You've tried the medications. They haven't worked. There is a next step.

Treatment-resistant depression is a clinical condition, not a personal failure. PMC Psychedelic specializes in exactly this — using FDA-approved treatments that work through a different mechanism than antidepressants.

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What treatment-resistant depression actually means.

Treatment-resistant depression (TRD) is a clinical diagnosis given when depression does not improve after trying at least two different antidepressant medications at adequate doses for an adequate period of time.

It is not a sign that your depression is untreatable. It means that the treatments you've tried work on serotonin and dopamine pathways — and your brain may need a different approach.

Affects an estimated one-third of people with major depressive disorder.
Defined clinically as inadequate response to two or more antidepressants.
Can persist for years despite consistent treatment attempts.
Often accompanied by significant impact on work, relationships, and daily functioning.

Signs you may have treatment-resistant depression.

You may be a candidate for TRD treatment if any of the following apply:

You have been diagnosed with major depressive disorder.
You have tried two or more antidepressants without adequate improvement.
Your depression has persisted for months or years despite treatment.
You feel like you have exhausted the standard options.
Your psychiatrist or doctor has suggested you explore other approaches.
You are still experiencing significant symptoms even while taking medication.

A formal diagnosis of TRD requires a clinical evaluation. The best way to find out if you qualify is to request a consult with Dr. Rueda's team.

How PMC Psychedelic treats treatment-resistant depression.

Our treatments work on the glutamate system — a completely different brain pathway than serotonin-based antidepressants. This is why they produce results in patients who haven't responded to traditional approaches.

Insurance Covered

Primary Treatment

Spravato® (Esketamine)

FDA-approved specifically for treatment-resistant depression.
Nasal spray, administered in-office under supervision.
Most PPO insurance plans cover it — we verify in advance.
Many patients notice improvement within hours of early sessions.

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Secondary Treatment · Out-of-Pocket

Ketamine IV Infusion

Intravenous ketamine with strong clinical evidence for TRD.
Precise, controlled dosing administered by our medical team.
No insurance required — paid out of pocket.
Often used when Spravato is not covered or clinically preferred.

Learn About Ketamine IV

Not sure which is right for you? Our telehealth consultation is the first step. Dr. Rueda evaluates every patient personally before recommending anything.

What our patients typically experience.

75–83%

Patient improvement rate for treatment-resistant depression

24–48 hrs

Time to first noticeable improvement for many patients

5,000+

Psychedelic treatments completed at PMC Psychedelic

Results represent improvement, not a cure. Psychedelic medicine does not work for every patient. Dr. Rueda is transparent about this in every evaluation — which is why patient selection is central to how we practice.

Common questions.

How do I know if I actually have treatment-resistant depression?

Clinically, TRD is defined as inadequate response to two or more antidepressants at adequate doses. If you have tried multiple medications without meaningful improvement, you may qualify. A consultation with Dr. Rueda is the only way to confirm this for your specific situation.

Does insurance cover treatment for treatment-resistant depression?

Spravato (esketamine) is FDA-approved specifically for TRD and is covered by most PPO insurance plans. We verify your coverage before your first appointment. Ketamine IV infusion is not covered by insurance and is paid out of pocket.

How quickly might I see results?

Many patients with TRD notice meaningful improvement within 24 to 48 hours of one of their first sessions. Others experience more gradual improvement over the first two to three weeks. Results vary significantly by individual.

Can I keep taking my current antidepressants?

In most cases, yes. Spravato is approved for use alongside an oral antidepressant, and Ketamine IV is also compatible with most medications. Dr. Rueda will review your full medication history during your evaluation.

What if I've already tried ketamine somewhere else?

Prior ketamine treatment does not disqualify you. Dr. Rueda will review your previous treatment history and determine whether a different protocol, dosing, or approach at PMC may produce better results for you.

From a patient with treatment-resistant depression.

I had been on four different antidepressants over three years. Nothing worked — not really. After my Spravato sessions at PMC, I felt a change I hadn't experienced in years. Dr. Rueda was honest with me from the start and the whole team made me feel safe throughout.

— M.T. · Westchester County, NY · Treatment-Resistant Depression · Spravato Patient

You don't have to keep trying treatments that aren't working.

Request a consult with Dr. Rueda's team. We will review your history, check your insurance, and tell you honestly whether our treatments are the right fit for you.

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PMC Psychedelic · Port Chester, NY · Serving Westchester & Fairfield County