Spravato, are designed for exactly this situation.
How many antidepressants do I have to fail to qualify for Spravato?
At least two. We’ll go through your history with you at your evaluation; you don’t need perfect records.
Where can I get treatment for treatment-resistant depression in New Jersey?
We treat it with Spravato at four New Jersey offices: Bridgewater, Morristown, Hoboken and Nutley. Call (908) 450-7002.