Comprehensive Options for Treatment-Resistant Depression
If you have tried multiple treatment approaches and your depression has not improved, you may be living with treatment-resistant depression. Homewood Ravensview now offers rTMS (repetitive transcranial magnetic stimulation) and pharmacological intranasal spray for TRD – and there is no additional cost.
Why specialized treatment matters
These key facts highlight the impact of treatment-resistant depression and the role of evidence-based treatment.
Up to 50%
of people with depression do not respond to standard antidepressants (Canadian Network for Mood and Anxiety Treatments, 2023)
80%
of rTMS patients experience some form of meaningful improvement (Sunnybrook’s Harquail Centre for Neuromodulation)
#1
cause of disability worldwide is depression (WHO), affecting hundreds of millions of people and significantly limiting daily functioning and quality of life.
1 in 5
Canadians will experience a mental illness in their lifetime (Government of Canada)
Wondering whether specialized treatment could help?
Our admissions team can answer your questions, explain the program, and help you understand whether Ravensview’s advanced depression treatment is the right fit for you or your loved one.
Understanding Treatment-Resistant Depression
If antidepressants haven’t worked, you are not alone – and you are not out of options.
Treatment-resistant depression (TRD) is a specific medical diagnosis given when depression does not respond adequately to different antidepressant medications – taken at the right dose, for long enough to give them a chance.
It affects approximately 30% of people diagnosed with major depression, meaning hundreds of thousands of Canadians are living with an illness that hasn’t responded to the tools doctors reach for first. This is not a character flaw or a failure of will. It is a biological reality: for some people, standard antidepressants do not reach the parts of the illness that need to be treated.
People with treatment-resistant depression often describe years of trying medications – adjusting doses, switching drugs, tolerating side effects – without finding the relief they were hoping for. Many begin to believe that nothing will work. That nothing can work. That belief, while completely understandable, is not accurate.
You may have treatment-resistant depression if:
You have tried antidepressants without adequate relief, your symptoms have persisted for months or years despite treatment, or your doctor has said your depression is “difficult to treat” or “not responding to medication.”
Depression that hasn’t responded to standard treatment deserves a different kind of approach -one that works through different biological mechanisms. And that’s why Homewood Ravensview now provides both rTMS and intranasal pharmacological therapy as part of its inpatient treatment program offering – at no extra cost.
What TRD feels like
People searching for answers often describe the same experiences.
If any of these sound familiar, you may be in the right place.
These are not uncommon experiences. They are, in fact, the lived reality of hundreds of thousands of Canadians – and they are exactly the experiences that these options were developed to address.
Interventional Psychiatry Services
rTMS and pharmacological intranasal spray therapy are not variations of the same thing. They are two entirely distinct, evidence-based treatments – each reaching depression through a different neurobiological mechanism. Both are now available at Homewood Ravensview at no cost.
rTMS Therapy · Repetitive Transcranial Magnetic Stimulation
Non-invasive · No medication · Health Canada approved
rTMS uses a targeted magnetic coil placed near the scalp to deliver focused pulses to the left dorsolateral prefrontal cortex – a region of the brain that is consistently underactive in people with depression. These pulses stimulate neural activity, gradually normalizing the circuits involved in mood regulation.
Sessions typically last 20 minutes or less. You remain fully awake and alert throughout. There is no anesthesia, no medication, and no recovery period. Most people receive daily sessions over several weeks as part of their inpatient program.
People who have not responded to antidepressant medications. Those who cannot tolerate the side effects of medication. Anyone whose doctor has indicated their depression is treatment-resistant.
Pharmacological Nasal Spray Therapy
Nasal spray · Health Canada approved · Fast-acting
Pharmacological nasal spray therapy is approved by Health Canada for treatment-resistant depression. Unlike traditional antidepressants – which primarily act on serotonin – this pharmacological nasal spray acts on glutamate receptors, targeting a fundamentally different pathway in the brain. This different mechanism is exactly why it can work when other medications haven’t.
Administered under clinical supervision at Ravensview, this can produce meaningful relief significantly faster than conventional antidepressants – for some people, within hours or days rather than weeks. It is also studied for its effectiveness in reducing acute suicidal ideation.
People whose depression has not adequately responded to antidepressant medications. Those experiencing active depressive symptoms, who need faster-acting support. Available under psychiatrist direction within the Ravensview inpatient program.
Why Homewood Ravensview
Interventional Psychiatry works best inside a comprehensive program.
Clinical evidence consistently shows that rTMS and intranasal pharmacological therapies produce the strongest results when delivered within a full therapeutic environment – not as standalone clinic visits. That’s the model Homewood Ravensview has built.
- Integrated, not isolated
- No additional cost
- Led by psychiatrists
- Vancouver Island: a healing environment
- Part of Canada's most trusted mental health network
Questions people with TRD are asking.
Treatment-resistant depression (TRD) is diagnosed when a person has not had adequate relief from depression despite trying different antidepressant medications, each taken at an appropriate dose for a sufficient duration. It is not a character flaw or a sign that you haven’t tried hard enough — it is a clinical reality that reflects the biological complexity of depression. Roughly 30% of people with major depressive disorder will experience TRD.
Yes. Homewood Ravensview on Vancouver Island now offers rTMS as part of its inpatient treatment programming, available from summer 2026. It is included at no additional cost to admitted clients. rTMS is approved by Health Canada for treatment-resistant depression and has been in clinical use in Canada since 2002.
No this treatment is not currently publicly funded in BC and is not covered by MSP. At private clinics, it typically costs $800 or more per treatment session. At Homewood Ravensview, this therapy is included within the inpatient treatment programming at no additional cost to admitted clients, removing the financial barrier that makes this treatment inaccessible for many people.
Start by speaking with your doctor or psychiatrist – and specifically ask whether treatment-resistant depression might apply to your situation. If you have tried antidepressants without adequate relief, you may be a candidate for Interventional Psychiatry treatments like rTMS or intranasal pharmacological therapy. You can also contact Homewood Ravensview’s intake team directly to discuss whether our residential program is right for you. You do not need to wait for a referral to call.
rTMS does not involve medication at all. It uses targeted magnetic pulses to directly stimulate specific neural circuits in the brain that are underactive in depression. It does not cause the systemic side effects associated with antidepressants – no weight changes, sexual side effects, or discontinuation syndrome. You remain fully awake during each session and there is no recovery period afterwards.
At Homewood Ravensview, rTMS and intranasal therapy are integrated into the inpatient programming. They are not offered as standalone outpatient appointments. This is a clinical design decision — the evidence shows these treatments produce the best results within a comprehensive therapeutic environment, not in isolation. To access IPS at Ravensview, clients must be admitted into a program.
Yes. Homewood Ravensview is a national resource and welcomes clients from across Canada. We have dedicated intake and admissions support for clients from other provinces, including guidance on out-of-province funding pathways. Contact our intake team to discuss your situation.
You've tried. There is still another path forward.
If depression hasn’t responded to medication, it doesn’t mean nothing will work. It means you need a different kind of treatment. Talk to our team about whether Homewood Ravensview’s Interventional Psychiatry Services are right for you.
Or ask your physician or psychiatrist about these services. You can also call directly – no referral required to start a conversation.