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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How can chronic depression be treated?

Hello, I ve had depression for 20+ years and have been on probably every ssri medication out there. I m considering one of these 3 treatments, ECT, TMS, OR Ketemine infusion? Would you recommend one over the other or maybe none of the above? Thank You for your time
Fri, 16 Feb 2018
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Psychiatrist 's  Response
Hello! Welcome to HealthcareMagic!

In my opinion treatment with TMS; how much of a dysfunction is being caused by the depression? Cognitive behavioral-therapy with a trained therapist is very useful.

Hope this clarifies your concerns. Thank you for the query.

Take care

Regards,
Dr. Gayathri, Psychiatrist
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Psychiatrist Dr. Bhagawan Rajana's  Response
Hello! Welcome to HealthcareMagic!

I have gone through your question and understood your concerns. As per your history, I feel your suffering with treatment resistant depression. If I were your treating psychiatrist, I would come out with these possibilities: 1) To add two antidepressants.
2) To add adjuvants like Lithium or Thyroxine.
3) Investigate other causes like thyroid profile and rule out any other organic causes for depression.

If these measures fail:

1) My first choice would be ECT. based on clinical studies it works very well.
2) My next choice RTMS.
3) Last Ketamine infusion. Effects last only for a short duration of time and relapses are frequent.

Hope this clarifies your concerns. Thank you for the query.

Take care

Regards,
Dr. Bhagawan Rajana, Psychiatrist
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