Depression Treatment Options Beyond Adding Another Medication
If you have tried multiple antidepressants and are looking for options beyond adding another medication, several evidence-based approaches exist. These include psychotherapy, traditional TMS, accelerated TMS (SAINT®), and other non-systemic treatments that do not involve adding another drug. Some patients may still appropriately use medication as part of a comprehensive plan — considering these options is not anti-medication. This page explains the non-medication options available and clarifies that medication may still play a role in your treatment.
Key takeaways
- Options exist beyond adding another medication.
- Psychotherapy, TMS, and SAINT® are non-medication approaches.
- Some patients may still appropriately use medication.
- Considering alternatives is not anti-medication.
- A psychiatric evaluation guides the right approach.
Psychotherapy
Psychotherapy — including CBT, behavioral activation, and interpersonal therapy — is effective for depression and does not involve medication. It may be used alongside medication or on its own. Therapy addresses underlying patterns, skills, and behaviors. If you have not tried therapy, it may be worth adding to your plan.
Learn more about psychotherapy.
Lifestyle Support as Adjunctive Care
Regular exercise, consistent sleep, daylight exposure, reduced alcohol, and social contact have evidence for depressive symptoms. These are adjunctive — helpful additions rather than stand-alone treatments for moderate-to-severe depression. They support overall treatment but are not a substitute for clinical care when symptoms are significant.
Traditional TMS
Traditional TMS is FDA-cleared for adults with major depressive disorder who have not improved on antidepressant medication. It is a medical device treatment — not a drug — that uses magnetic pulses to stimulate the prefrontal cortex. It is delivered one session per day for about six weeks and is broadly covered by insurance.
Learn more about TMS therapy.
Accelerated TMS (SAINT®)
SAINT® is an FDA-cleared accelerated TMS protocol delivered over five consecutive days with fMRI-guided targeting. Like traditional TMS, it is a device treatment, not a drug. It is faster in delivery and typically self-pay. Individual response varies.
Learn more about SAINT® TMS.
Other Non-Systemic Treatment Approaches
Other non-systemic approaches include Spravato (esketamine), which is a medication but acts differently from oral antidepressants, and ECT for severe cases. These are not 'non-medication' in the strict sense but may be considered when oral antidepressants have not worked. Discuss all options with your psychiatrist.
Medication May Still Play a Role
Considering non-medication options is not anti-medication. Some patients benefit from medication; others prefer or need alternatives. Many treatment plans combine medication and non-medication approaches — for example, continuing an antidepressant during TMS. The goal is to find what works for you, guided by a psychiatrist. Do not stop medication on your own.
Understanding SAINT® TMS: How It Works & What to Expect
SAINT® is an FDA-cleared treatment for adults with major depressive disorder who have not improved on antidepressants in the current episode. These videos explain how it works and how it differs from conventional TMS.
SAINT® is an FDA-cleared, fMRI-guided form of TMS developed at Stanford. Most patients complete treatment in one week — not the six weeks standard TMS requires.
Follow a real patient through the five-day SAINT® treatment week
Is SAINT® TMS Right for You?
Tried antidepressants without enough relief? SAINT® TMS is an FDA-cleared, fMRI-guided treatment for adults with major depressive disorder who have not improved enough with antidepressant medication.
SAINT® uses a personalized brain target and delivers treatment over five consecutive days. It differs from standard TMS in its targeting approach, treatment schedule, and research background. In a small randomized trial, 11 of 14 people receiving active treatment reached remission at the four-week assessment, compared with 2 of 15 receiving sham treatment. Results vary, and a five-day treatment course does not guarantee remission in five days.
How SAINT® Works and How It Differs From Conventional TMS
SAINT® is an FDA-cleared treatment for adults with major depressive disorder who have not improved on antidepressants in the current episode. This video explains how it works, and how it differs from conventional TMS.
Conventional TMS usually means about 30 visits over 6 to 9 weeks. SAINT is five visits over five days.
What makes it different: SAINT is the only FDA-cleared depression treatment that uses an fMRI scan to personalize the stimulation target to your individual brain. A 45-minute scan maps your brain and identifies the specific circuit linked to depression. Treatment is then delivered as ten 10-minute sessions per day, with 50-minute breaks between them, across five consecutive days.
In clinical trials, 79% of participants reached remission, with an average of 2.6 days to remission. SAINT is generally well tolerated; the most common side effects reported were mild headache and temporary scalp discomfort at the treatment site.
SAINT® at Neuro Wellness TMS Centers of America
Coral Springs, Florida
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Call or Text: 954-827-9793
Sources: Cole et al., American Journal of Psychiatry 2020;177:716-726 and 2022;179(2):132-141. magnusmedical.com/depression-therapy. PubMed 34711062. FDA 510(k) K220177.
Insurance coverage for SAINT is currently limited and varies by plan. Individual results may vary. This video is educational and is not medical advice. Talk to a qualified clinician about whether SAINT is appropriate for you. If you are in crisis, call or text 988.
Frequently Asked Questions
Can depression be treated without more medication?
Yes. Options include psychotherapy, traditional TMS, accelerated TMS (SAINT®), and other non-systemic approaches. Some patients may still appropriately use medication as part of treatment. The right approach depends on your history and should be discussed with a psychiatrist.
Is TMS a medication?
No. TMS is a medical device treatment, not a drug. It uses magnetic pulses to stimulate a specific brain region and introduces no chemical into the body. TMS devices are FDA-cleared, not FDA-approved (the term used for medications). Many people continue an antidepressant during TMS, but TMS itself can be delivered without medication when a clinician judges that appropriate.
Can I stop my antidepressant if I start TMS?
Not on your own. Stopping abruptly can cause discontinuation symptoms and raise the risk of relapse. If you want to reduce or stop medication, ask your prescriber to plan a gradual taper and to decide the timing relative to TMS. TMS is commonly delivered alongside medication.
What non-medication treatments are available?
Non-medication options include psychotherapy (CBT, behavioral activation, interpersonal therapy), traditional TMS, accelerated TMS (SAINT®), and lifestyle support as adjunctive care. ECT is also non-medication but is reserved for severe cases. Each has different evidence, risks, and suitability.
Is it anti-medication to consider these options?
No. Considering non-medication options is not anti-medication. Some patients benefit from medication; others prefer or need alternatives. Many treatment plans combine medication and non-medication approaches. The goal is to find what works for you, guided by a psychiatrist.
Cited Research
SAINT® is delivered only by verified providers on the Magnus Medical system. Programs described as SAINT “alternatives”, “equivalents” or “fMRI-guided accelerated TMS” are not SAINT®, are not affiliated with us, and SAINT® results do not apply to them. Read our SAINT® disclaimer.
Have questions about whether TMS may be appropriate for you?
Speak with our clinical team. A free consultation is the best way to get answers specific to your situation.
Related Patient Education
SAINT® Accelerated TMS
The 5-day, fMRI-guided protocol offered at our clinic
What Is TMS Therapy?
How transcranial magnetic stimulation works for depression
Cost & Insurance
Benefits verification, CPT codes, and self-pay options
Am I a Candidate?
Screening factors for TMS and SAINT® eligibility
Schedule a Consultation
Book a free consultation with our clinical team
Contact & Directions
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When Antidepressants Don't Work
What to try next
Depression Treatment Without Medication
Evidence-based non-medication treatments