Home / Treatment-resistant depression
Treatment-resistant depression · Salem
When antidepressants haven't worked, you still have options
If you've tried two or more medications without enough relief, ketamine therapy and Exomind TMS work in completely different ways, and they are often helpful when other treatments weren't.
- 5.0 from 48 Google reviews
- No referral needed
Not out of options
What treatment-resistant depression means
Depression is usually called treatment-resistant when at least two antidepressants, taken at an adequate dose for long enough, haven't brought enough relief. It's common, and it is not a personal failure.
Most antidepressants work on serotonin and related chemicals. Ketamine works on glutamate instead, and Exomind TMS uses magnetic stimulation with no medication at all. Because they work differently, they give people who haven't responded before a genuinely new approach.
This may be you if
- You've tried two or more antidepressants
- Side effects outweighed the benefits
- Therapy helped, but symptoms keep coming back
- You feel stuck, numb or exhausted most days
- You want an option that works faster
Treatment
Treatments that work differently
Your provider reviews what you've already tried, then recommends ketamine, TMS or a combination.
Ketamine therapy
IV infusions in a private, monitored room, or low-dose oral ketamine for mild to moderate symptoms.
Oral $200–$250 · IV $450 per infusion Drug-freeExomind TMS
Gentle magnetic pulses with no medication, sedation or downtime. About 30 minutes, and you drive yourself home.
$350 per session Ketamine + therapyKetamine-assisted psychotherapy
Ketamine paired with guided therapy and integration support, to help you work through what's underneath.
Discussed at your consultationBring a list of the medications you've tried, with doses if you have them. It helps us build the right plan at your first visit.
Getting started
What to expect
Book a consultation
Schedule online or call us. Consultations are $75 and may be covered by insurance.
Careful evaluation
Your provider reviews your symptoms, history and medications.
Your plan
We recommend the treatment that fits you, and explain costs and financing up front.
Ongoing support
We track your progress and adjust your plan as you improve.
Patient stories
Care that patients trust
"He listened to my experiences, explained everything well, answered my questions, and let me know how treatment would go and what to expect. Very comfortable, safe space."
Alicia P.Google review
"Dr. Fillmore spent the time to talk with us about the procedure, what it would be like and continued throughout the meeting to ask if we had further questions."
Kathleen W.Google review
"This therapy has been life changing in itself, and made all the more meaningful by the professionalism, kindness and down to earth manner of Dr. Fillmore."
Laurie P.Google review
Questions
Treatment-resistant depression FAQs
What counts as treatment-resistant depression?
It usually means depression that hasn't improved enough after at least two antidepressants taken at an adequate dose and for long enough.
Why might ketamine or TMS work when medications didn't?
Most antidepressants act on serotonin. Ketamine acts on glutamate, and TMS stimulates the brain's mood centers directly with no medication, so both offer a genuinely different approach.
Can I combine ketamine and TMS?
Yes. Some patients use both. We help you decide at your consultation whether one or both make sense.
Do I need a referral?
No. You can book a $75 consultation directly. If you have records from past treatment, bring them along.
How much does treatment cost?
IV ketamine is $450 per infusion, with discounts often available for full packages and cash pay. Oral ketamine is $200–$250, and TMS is $350 per session. Financing is available.
You're not out of options
Book a $75 consultation at our Salem clinic. No referral needed.