Over half of people on antidepressants don’t get adequate relief. Here are 12 reasons TMS, Spravato, and IV Ketamine are becoming the treatments patients wish they’d found sooner.
You don’t need to be convinced that depression is serious. You’ve lived it. What you need isn’t another pitch. It’s proof that something better exists.
Targeted magnetic pulses stimulate nerve cells in the brain’s mood regulation center. No drugs, no anesthesia, no downtime. FDA-approved since 2008.
A nasal spray targeting glutamate to promote rapid synaptogenesis. The first FDA-approved monotherapy for treatment-resistant depression.
A sub-anesthetic ketamine infusion delivered directly into the bloodstream. Acts on NMDA receptors to create rapid neuroplastic changes.
Antidepressants force you into a 1–4+ week waiting game. IV Ketamine and Spravato can produce measurable symptom relief within 24 hours. TMS typically shows response within 1–3 weeks, with accelerated protocols working even faster.
✦ TRANSFORM-2 Trial · SAINT ProtocolUp to 70% of SSRI and SNRI users experience treatment-emergent sexual dysfunction. Spravato reports less than 1% incidence. IV Ketamine doesn’t affect sexual function. TMS carries zero risk.
✦ Phase III meta-analysis · <1% TESDTMS directly stimulates the brain’s mood center. Spravato and IV Ketamine act on NMDA glutamate receptors to trigger synaptogenesis — your brain literally grows new connections.
✦ Glutamate pathway · Distinct from SSRIs/SNRIsTMS and IV Ketamine both show 70% response rates. Spravato achieves 65%. Compare that to 46% from antidepressants alone — these treatments are designed for the people the old system left behind.
✦ STAR*D reanalysis · ESCAPE-TRD (NEJM 2023)Many antidepressants drive significant weight gain and metabolic changes. TMS has zero systemic effects. Spravato and IV Ketamine’s transient side effects resolve within hours.
✦ No systemic pharmacological effects (TMS)Conventional antidepressants carry an FDA black box warning. Both Spravato and IV Ketamine produce rapid anti-suicidal effects, often within hours. Esketamine is one of only two drugs ever proven to decrease suicidal thoughts.
✦ ASPIRE I & II TrialsMany patients stay on antidepressants indefinitely. TMS completes in 1–6 weeks, and follow-up studies show the majority maintained improvement a full year later.
✦ 1-year durability data · Dunner et al., 2014Many patients report a noticeable mood shift within hours of their first infusion. A protocol of 1–4+ infusions over 1–3 weeks often produces results antidepressants take months to approach.
✦ Berman et al. (2000) · Zarate et al. (2006)Antidepressant discontinuation syndrome is real — brain zaps, vertigo, irritability. TMS doesn’t interact with any medication because it isn’t one.
✦ Compatible with all medication regimens (TMS)For pregnant and breastfeeding women, antidepressants present an agonizing risk-benefit calculation. TMS is non-pharmacological — no drugs, no chemicals in your bloodstream.
✦ No systemic medication exposure to fetusIn the ESCAPE-TRD trial (NEJM), Spravato patients were 1.54x more likely to reach remission than those on quetiapine XR, and 1.55x more likely to stay relapse-free for up to 32 weeks.
✦ NEJM 2023 · ESCAPE-TRDTMS, Spravato, and IV Ketamine are all compatible with each other and with existing medications and therapy. You don’t have to abandon what’s partially working.
✦ Journal of Psychiatric Research 2019Every depression treatment makes the same promise: you’ll feel like yourself again. Antidepressants deliver for some — but for millions, they don’t.
TMS uses magnetic fields to reactivate underperforming brain circuits. Spravato and IV Ketamine bypass serotonin entirely. These aren’t slight variations. They’re a fundamentally different approach.
How TMS, Spravato, and IV Ketamine stack up against traditional antidepressants.
| Treatment | Cost | Frequency | Time to Response | Treatment Length | Response % |
|---|---|---|---|---|---|
| Antidepressants | free* – $450 per month | 1 – 3 times per day | 1 – 4+ weeks | 6+ months – indefinitely | 46% |
| Spravato | free* – $1,000 per treatment | 1 – 2 times per week | instant* – 4 weeks | 1 – 2+ months | 65% |
| IV Ketamine | $250 – $2,000 per infusion | 1 – 4+ times per week | instant* – 2 weeks | 1 – 3+ weeks | 70% |
| TMS | free* – $400 per treatment | 5 times per week | 1 – 3+ weeks | 1 – 6 weeks | 70% |
| TMS | Spravato | IV Ketamine | Antidepressants | |
|---|---|---|---|---|
| Sexual Side Effects | None | <1% | None | Up to 70% |
| Weight Gain | None | None | None | Common |
| Drug Interactions | None | Minimal | Minimal | Many |
| Withdrawal Risk | None | None | None | Discontinuation syndrome |
| Suicidal Ideation | Neutral | Proven to reduce | Rapid reduction | Black box warning |
| Pregnancy Safe | Yes | No | Not recommended | Risk/benefit |
| FDA Approved | Yes (2008) | Yes (2019) | Off-label | Yes |
If you’ve tried antidepressants and felt stuck — you’re not the problem. The approach was. TMS, Spravato, and IV Ketamine represent a fundamentally different way to treat depression.
Important: This content is for educational and informational purposes only and does not constitute medical advice. Individual results vary. Always consult your doctor before starting, stopping, or changing any treatment.