Treatment-Resistant Depression When Antidepressants Haven't Been Enough
If two or more antidepressants have not worked, you are not alone and you are not out of options. About 30 percent of people with major depression do not respond to standard medications. That is a clinical reality, not a personal failure. Turnwell works specifically with this population, offering TMS therapy and Spravato at all four locations and IV ketamine at our Tampa Bay location.
What Makes Depression Treatment-Resistant
Treatment-resistant depression (TRD) is defined as major depressive disorder that has not responded adequately to at least two antidepressant medications taken at a therapeutic dose for a sufficient duration. It is not a character flaw or a lack of effort. It reflects the neurobiological complexity of depression and the limitations of medications targeting monoamine neurotransmitter pathways.
When serotonin-based medications don't work, it often suggests the depression is being driven by circuits that SSRIs and SNRIs do not directly address. This is why TMS therapy, which directly stimulates underactive mood-regulating brain circuits, and Spravato, which targets NMDA glutamate receptors, can be effective precisely where standard antidepressants have not been.
Turnwell's board-certified psychiatrists evaluate your full medication history, previous diagnoses, and treatment responses to build a plan that moves beyond what has already been tried. For qualifying patients, advanced interventional treatments are coordinated alongside ongoing medication management and psychotherapy.
At Turnwell, Treatment Includes
What Turnwell Offers for Treatment-Resistant Depression
Turnwell offers the full range of evidence-based and FDA-cleared interventional options for TRD, coordinated by the same clinical team across all four locations.
TMS Therapy
Non-invasive brain stimulation targeting underactive mood circuits. Covered by most insurance. Alpharetta GA, Charleston SC, Tampa Bay FL.
Learn about TMSSpravato (Esketamine)
FDA-approved nasal spray for TRD. Works on NMDA glutamate receptors. Covered by most insurance. All four Turnwell locations.
Learn about SpravatoIV Ketamine Therapy
Rapid-acting IV ketamine for TRD and PTSD. Available at Turnwell of Tampa Bay. Not typically covered by insurance.
Learn about KetamineMedication Management
Board-certified psychiatrists evaluate your full medication history and optimize your regimen, including augmentation strategies for treatment-resistant cases.
Psychotherapy
Individual therapy coordinated with medication management for a comprehensive approach. CBT, EMDR, and DBT available at all four locations.
Telehealth Options
Psychiatric evaluation and medication management available via telehealth throughout Georgia, South Carolina, and Florida for new and established patients.
If you or someone you know is in crisis, please call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room. Turnwell is not an emergency or crisis facility.
Call 988 NowYour Questions Answered
What is treatment-resistant depression?
What treatments are available for TRD?
Is TMS or Spravato covered by insurance for TRD?
How do I know if I qualify for TMS or Spravato?
Most Major Insurance Plans Accepted
We verify your benefits before your first appointment and handle prior authorization for TMS and Spravato.
Coverage varies by plan and medical necessity criteria. Contact us to verify your specific benefits before your first appointment.
Looking for additional information about mental health conditions and treatment options? These organizations provide reliable, evidence-based guidance.
Your Next Step Does Not Have to Feel Complicated
Our team reviews your full antidepressant history, discusses which advanced options apply to your situation, and verifies your insurance benefits before anything is scheduled. Most patients are seen within a few days of first contact. There is no obligation to commit to a specific treatment path before your evaluation.efore any treatment begins.