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A Partner in Interventional Psychiatry—Working Alongside Your Ongoing Care
Breakthru provides specialized interventional psychiatric services designed to complement—not replace—ongoing medication management and psychotherapy. We collaborate with referring clinicians to ensure continuity of care, shared decision-making, and timely clinical updates. Patients return to their primary psychiatrist or therapist with treatment insights and recommendations that support long-term stability and progress.
Depression Treatment Comparison Guide
TMS
TRANSCRANIAL MAGNETIC
STIMULATION
This non-invasive treatment involves applying magnetic pulses to the brain to improve communication between the neurons involved in mood.
EFFICACY
Among Breakthu’s patients with depression, 93.9% experienced an improvement in symptoms, with 42.4% achieving remission. Similarly, 87.9% of patients with anxiety showed improvement, with 42.4% achieving remission.
SIDE EFFECTS
One major advantage of TMS is the lack of systemic side effects. Patients may experience a slight headache after the first 1-2 treatments.
LOGISTICS
TMS protocol is 36 treatments over 9 weeks, with improvement likely by the 4th week. Treatment is 5x a week for 6 weeks and then a taper down for the last 3 weeks. Appointments last 30 minutes, and patients can drive themselves after treatment.
FDA-APPROVED DIAGNOSES
- Major Depressive Disorder
CONTRAINDICATIONS
- Bipolar 1 and 2
- Epilepsy
- Metal implant above the waist
- Mood stabilizers
OFF-LABEL USE
- Generalized Anxiety Disorder
- Obsessive Compulsive Disorder
SPRAVATO®
Spravato is an FDA-approved refined form of IV Ketamine administered nasally. It has the same beneficial effects as IV Ketamine at a lower dosage.
EFFICACY
Because Spravato is a refined form of IV Ketamine, it elicits lower levels of side effects than IV Ketamine at the dosage effective for treating depression.
SIDE EFFECTS
One major advantage of TMS is the lack of systemic side effects. Patients may experience a slight headache after the first 1-2 treatments.
LOGISTICS
Spravato treatment is 2x week for 4 weeks, then 1x week for 4 weeks. Maintenance treatments are required to maintain symptom relief. Appointments last 2 hours, and patients cannot drive themselves after treatment.
FDA-APPROVED DIAGNOSES
- Major Depressive Disorder
CONTRAINDICATIONS
- Bipolar 1 and 2
- High blood pressure
- History of aneurisms
- Arteriovenous malformation
- Substance Use Disorder
OFF-LABEL USE
- None
IV KETAMINE
IV Ketamine works by rapidly improving the brain’s neuroplasticity. Its fast-acting effects make it ideal for severe, treatment-resistant, or suicidal depression.
EFFICACY
Among Breakthru’s patients with depression, 95.8% of patients showed improvement, and 41.7% achieved remission by treatment 9. For anxiety patients, 90.9% of patients showed improvement, and 54.5% achieved remission by treatment 9.
SIDE EFFECTS
IV Ketamine may cause mild side effects of nausea, headache, dizziness, and dissociation, which are temporary and only occur during infusion.
LOGISTICS
IV treatments are typically 2-3x week for 3 weeks and then decreased with the goal of one treatment per month. Maintenance treatments are required to maintain symptom relief. Appointments last 90 minutes, and patients cannot drive themselves after treatment.
FDA-APPROVED DIAGNOSES
IV Ketamine is not FDA-approved but has been extensively studied in the field of psychiatry and is established as safe and effective.
CONTRAINDICATIONS
- High blood pressure
- History of aneurisms
- Arteriovenous malformation
- Substance Use Disorder
OFF-LABEL USE
- Major Depressive Disorder
- Generalized Anxiety Disorder
- Obsessive Compulsive Disorder
- Post-Traumatic Stress Disorder
PRISM
Prism is an FDA-cleared, neuroscience-informed treatment for PTSD. Using an amygdala-based biomarker, patients engage in a nontrauma-based experience to manage and reduce PTSD symptoms.
EFFICACY
In a clinical trial, 67% of patients showed significant symptom improvement, and +32% experienced remission. Patients continue to improve after treatment is complete.
SIDE EFFECTS
The most common side effects experienced by subjects were mild, such as headaches, dizziness, and fatigue, which resolved after the end of the session without intervention.
LOGISTICS
Prism treatment is 15 treatments over 8 weeks. Scheduling is flexible. Appointments are 45 minutes, and no maintenance is required.
FDA-APPROVED DIAGNOSES
- Post-Traumatic Stress Disorder
CONTRAINDICATIONS
- None
OFF-LABEL USE
- Generalized Anxiety Disorder
- High-Performance Stress
VNS
VAGUS NERVE
STIMULATION
VNS Therapy involves a device that is implanted via outpatient surgery. It stimulates the vagus nerve by sending mild pulses, which have been shown to improve depression symptoms.
EFFICACY
Nearly 7 in 10 patients saw significant improvement when VNS Therapy was added to their usual treatment. Nearly 4 in 10 fully or almost fully recovered.
SIDE EFFECTS
VNS Therapy may cause mild side effects including hoarseness or changes in voice, prickling or tingling in the skin, or cough only while an electrical pulse is occurring (5-sec duration).
LOGISTICS
VNS Therapy often takes 6 months for prior authorization. Outpatient surgery is scheduled at a local hospital, and then in-clinic follow-up appointments for device interrogation are required.
FDA-APPROVED DIAGNOSES
- Major Depressive Disorder
- Bipolar Depression
CONTRAINDICATIONS
- Vagotomy
OFF-LABEL USE
- None
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