Antidepressants Not Working? You May Have Treatment-Resistant Depression — and More Options Than You Think
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If you've tried two or more antidepressants without real relief, you're not out of options and you're not alone. Newer FDA-approved treatments work differently than daily pills — and many are covered by insurance.
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TMS Treatment — a proven path forward when medications haven't worked
FDA-cleared, non-invasive therapy for treatment-resistant depression, with many patients experiencing meaningful relief within weeks
Insurance-Covered Treatment for Depression That Hasn't Responded to Medication
Advanced depression treatments like SPRAVATO® (esketamine) and TMS are FDA-approved for treatment-resistant depression — which means most insurance covers them. Bright Horizons Psychiatry accepts Medicare and most major private insurance plans in Maryland, including Aetna, CareFirst Blue Cross Blue Shield (BCBS), Cigna, Elevance, Kaiser Permanente, Optum, Tricare, and United Healthcare.
The Bright Horizons Psychiatry medical team
Our board-certified and academically-affiliated psychiatrists specialize in exactly this situation: depression that hasn't improved with standard antidepressants. As specialists in advanced interventional psychiatry — TMS, Spravato (esketamine), and IM ketamine — we look deeper at why previous treatments fell short and build a personalized plan around what's most likely to work for you.
Dr. Amir Etesam
Psychiatrist
Shelly Valliath
Nurse Practitioner
Anita Paudel
Nurse Practitioner
The Bright Horizons Psychiatry patient care team
Reaching out about depression treatment can feel like one more exhausting task — so our patient care team carries the load. They manage insurance verification, scheduling, and intake, and they'll patiently answer every question about your treatment options, what to expect, and costs. We handle the details so you can focus on getting better.
Sianne Bell
Esketamine Coordinator
Mehjabeen Khalid
TMS Coordinator
Kendall Myers
IM Ketamine Coordinator
Isabella Kronau
Integrative Psychiatry Coordinator
A newer kind of depression treatment, in a calm and comfortable setting
Treatments like SPRAVATO® (esketamine nasal spray) don't work like daily pills — they're administered in-office, in a private treatment room designed for calm and comfort. You'll relax in a reclined chair while our team monitors you closely throughout your session. Many patients use the time to rest with an eye mask or listen to music. For Spravato visits, plan to have someone drive you home afterward.
Spravato treatment could begin in just a few weeks
Step 1
Get in touch with Bright Horizons Psychiatry
Book a free consultation through our online calendar or call us at (240) 599-1001. No commitment — just a conversation about what you've tried and what options remain.
Step 2
Intake call & insurance coordination
Our clinician will review your treatment history and discuss which advanced options fit your situation — Spravato, TMS, or a fresh medication strategy. We'll handle all insurance verification and prior authorization on your behalf.
Step 3
Scheduling & getting started
We'll onboard you and walk you through exactly what to expect from your chosen treatment. We'll schedule your sessions at times that work for you, so getting better fits into your life.
Frequently asked questions
What is treatment-resistant depression?
Treatment-resistant depression (TRD) is generally defined as depression that hasn't responded adequately to at least two different antidepressants taken at the right dose for the right duration. It's more common than most people realize — roughly one in three people treated for depression experience it. TRD doesn't mean you're untreatable or that you've failed; it means standard medications target the wrong mechanism for your depression. Newer FDA-approved treatments work on entirely different brain systems.
I've tried multiple antidepressants. What are my options now?
More than you might expect. SPRAVATO® (esketamine nasal spray) is FDA-approved specifically for TRD and works on the brain's glutamate system rather than serotonin. TMS uses targeted magnetic stimulation with no systemic medication at all. And sometimes a rigorous medication re-evaluation by a specialist uncovers combinations that were never tried. At your consultation, we'll review your history and recommend the path most likely to help.
What is Spravato?
Spravato is the brand name of esketamine nasal spray — an FDA-approved treatment developed specifically for people whose depression hasn't responded to antidepressants. It's taken in-office under medical supervision, and because it works through a different mechanism than daily pills, many patients notice relief within days or weeks rather than months.
Is this covered by insurance?
Yes — FDA-approved treatments like Spravato and TMS are covered by most major plans, including Aetna, CareFirst BCBS, Cigna, Tricare, Medicare, and Maryland Medicaid. We verify your coverage and handle prior authorization at no cost to you.
What are the side effects?
The most common short-term side effects occur during or shortly after the dosing session and resolve within the two-hour monitoring period. These include dissociation (a temporary feeling of being disconnected from your body or surroundings), mild sedation, dizziness, nausea, increased blood pressure, and headache. Because of these effects, Spravato is only administered in REMS-certified clinics like ours, where you're monitored throughout. You cannot drive the rest of the day after a session and will need to arrange a ride home.
Can I do normal activities during treatment?
Yes — with one important exception. Each Spravato session takes about 2.5 hours total (dosing plus the required two-hour monitoring period), and you can't drive for the rest of that day, so plan your transportation in advance. You should also avoid operating heavy machinery and making important decisions until the next day. Outside of your dosing days, you can work, exercise, and continue your normal routine without restriction.
How soon can I be seen?
Most new patients are seen within 7–10 days. We reserve dedicated new-patient slots each week. Call (240) 599-1001 for the earliest available appointment.
State of the Art psychiatric care for treatment-resistant depression and adult ADHD. Hopkins-trained MD, in-network with most major insurance, statewide telehealth across Maryland.
Our Locations
6000 Executive Blvd STE 101
Rockville, MD 20852
7360 Guilford Dr STE 100
Frederick, MD 21704
Monday - Friday : 8am - 6pm
