My Zoloft isn’t working, now what?
This is a common concern. The number needed to treat for Zoloft (sertraline) ranges from 4-14 (4 for severe depression and 14 for mild depression). Assuming the best of medications, that means out of 4 people only 1 of those 4 people would have a positive effect above placebo. That’s not great odds. So, if you are depressed, assuming the best of the medication, more likely than not the medication is not going to work for you. You can switch to a new medication, you can augment with another medication, or you can try other things.
Okay, so what happens after that if nothing has worked? Well, if your still not getting benefit from medications, then TMS (Transcranial magnetic stimulation) also known as rTMS (repetitive Transcranial Magnetic Stimulation) is a good alternative. It is FDA cleared for the treatment of major depressive disorder and can help those who are either drug-resistant (drugs are not effective) or drug intolerant (drugs have too many side effects to be taken) to standard anti-depressant treatments.
rTMS/TMS is a good tool to help answer the questions about what to do when your current anti-depressant stops working. The treatment for depression with TMS is 30-36 sessions of repetitive magnetic stimulation. The repetitive magnetic pulses stimulate the hypofunctioning (low functioning) area of the brain known as the “depression center” or medically known as the dorsolateral prefrontal cortex. fMRIs will show that after TMS, the activity in the depression center has gone up significantly which is associated with relief from depression.
If you are interested in TMS, we invite you to set up an Appointment with Dr. Tanner by going to our contact page located here. You can discuss with Dr. Tanner all of your questions about TMS and see if TMS is a good fit for you.