Many people who suffer from depression have found effective remedies. For some people, though, standard depression treatments alleviate few or none of their symptoms. In his 1998 article "Practical Management of Treatment-Resistant Depression," Dr. Roger Cadieux from the Pennsylvania State University College of Medicine reported 10 to 30 percent of depressed patients taking antidepressants experience little or no antidepressant effect. For these patients, many other treatment options still exist that provide hope and the promise of relief.
Optimization
Even if you've tried antidepressants or different medications and they have not helped, do not lose hope. You may simply have not tried the right medication or combination of medications. Several strategies exist that may bring better relief. One such option is called optimization.
Antidepressants can take a long period of time to reach full effect. For some people, they will not respond unless their medication dosage increases to a high level. Optimizing your antidepressant by allowing at least a four- to six-week trial and then, if partial effectiveness is shown, increasing the dosage and allowing another four to six weeks may prove beneficial.
Drug Substitution
If you do not show even slight symptom improvement on your current medication, switching to an entirely different medication may prove helpful. In 2009, Mayo Clinic staff reported in nearly one in three people, the first antidepressant they tried did not work at all. Each person responds to medications differently, and you may need to try a few different ones before you find the one that works for you.
Augmentation
Augmentation refers to taking an antidepressant and adding another medication generally used for another mental health condition to amplify the effect of the antidepressant. Many different drugs provide augmenting effects; therefore, it may take some initial trial and error to find the right agent. Common augmenting medications include anti-anxiety medications, anti-seizure medications, mood stabilizers, beta blockers, antipsychotics and stimulants. Some of these medications have bothersome side effects, which can prove a potential downside of augmentation.
L-methylfolate
A form of the B-vitamin folic acid, which is necessary for the production of neurotransmitters linked to mood, this prescription supplement may help with depression if you lack the enzymes to properly break down folate from foods or from standard folic acid supplements.
Cytochrome P450 (CYP450) Genotyping Test
This test searches for specific genes that determine how your body responds to antidepressants. The P450 can help predict whether your body can or cannot metabolize a medication, and this can help identify which antidepressant may work well for you.
Electroconvulsive Therapy (ECT)
Still the most effective treatment for psychotic depression and severe refractory depression, asserts Dr. Roger Cadieux in the December 1998 issue of "American Family Physician," electroconvulsive therapy (ECT) involves passing electrical currents through the brain to induce a seizure. Although many people are leery of ECT and its side effects (such as confusion or amnesia), it typically offers instant alleviation of even severe depression when other treatments do not work, and is conducted appropriately and safely under medically monitored conditions.
