Treatment-resistant depression is depression that has failed to respond to at least two previous antidepressant treatments. In order for depression to be considered treatment-resistant, you have to have tried at least two antidepressant treatments for a period of six weeks each, without achieving at least a 50% improvement in your symptoms.
Treatment-resistant depression is common; about 50-60% of patients don’t respond to their first or second antidepressant treatments.
Treatment-resistant depression also refers to the reality that for many people with depression, full recovery is elusive. While standard treatment may help to a degree, full return to normal function is less likely for those with treatment-resistant depression.
Estimates indicate 80% of patients with treatment-resistant depression experience a relapse of symptoms within a year of remission. Those who have treatment-resistant depression over the course of a decade are likely to recover to full function only about 40% of the time.
Treatment Resistant Depression Options
In recent years, promising new treatments have emerged for treatment-resistant depression, including ketamine therapies and esketamine. Esketamine is a nasal spray version of ketamine used in conjunction with a more traditional antidepressant medication.
Psilocybin (the active ingredient in magic mushrooms) also shows a great deal of promise for treating treatment-resistant depression. Early studies suggest that two to three sessions of psilocybin-assisted therapy seem to cause full, lasting remission of treatment-resistant depression in a large percentage of patients.
https://pubmed.ncbi.nlm.nih.gov/12706951/
https://onlinelibrary.wiley.com/doi/abs/10.1002/da.22968
https://www.sciencedirect.com/science/article/abs/pii/S0193953X05702835
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982454/