Comparing Depression Treatments

In considering ECT vs ketamine treatments or talk therapy vs conventional antidepressants here is an abbreviated list of key considerations:
Talk Therapy
•Prices vary
•Easily Accessible from many sources
•Once a week for months or years
•Possibly covered by insurance
Traditional Antidepressants
•Slow acting, high rate of relapse after months and rebound with discontinuation
•Easily Accessible from many sources
•Prices vary
•Possibly covered by insurance depending on your insurance company
Electro-Convulsive Therapy (ECT)
•Side effects may include short term memory loss
•Have to be under general anesthesia
•Needs boosters for continued benefit
•Accessible from psychiatrists only 
•Generally covered by insurance
Transcranial Magnetic Stimulation (TMS)
•Time-Consuming, daily treatments
•Possibly covered by insurance if you meet stringent criteria
•Accessible from psychiatrists
Intra-Nasal Ketamine Treatments (ketamine or esketamine)
•Easy to administer, but burns and has increased nausea
•Not as effective as IV Ketamine, limited research to date
•Possibly covered by insurance
•Patients are more likely to show addictive behaviors than with IV administration
•Appears to be free from lasting negative side effects
IV Ketamine Treatments
•Not yet covered by insurance
•Appears to be free from lasting negative side effects
•Immediate action
•Works well for around 75% of patients
•Works regardless of other treatments – even when other treatments do not
Deep Brain Stimulation
•Involves brain surgery and a permanently implanted device 
Of course, this list isn’t exhaustive, and treatment considerations are highly dependent on a patient’s specific situation. You can use this list as a kind of cheat sheet, or roadmap, to frame the discussion.
Please click here for more information on how to treat depression and the best treatment options.
Dr. Allison Wells, MD

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