Understanding Treatment-Resistant Depression and How Ketamine Can Help

Creator: Dr. Devin Tang
Published: 2025-01-15

Nearly one-third of people with major depression don’t respond adequately to traditional antidepressants. If you’ve tried multiple medications without relief, you may have treatment-resistant depression (TRD). Fortunately, ketamine infusion therapy offers new hope with rapid, effective results.

What is Treatment-Resistant Depression?

Clinical Definition

Treatment-resistant depression is typically defined as depression that hasn’t responded to at least two different antidepressant medications taken at adequate doses for a sufficient duration (usually 6-8 weeks each).

Common Symptoms

People with treatment-resistant depression often experience:

Persistent sad, empty, or hopeless mood
Loss of interest in activities once enjoyed
Severe fatigue and low energy
Sleep disturbances (insomnia or oversleeping)
Difficulty concentrating or making decisions
Changes in appetite and weight
Physical aches and pains with no clear cause
Thoughts of death or suicide

Why Traditional Treatments May Fail

Several factors can contribute to treatment resistance:

Misdiagnosis: The underlying condition may not be depression alone
Wrong medication class: SSRIs don’t work for everyone
Inadequate dosing or duration: Not taking medication long enough or at high enough doses
Co-occurring conditions: Anxiety, PTSD, or substance use disorders complicate treatment
Medical conditions: Thyroid problems, chronic pain, or other health issues interfere with recovery
Genetic factors: Some people metabolize antidepressants differently
Inflammation: Chronic inflammation may block traditional antidepressant effectiveness

How Ketamine Works Differently

A New Mechanism of Action

Traditional antidepressants (SSRIs, SNRIs) work by increasing serotonin or norepinephrine levels gradually over weeks. Ketamine works through an entirely different mechanism:

Ketamine targets glutamate, the brain’s most abundant neurotransmitter, triggering a cascade of neurological changes:

NMDA receptor modulation: Blocks overactive NMDA receptors
BDNF production: Increases brain-derived neurotrophic factor, promoting new neural connections
Synaptogenesis: Stimulates growth of new synapses (connections between brain cells)
Neural plasticity: Helps the brain form new, healthier thought patterns
Anti-inflammatory effects: Reduces neuroinflammation linked to depression

Rapid Results

Unlike traditional antidepressants that take 4-8 weeks to work, ketamine often provides relief within:

Hours to days for acute symptoms
1-3 infusions for noticeable improvement
4-6 infusions for optimal long-term results

Clinical Evidence

Research consistently demonstrates ketamine’s effectiveness for TRD:

67-75% of treatment-resistant patients respond to ketamine
Response rate 3x higher than traditional antidepressants
Effects begin within 2-4 hours in many patients
Sustained improvement with maintenance therapy

Our Treatment Protocol at Klarity Clinic

Initial Consultation

Your journey begins with a comprehensive evaluation:

Complete medical and psychiatric history
Review of previous treatments and responses
Physical examination and health screening
Discussion of goals and expectations
Customized treatment plan development

Safety first: We carefully screen to ensure ketamine therapy is appropriate and safe for you.

Induction Phase (Weeks 1-3)

The initial treatment series typically includes:

6 infusions over 2-3 weeks
Each session lasts approximately 45-60 minutes
Comfortable, private treatment room
Continuous monitoring by medical staff
Gradual dose optimization for best results

During your infusion:

You’ll relax in a comfortable recliner
Vital signs monitored throughout
Most patients experience a mild dissociative state
Some describe feelings of peacefulness or detachment
Music or quiet rest depending on preference

Maintenance Phase

After the initial series, most patients benefit from ongoing maintenance:

Monthly or bi-monthly infusions
Frequency tailored to individual response
Prevents symptom return
Maintains neuroplastic changes
Adjusted based on your progress

Integrated Care Approach

Ketamine therapy works best as part of comprehensive treatment:

Continued therapy: Individual counseling or psychotherapy
Medication management: Working with your prescribing physician
Lifestyle modifications: Sleep, exercise, nutrition support
Stress management: Mindfulness, meditation, relaxation techniques
Social support: Building and maintaining healthy relationships

What to Expect: Real Patient Experiences

Week 1-2: Initial Changes

Subtle mood improvements
Better sleep quality
Reduced negative thoughts
Increased motivation
Improved concentration

Week 3-4: Significant Improvement

Noticeable mood elevation
Return of interest in activities
Better energy levels
Clearer thinking
Improved social engagement

Long-term: Sustained Wellness

Stable mood regulation
Maintained improvements with occasional boosters
Better stress resilience
Improved quality of life
Ability to engage fully in therapy and life

Who is a Good Candidate?

Ideal Candidates

Ketamine therapy may be right for you if you:

Have tried at least 2 antidepressants without adequate relief
Experience severe depression that impacts daily functioning
Are looking for rapid symptom relief
Have co-occurring anxiety or PTSD
Are under care of a mental health professional
Are committed to comprehensive treatment

Safety Considerations

Ketamine therapy may not be appropriate if you have:

Uncontrolled high blood pressure
History of psychosis or schizophrenia
Active substance abuse (except as part of addiction treatment)
Certain heart conditions
Pregnancy or breastfeeding

Important: A thorough medical evaluation determines if ketamine therapy is safe for you.

Addressing Common Concerns

Is ketamine therapy safe?

When administered in a medical setting by trained professionals, ketamine is very safe. We use sub-anesthetic doses—far lower than used in surgical settings. All patients are monitored throughout treatment.

Will I become addicted?

When used as prescribed in a clinical setting, ketamine has minimal abuse potential. The medical doses and controlled environment significantly reduce any risk.

How long do the effects last?

Initial improvements may be noticeable within hours to days. With maintenance therapy, many patients maintain their improvement indefinitely.

What about side effects?

During infusion, temporary effects may include:

Mild dissociation or dreamlike state
Changes in perception
Slight increase in blood pressure
Nausea (uncommon with proper preparation)

Most side effects resolve quickly after the infusion ends.

Does insurance cover ketamine therapy?

Coverage varies by insurer and plan. Many insurance companies are beginning to cover ketamine for treatment-resistant depression. We provide documentation to help with reimbursement.

Why Choose Klarity Clinic?

Experienced Medical Team

Board-certified physicians specializing in ketamine therapy
Extensive experience treating treatment-resistant depression
Compassionate, patient-centered care
Comprehensive approach to mental health

Evidence-Based Protocols

Following latest clinical research
Individualized treatment plans
Careful dose optimization
Regular progress monitoring

Comfortable, Safe Environment

Private treatment rooms
State-of-the-art medical equipment
Warm, welcoming atmosphere
Convenient locations in Las Vegas and Upland

Comprehensive Support

Free initial consultations
Coordination with your existing providers
Ongoing mental health support
Flexible scheduling

Take the Next Step

If you’ve struggled with depression despite trying multiple treatments, ketamine therapy may be the breakthrough you’ve been seeking. The research is clear: ketamine offers real hope for treatment-resistant depression.

Don’t wait to feel better. Relief may be closer than you think.

Schedule Free Consultation → | Call 844-552-7489

About the Author: Dr. Devin Tang, MD, is a board-certified psychiatrist at Klarity Clinic specializing in treatment-resistant depression and innovative ketamine therapy protocols. Dr. Tang has helped hundreds of patients find relief when traditional treatments have failed.