1. Mechanism: Ketamine is an anesthetic medication that, at lower doses, has been found to have rapid-acting antidepressant effects. It acts on the glutamate system in the brain, promoting synaptic plasticity and potentially reversing the neurobiological changes associated with depression.
2. Treatment Process: Ketamine infusion therapy involves the intravenous administration of ketamine in a controlled medical setting. The treatment is typically administered as a series of sessions over a few weeks, with each session lasting around 40 minutes to a few hours. The infusion process is closely monitored by healthcare professionals.
3. Efficacy: Ketamine infusion therapy has demonstrated promising results in rapidly relieving depressive symptoms, even in individuals with treatment-resistant depression. Many people experience significant improvements shortly after the infusion, but the duration of the effects can vary. Additional research is still being conducted to determine the long-term effectiveness and safety of ketamine.
4. Maintenance: Depending on the individual’s response, maintenance ketamine treatments may be necessary to sustain the benefits. These can be administered less frequently than the initial series of infusions, ranging from weeks to months apart.

It’s worth noting that TMS and ketamine can also be used in combination as a treatment approach for resistant depression in certain cases, known as “sequential therapy.” This involves starting with one treatment modality and then transitioning to the other if the initial approach does not yield the desired results.

Ultimately, the choice between TMS and ketamine for treating resistant depression should be based on individual factors, preferences, and discussions with a healthcare professional experienced in these treatments. They can evaluate your specific situation, consider your medical history, and help determine the most appropriate treatment option for you.