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If you have completed both SPRAVATO and TMS without the response you needed, you are not at the end of psychiatry. A patient guide to the evidence-based options that come next.
Read MoreYou've tried two antidepressants. Now your psychiatrist is talking about Spravato — or TMS. A specialist breaks down both, with the numbers and the realities.
Read MoreBoth Spravato (esketamine) and IV ketamine work fast for treatment-resistant depression. Here's how they differ in FDA approval, safety oversight, insurance coverage, and clinical evidence — and why our practice offers Spravato. By Nefretiri Abat,
Read MoreFor most patients with TRD, SPRAVATO and TMS can be combined or sequenced. Here's what the evidence says — and how we sequence at Exxceed Wellness.
Read MoreWhy Spravato (esketamine) acts in 24 hours when SSRIs take six to eight weeks — and why the dissociation patients fear is not the antidepressant. A patient-first walkthrough of the NMDA → AMPA → BDNF
Read MoreA patient-facing clinical guide to the FDA/EMA two-failed-trials standard for diagnosing treatment-resistant depression — what counts as an adequate trial, why pseudoresistance must be ruled out first, and what comes next. By Nefretiri Abat, PMHNP-BC,
Read MoreA 2026 clinical guide to treatment-resistant depression: definitions, pseudoresistance workup, evidence-based treatments including SPRAVATO monotherapy, SAINT, and a 10-step management algorithm. By Nefretiri Abat, PMHNP-BC, JD.
Read MoreIn 2019, a multicenter, randomized, double-blind clinical trial published in The American Journal of Psychiatry reported something significant: targeted transcranial magnetic stimulation produced statistically meaningful reductions in OCD symptoms compared to sham treatment. Participants in
Read MoreIf you’re dealing with severe clinical depression, the kind that does not lift with a few lifestyle changes or a few months of talk therapy, you’ve probably already lived through the long list: medication switches,
Read MoreIn 2019, a multicenter randomized controlled trial published in The American Journal of Psychiatry found that targeted transcranial magnetic stimulation significantly reduced OCD symptom severity compared to sham treatment. Patients in the active treatment group
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