Ketamine is a lot cheaper; around my area, TMS is $10 - $13 THOUSAND dollars. It's daily treatments, five days a week, for at least 6 weeks (I think). My shrink doesn't believe that TMS is "ready for prime time," since it has about 50% efficacy. One university is testing more targeted TMS that uses an MRI to make an initial map of the brain, and apparently their results are reaching the 90%s (totally second-hand knowledge here). I'd be more inclined to re-investigate TMS once the treatment is more regulated. I think a lot of Doctors of Nursing are getting in on it because it's a good money maker. Just my observation.

If you can find someone who will do Ketamine IV therapy, it's usually four or five treatments. Not sure how much each - maybe 600 each?

I personally don't think the Spravato is a good idea (the squirt-it-up-your-nose method); you have to go to a ketamine clinic, where they send detailed data (with your name attached) back to the pharmaceutical company. Also, you have to agree to be observed at the clinic for two hours after your squirt. Lastly, Spravato only has one of the two "shapes" of ketamine (as in LEVOthyroxine, so in this case the left side of the pair), so I don't know that it works as well. And if you have a cold, then forget it. I can't imagine ketamine gets past snotty sinuses.

I also got denied for TMS by my insurance - after they told my husband I qualified.

The talk of "mental health matters" is a whole lot of talk, unfortunately. At least where I live, there is very little for us who suffer mental illness unless you are on medicare, have cancer, or have a drug addiction. Otherwise, you're left to just suffer on your own.

Oh, and don't feel so bad about the drugs: I'm on 12 Rx drugs and 13 doctor-directed supplements. Doctors turn me down because I'm too "pharmaceutically and medically complex."

12 mental health drugs??? I am on Medicare. TMS is noninvasive, lower risk of side effects. It's been around since 1985 and was FDA approved in 2008 for MDD and medication resistant MDD and is covered by Medicare. I just think maybe it is the better place to start for me. I'm doing loads of research on all 3. Now would love to hear from people who have experienced it (good or bad). Thanks for your input.

Dear @blessedintx,
I was able to find what I wrote to a father who was considering TMS for his young daughter. I wrote about my experience with TMS. I have copied what I wrote to him then, hoping this can be of help to you. So here, it is:
"I hope TMS is going to work for her. I know it does for many people. I heard about Transcranial Magnetic therapy from a close friend. For her, it worked after only 6 (six !) treatments, so I hope it is going to help your daughter too. I couldn't take it, even though I so much wanted it to work. I know it is NOT listed among the side effects, but all of a sudden I got toothache and I started having such bad pain in the right side of my belly, where my right ovary is, that I had to go to the emergency room after my fifth treatment. I also started getting hot flushes like crazy. When I called the center where they gave me TMS and asked them to check with the doctor if TMS in some way affects the endocrine system they said the doctor had said it did not, that the only side effects they knew of were the known ones: pain at the treatment site, headache, and toothache and they all go away after a little while. Well, to make a long story short: I stopped after my 5th treatment. I kept having a pain in my ovary for a little while after I interrupted TMS, while hot flashes continued bothering me for much longer).
But, as I said, I hear TMS does help many, so I do hope the 36 treatments your daughter is going to take also will help her to get ridden of her debilitating depression and anxiety. I wish you and your daughter the very best and thank you so much for sharing your experience. 😊 Merry Christmas to you and to your family!".

This is what I wrote then, and it is pretty much all I can say about TMS.

I hope the TMS treatment - if you decide to undergo it - will be beneficial to you, with no side effects.

All the best to you. ❤

Well, that is scary. And that little girl was going to have to do 35 treatments?
I just don't even know what to think...

Hello,
I'm sorry for what you are going. I have Severe Treatment Resistant Major Depression. I've been on all but one of meds you mentioned. I have tried ECT, TMS, Spravato and Ketamine infusion. The only one of those that helped was ketamine infusion. It was a game changer!! I didn't realize how depressed I really was until I was on the other side. The effect of the first infusion lasted close to two weeks. It was amazing! I was hopeful, getting out of bed and getting things done..I had zero suicidal ideation. Unfortunately, the clinic stopped doing it by infusion and would only do it by injection. It just didn't have the same effect at all. I'm on SSDI for my depression and anxiety, so I only work part-time. I can't afford to pay out of pocket at another clinic that does the infusion. TMS didn't do a single thing for me, but for others it has helped. My PCP has suggested that because of weight, the medications aren't working. He said that the drugs are tested on people who are average weight and I'm morbidly obese. I'm working towards bariactric surgery this summer, so I'm hoping that he is right. I know I'll definitely feel better losing weight but I don't know if it will be the "cure". Only time will tell. What he says makes sense, though, that my weight impacts the medication working properly. I hope you will try ketamine infusion, I know that everyone is different and responds differently, but it certainly was amazing for me.

What is TMS? I have never heard of it before. Thank you in advance.
Hope you can feel better soon! Pat

TMS is Transcranial Magnetic Stimulation, a treatment for Medication Resistant MDD (Major Depressive Disorder).

Hi- I just joined this group. You and I are in the same profession, and I have the same diagnosis. I’m struggling to keep a job in it, I just don’t seem to care anymore. I was first diagnosed with MDD at 21, have had years between episodes without need for meds. For the past 5-10 years I have been on so many different meds, I’m wondering if it’s due to age. I’ve held a full time job for many years at a time, for almost 30 years. Now I can barely hold one for 3 months, I panic the night before going to work. I wake up in the middle of the night, then can’t get up in the morning. I take lamictal and straterra( ADHD too). I’ve thought about tms or ketamine, and I never thought I’d get to this place, I managed most of my life on and off meds, but no heavy hitters. My Dr wanted to try Caplyta, but I declined to start with the anti psychotic class of meds to address depression. I’m just so tired of dealing with it.