Innovative approaches in the treatment-resistant depression: exploring different therapeutic pathways.
GeroScience March 25, 2025 Anna Łysik, Katarzyna Logoń, Aleksandra Szczygieł et al. 8 citations
Treatment-resistant depression (TRD) affects many people with major depressive disorder, and standard medications often fall short. This review covers recent advances, including non-pharmacological therapies like transcranial magnetic stimulation, deep brain stimulation, electroconvulsive therapy, and vagus nerve stimulation, along with their mechanisms. Novel drugs such as ketamine and esketamine show promise; esketamine has been available in Poland since 2023. Electroconvulsive therapy remains effective, with side effects like temporary memory issues, headache, or cardiovascular changes. Transcranial magnetic stimulation is non-invasive and recommended by psychiatric organizations. Deep brain stimulation is newer and carries surgical risks. Vagus nerve stimulation appears promising as an adjunct, especially at higher doses, with no reported side effects. Personalized approaches are key, and future research should refine techniques, improve safety, and confirm long-term efficacy.