• Clinical Insights

Currently available and emerging therapy options for treatment-resistant depression

Aug 2nd, 2023

Studies show that 50% of people with major depressive disorder don’t respond adequately to initial antidepressant treatment.1 Additionally, an estimated 30% of people with major depressive disorder (MDD) experience treatment-resistant depression (TRD), characterized by major depressive episodes that do not respond satisfactorily to at least two trials of optimally dosed antidepressant monotherapy.2 Fortunately, several TRD treatment options exist today, with additional therapies on the horizon. Read on and watch clips from Genoa’s recent webinar on caring for those with treatment-resistant depression to learn more.


Currently approved and available:

  • Spravato® (Intranasal esketamine)3
    • A nasal spray that provides patients with a quick onset of action, with results experienced within days or a few weeks. Spravato® is indicated for the treatment of TRD and depressive symptoms in adults with MDD with acute suicidal ideation or behavior.
    • Spravato® can only be administered in health care settings that are certified through the Spravato® Risk Evaluation and Mitigation Strategy (REMS) program.

 Click here to learn more about Spravato® and how to become a certified treatment center.

  • Symbyax®4
    • A fixed dose combination of olanzapine and fluoxetine, which is very similar to what can be created independently with fluoxetine and augmenting with olanzapine.
    • Symbyax® is indicated for the treatment of TRD and treatment of acute bipolar major depression in patients 10 years of age and older.

Watch to learn more about Symbyax®.

  • Electroconvulsive Therapy (ECT)5
    • A non-invasive procedure performed under general anesthesia in which small electric currents are passed through the brain to intentionally trigger brief seizures. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions, such as TRD.
    • ECT is indicated for the treatment of TRD in patients 13 years of age and older.

Watch to learn more about ECT.

Emerging treatment options

  • Auvelity®6 | Currently available. Indicated for treatment of major depressive disorder in adults.
  • Sage-217 | Being investigated for treatment of major depressive disorder and post-partum depression. If approved, could be on the market by early 2024.
  • SPN-820 | Being investigated for treatment of TRD. Currently in phase 1 trials.
  • NRX-101 | Being investigated for treatment of suicidal bipolar depression. Currently in phase 3 trials.
  • Psilocybin | Being investigated for treatment of major depressive disorder. Studies have been small, but findings have been promising.

Watch to learn more about these emerging treatment options.


Interested in learning more? Click here to watch the full recording of Genoa’s recent webinar on caring for those living with TRD. The discussion included detail on emerging therapies for TRD, tips for overcoming barriers in care for those living with TRD, and highlighted ways to maximize your relationship with your pharmacy partner to increase positive outcomes for the patients you serve.

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[1] https://pubmed.ncbi.nlm.nih.gov/17074942/

[2] https://www.uptodate.com/contents/unipolar-treatment-resistant-depression-in-adults-epidemiology-risk-factors-assessment-and-prognosis?sectionName=Treatment-resistant%20depression&topicRef=14685&anchor=H6075260&source=see_link#H6075260

[3] https://www.spravato.com/why-spravato

[4] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6b28c424-0b7e-4b75-b090-f116b113554e

[5] https://www.psychiatry.org/patients-families/ect#:~:text=Electroconvulsive%20therapy%20(ECT)%20is%20a,the%20patient%20is%20under%20anesthesia.

[6] https://www.auvelity.com/how-auvelity-works

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