Treatment Resistant Depression Program



Various modalities of treatment can be useful for patients experiencing Treatment Resistant Depression (TRD). Those offered at Greater Houston Psychiatric Associates include Transcranial Magnetic Stimulation (TMS) and SPRAVATO®/esketamine intranasal spray. If indicated, Electroconvulsive Therapy (ECT) may be provided by one of our physicians at a local behavioral health hospital. All of these FDA approved methods for TRD require a consultation with one of our qualified providers to appropriately determine efficacy. These TRD methods are utilized in addition to, and do not replace, the use of oral medications and psychotherapy.


    Transcranial Magnetic Stimulation (TMS)
              Greater Houston Psychiatric Associates is proud to partner with Salience TMS Neuro Solutions to provide TMS Therapy in our offices. Transcranial magnetic stimulation (TMS) is a safe and effective treatment that uses MRI strength pulses to treat the cause of mood disorders like depression. To directly target the cause of depression, TMS strengthens the salience network, a large-scale intrinsic network of the brain which regulate our thoughts, behaviors and emotions. The lack of communication between neurotransmitters of this network often results in symptoms of depression and other mood disorders. During TMS sessions, you will recline in a comfortable chair with a small magnetic coil resting lightly on your forehead. You are free to chat with our staff or listen to music during treatment. There is little to no downtime and you are able to drive to and from treatments. To learn more about TMS Therapy, visit
    Spravato / esktamine Nasal Spray
              Greater Houston Psychiatric Associates is a certified SPRAVATO® REMS treatment center. Spravato / esketamine Nasal Spray is a treatment that involves the administration of Spravato/esketamine by nasal spray under the direct supervision of a trained mental health care provider followed by a 2 hour monitoring period in a healthcare setting. This required monitoring is part of the Spravato REMS program due to the potential serious side effects including sedation, possible dissociation and misuse of abuse.
    Electroconvulsive Therapy (ECT)
              Electroconvulsive Therapy (ECT) is a procedure performed under general anesthesia in which small electrical currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in the brain chemistry that can improve symptoms of certain mental health conditions. In addition to the indication of Treatment Resistant Depression (TRD), ECT can also improve symptoms of severe depression in major depressive disorder and bipolar disorder, mania, catatonia, schizophrenia and agitation / aggression in people with dementia.