Transforming treatment-resistant depression (TRD) care in the Gulf Cooperation Council (GCC) countries: a narrative review of emerging therapies, advancements, and implementation barriers.
Annals of general psychiatry January 21, 2026 Mohammed A Alhassan
Treatment-resistant depression (TRD) remains a major clinical challenge in Gulf Cooperation Council (GCC) countries, where conventional therapies often yield incomplete remission and cause significant side effects. Ketamine, esketamine, and repetitive transcranial magnetic stimulation (rTMS) show clinical efficacy and feasibility in the region. Esketamine adoption is increasing, led by the United Arab Emirates and Qatar, where it is administered in controlled clinical settings. rTMS is being gradually integrated, with expansion through private providers in the UAE and Hamad Medical Corporation in Qatar. However, access is limited by regulatory challenges, high costs, infrastructure constraints, cultural stigma, limited insurance coverage, and workforce shortages. Strategic investments, policy reforms, and awareness initiatives are critical to embedding these treatments into mental health systems.