A Second Opinion for Treatment-Resistant Depression in the East Bay

A second opinion for treatment-resistant depression is a review of what has been tried and what should come next, by a clinician who was not involved in the first plan. People ask for one after two or three antidepressants have not worked, after a TMS or Spravato course that did less than expected, or when they have been offered one treatment and want to know whether the other would fit better. It is a normal request and a reasonable one.

What a second opinion looks at

• The medication history, in detail. Which drugs, at what dose, for how long, and what each one did. Many “failed” trials turn out to have been too short or too low, and that changes the next step.
• Whether the diagnosis still fits. Depression that has not responded is sometimes depression with something alongside it: an anxiety disorder, trauma, a bipolar pattern, a thyroid or sleep problem, substance use. A second look is the moment to check.
• Whether you meet treatment-resistant criteria, and whether the chart documents it in the way insurers require for TMS or Spravato authorization.
• Which of the options fits your situation: TMS, Spravato, a different medication strategy, or a combination, weighed against your schedule, your ability to get a ride home, your insurance, and how you have reacted to treatments before.

Why it helps to get it from a clinic that offers both treatments

A practice that only runs TMS tends to recommend TMS. A practice that only runs Spravato tends to recommend Spravato. We deliver both in the same Hayward clinic, so the recommendation can rest on your history rather than on the equipment in the building. If the honest answer is that neither is the right next step, that is what you will hear.

What to bring

• A list of every antidepressant and augmenting medication you have taken, with doses and rough dates. Pharmacy printouts work well.
• Records from any previous TMS or Spravato course, including the number of sessions completed.
• Your insurance card, so we can tell you what your plan requires before you decide anything.

Practical details

The evaluation can be done by secure telehealth anywhere in California or in person at 21297 Foothill Blvd, Suite 203, Hayward. New patients are usually seen within a week. TMS and Spravato themselves are delivered in person at the Hayward clinic; patients come from across the East Bay, including Oakland, Fremont, San Leandro, Castro Valley and Union City.

Book a consultation or call (415) 636-9700.

This page is educational information and is not medical advice. Reviewed by Nefretiri Abat, J.D., PMHNP-BC. If you are having thoughts of harming yourself, call or text 988 or go to your nearest emergency department.