Faster Treatment Options for Treatment-Resistant Depression
Treatment-resistant depression — major depressive disorder that has not improved adequately after at least two antidepressant trials — can be frustrating, and patients often want faster relief. Options include medication adjustments, psychotherapy, traditional TMS, accelerated TMS (SAINT®), Spravato (esketamine), and ketamine. 'Fast' varies: SAINT® is delivered in five days, Spravato may produce effects within hours, but individual response varies. No single option is universally 'best' — faster does not necessarily mean better for everyone. This page compares the options and explains why a psychiatric consultation is the right next step.
Key takeaways
- Multiple options exist for treatment-resistant depression.
- SAINT® is delivered in five days; Spravato may act within hours.
- Speed is one factor — effectiveness and safety matter too.
- Faster does not mean better for everyone.
- A psychiatric consultation determines what may be appropriate.
Medication Changes
Medication adjustments — optimizing dose, switching to a different antidepressant, or adding an augmenting agent — are often the first step. Antidepressants typically take four to eight weeks to show full effect. If multiple trials have failed, other options may be considered. Do not stop medication on your own; discuss changes with your prescriber.
Learn more about what to try when antidepressants don’t work.
Psychotherapy
Psychotherapy — including CBT, behavioral activation, and interpersonal therapy — is effective for depression and may be combined with medication or brain stimulation. Therapy is not 'fast' in the sense of producing immediate relief, but it addresses underlying patterns and skills. It is often part of a comprehensive plan.
Learn more about psychotherapy.
Traditional TMS
Traditional TMS is FDA-cleared for adults with major depressive disorder who have not improved on antidepressants. It is delivered one session per day, five days a week, for about six weeks. It is broadly covered by insurance. It is not 'fast' in terms of delivery, but it is non-invasive and medication-free.
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. It is faster in terms of delivery than traditional TMS. In trials, remission was measured at four weeks. SAINT® is typically self-pay. Individual response varies.
Learn more about SAINT® TMS.
Spravato (Esketamine)
Spravato is an FDA-approved nasal spray for treatment-resistant depression. It is administered in a certified clinic twice a week for four weeks, then weekly. It may produce effects within hours of a session. It causes dissociation and requires two hours of monitoring. Coverage varies by plan.
Learn more about Spravato vs TMS.
Ketamine
IV ketamine is used off-label for depression. It is administered by infusion in a clinic and may produce rapid effects. It is off-label because ketamine is FDA-approved only as an anesthetic. It causes dissociation and requires monitoring. Insurance is less likely to cover it than Spravato.
Learn more about SAINT® vs ketamine.
Why 'Fast' Does Not Mean 'Best for Everyone'
Speed of delivery is one factor. Effectiveness, safety, cost, insurance coverage, and individual suitability matter too. A faster treatment that is not appropriate for your situation is not better. Some patients respond well to medication changes; others need brain stimulation. A psychiatric evaluation can clarify which option may be appropriate for you.
Consultation as the Next Step
The right next step is a psychiatric consultation. Discuss your full treatment history, what has and has not worked, how quickly you need relief, what your insurance covers, and the risks and benefits of each option. Neuro Wellness offers consultations — in person or by telehealth.
To request a consultation, contact our team or call 954-827-9793.
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
Free benefits check · Self-pay options available
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
What are the fastest treatment options for treatment-resistant depression?
Options include medication adjustments, psychotherapy, traditional TMS, accelerated TMS (SAINT®), Spravato (esketamine), and ketamine. 'Fast' varies — SAINT® is delivered in five days, Spravato may produce effects within hours, but individual response varies. No option is universally 'best.' A psychiatric evaluation determines which may be appropriate for you.
Is faster treatment always better?
No. Speed of delivery is one factor. Effectiveness, safety, cost, insurance coverage, and individual suitability matter too. A faster treatment that is not appropriate for your situation is not better. Discuss the full range of options with your psychiatrist before deciding.
How does SAINT® compare to Spravato for speed?
SAINT® is delivered over five days; Spravato is administered twice a week for four weeks, then weekly. Spravato may produce effects within hours of a session. SAINT®'s remission was measured at four weeks in trials. They work differently — SAINT® is brain stimulation, Spravato is a medication. Individual response varies for both.
Can medication changes work quickly?
Sometimes. Adjusting a dose, switching medications, or adding an augmenting agent may produce improvement, but antidepressants typically take four to eight weeks to show full effect. Medication changes are often the first step, but if multiple trials have failed, other options may be considered.
What should I discuss with my psychiatrist?
Discuss your full treatment history, what has and has not worked, how quickly you need relief, what your insurance covers, and what the risks and benefits of each option are. A psychiatric evaluation can clarify which treatment may be appropriate for your specific situation.
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
9734 W Sample Rd, Coral Springs, FL 33065
When Antidepressants Don't Work
What to try next
SAINT® vs Spravato
Comparing two options