Calculators,
protocols, trackers.

70-90% response

Highest efficacy of all treatments. Gold standard for severe TRD.

35-50% response

First-line effectiveness. Diminishes with each failed trial.

1-2 weeks

Rapid response, often within days. ECT is the fastest-acting treatment.

4-8 weeks

Slow onset. Must wait 4-6 weeks to assess efficacy at each dose.

Significant short-term

Memory disruption (anterograde/retrograde), confusion, anesthesia risk.

Moderate, chronic

Sexual dysfunction, weight gain, nausea, discontinuation syndrome.

6-12 treatments

Fewer sessions but requires anesthesia, fasting, escort. Slower return to normal activity.

Daily, ongoing

Take one pill per day. Can be integrated into normal life.

Significant impairment

Retrograde amnesia can span months. May affect working memory for weeks.

Minimal impact

Some anticholinergic effects possible. Generally cognitively neutral.

Highly invasive

General anesthesia required. Muscle relaxants. Seizure induced under supervision.

Non-invasive

Oral medication. No procedures required.

Maintenance ECT often needed

Relapse rate ~50% without maintenance. Monthly or biweekly continuation.

Continuous medication

Discontinuation leads to high relapse rates. Long-term use often necessary.

$3,000–$10,000

Anesthesia + facility + physician fees. Typically covered for severe TRD.

$20–$200/month

Generic SSRIs $10-30/mo. Newer agents $100-300/mo. Ongoing cost.