If you're struggling with treatment-resistant depression (TRD) in the Atlanta area, you're not alone—and you have more options than ever before. The metro Atlanta region offers access to several advanced treatments that can help when traditional antidepressants haven't worked. Here's a comprehensive guide to what's available.
What Is Treatment-Resistant Depression?
Treatment-resistant depression is typically defined as major depressive disorder that hasn't adequately responded to at least two different antidepressant medications tried at proper doses for adequate duration. This affects approximately one-third of people diagnosed with depression.
You May Have TRD If:
- • You've tried multiple antidepressants without significant relief
- • Medications that initially helped have stopped working
- • Side effects prevent you from taking effective doses
- • Depression continues to significantly impact your daily life
- • You've combined medication with therapy without improvement
Advanced Treatment Options Available in Atlanta
1. Spravato (Esketamine) Treatment
What It Is
Spravato is an FDA-approved nasal spray containing esketamine, a derivative of ketamine. It works through a completely different mechanism than traditional antidepressants, targeting the glutamate system rather than serotonin.
Key Benefits:
- • FDA-approved specifically for TRD
- • Rapid onset—many patients notice improvement within weeks
- • Often covered by insurance (including Medicare and Medicaid)
- • Administered at certified treatment centers
Multiple certified Spravato treatment centers operate in the Atlanta metro area, including our practice in Roswell. Treatment involves twice-weekly sessions initially, with each visit lasting about 2.5 hours due to required monitoring.
2. Transcranial Magnetic Stimulation (TMS)
What It Is
TMS uses magnetic pulses to stimulate nerve cells in areas of the brain involved in mood regulation. It's FDA-cleared for treatment-resistant depression and requires no anesthesia or sedation.
Key Benefits:
- • Non-invasive—no medications enter your system
- • Minimal side effects (primarily mild headache)
- • Can return to normal activities immediately
- • Often covered by insurance after medication failure
Traditional TMS requires daily sessions (5 days/week) for 4-6 weeks. Newer accelerated protocols can compress this timeline. Several TMS clinics operate throughout Atlanta.
3. Ketamine Infusion Therapy
What It Is
IV ketamine infusions deliver the anesthetic drug intravenously at sub-anesthetic doses. While not FDA-approved specifically for depression (off-label use), significant research supports its effectiveness.
Key Considerations:
- • Rapid effects—some patients feel better within hours
- • Typically not covered by insurance
- • Cost: $400-800 per infusion
- • Initial series usually 6 infusions over 2-3 weeks
Multiple ketamine clinics operate in the Atlanta area. If cost is a barrier, Spravato (which works similarly) is often a more affordable option with insurance coverage.
4. Electroconvulsive Therapy (ECT)
What It Is
ECT delivers controlled electrical currents to the brain under anesthesia to trigger brief seizures. Despite outdated stigma, modern ECT is considered one of the most effective treatments for severe depression.
Key Points:
- • Highly effective, especially for severe cases
- • Performed under general anesthesia
- • Typically 6-12 sessions over several weeks
- • Available at major Atlanta hospitals
- • Memory side effects possible but usually temporary
ECT is typically reserved for severe cases, including depression with psychosis, catatonia, or high suicide risk. Several Atlanta-area hospitals, including Emory and Grady, offer ECT programs.
5. Medication Augmentation Strategies
Sometimes the answer isn't a new treatment modality but a strategic combination of medications. A skilled psychiatrist can try various augmentation approaches:
Atypical Antipsychotics
Adding medications like aripiprazole or quetiapine to enhance antidepressant effect
Lithium Augmentation
Adding lithium to boost antidepressant response
Thyroid Hormone
T3 supplementation can enhance antidepressant effectiveness
Combination Antidepressants
Strategic combination of different antidepressant classes
Choosing the Right Treatment
The best treatment depends on multiple factors unique to your situation:
Consider These Factors:
- Severity of Depression: More severe cases may warrant ECT or intensive ketamine/Spravato protocols
- Insurance Coverage: Spravato and TMS are often covered; ketamine typically is not
- Time Commitment: TMS requires daily visits; Spravato twice weekly initially
- Previous Treatments: What you've tried already guides what to try next
- Medical History: Some treatments may not be appropriate for certain conditions
- Personal Preference: Some prefer non-medication approaches; others want faster-acting options
Why Location Matters for TRD Treatment
Many advanced depression treatments require frequent in-person visits. When choosing a provider, consider:
- Proximity to home or work: Twice-weekly Spravato visits or daily TMS sessions are easier to maintain if the clinic is convenient
- Traffic patterns: Atlanta traffic is real—consider timing and location carefully
- Transportation needs: Some treatments (Spravato, ketamine) require someone else to drive you home
- Provider expertise: Look for clinics specializing in TRD, not just general psychiatry
Our Approach at Next Step Psychiatry
We specialize in treatment-resistant depression and offer Spravato treatment at our Roswell location, serving patients throughout metro Atlanta. We're known for our expertise in obtaining insurance coverage for Spravato—even when other clinics have said it's not covered.
What Sets Us Apart:
- • Certified Spravato treatment center
- • Expertise in insurance navigation and prior authorizations
- • Comprehensive psychiatric care alongside Spravato
- • Experience with complex, treatment-resistant cases
- • Convenient Roswell location serving North Atlanta
Taking the Next Step
If you've been struggling with depression that hasn't responded to traditional treatments, don't give up. The landscape of depression treatment has evolved significantly, and options that didn't exist a few years ago—like Spravato—are now accessible to Atlanta-area patients.
The first step is connecting with a provider who understands treatment-resistant depression and can help you navigate the options available. Whether Spravato, TMS, or another approach is right for you, specialized care makes all the difference.
Told Spravato Isn't Covered? Give Us a Chance.
We specialize in obtaining Spravato coverage when other clinics couldn't. Whether you have commercial insurance, marketplace plans, Medicare, Medicaid, or other coverage—we very likely can figure it out.
Ready to Explore Your Options?
We're a certified Spravato treatment center serving the Atlanta metro area from our Roswell location.