There are a large number of depression treatment options available in Scottsdale, and depending on the severity of symptoms and a patient’s medical history, some therapies and treatments may be more successful than others.

This guide outlines depression treatment options available in Scottsdale and the greater Phoenix area: medication, psychotherapy, transcranial magnetic stimulation (TMS), accelerated TMS, transcranial direct current stimulation (tDCS), esketamine/Spravato, electroconvulsive therapy (ECT), and lifestyle support. At the TMS Institute of Arizona, Ruchir P. Patel, MD, FACP and his clinical team offer TMS, Accelerated TMS, and tDCS.

Most treatment plans for major depressive disorder (MDD) start with medication, psychotherapy, or both. If these don’t provide enough relief or if someone has treatment-resistant depression, neuromodulation treatments like TMS and newer options such as esketamine may be considered. The best treatment depends on symptom severity, previous treatments, and personal preferences about methods and possible side effects.

Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are the most common medications for depression. They can help, but people respond differently, and it often takes weeks or several tries to find the right medication for the patient.

The largest and longest clinical trial study of antidepressants, the NIMH-funded STAR*D trial, included more than 4,000 outpatients with depression through a series of medication steps. Approximately a third became symptom-free on their first antidepressant. For the remaining two-thirds, remission dropped with each new medication, from about 31% at the second step to 14% and 13% at the third and fourth. Patients who required more medication steps were more likely to relapse and more likely to stop treatment because of side effects.

Common side effects include weight changes, sexual dysfunction, trouble sleeping, and feeling emotionally numb. Some people have withdrawal symptoms when stopping medication. In 2026, the U.S. Department of Health and Human Services announced a plan to reduce overprescribing and help patients taper off psychiatric medications, including SSRIs. Patients should never stop prescribed medication without talking to their doctor first. Any changes must be made with medical supervision.

When two or more medications haven’t provided enough relief, many patients and their doctors begin looking at other options, such as TMS.

Cognitive behavioral therapy (CBT) and other talk therapies are common treatments for depression and may be combined with medication. Therapy helps build coping skills and address negative thought patterns but may not be enough for moderate to severe or treatment-resistant depression.

TMS is an FDA-approved treatment for major depressive disorder that does not involve medication. It is one of the options available at the TMS Institute of Arizona in Scottsdale.

TMS uses targeted magnetic pulses delivered through a coil on the scalp to stimulate brain areas involved in mood regulation. The treatment is painless, requires no anesthesia, and each session is usually under five minutes, with sessions spread out over several weeks.

The side effects of TMS are generally mild and can include scalp discomfort or headache during the first few sessions. Patients generally resume their normal daily activities after a session. Unlike antidepressants, TMS doesn’t carry systemic side effects like weight gain or sexual dysfunction, and there is no withdrawal process when treatment ends. More detail on what TMS does and does not resolve is covered in Is TMS a Cure for Depression or Just Symptom Management? and Side Effects of Transcranial Magnetic Stimulation.

TMS is FDA-approved for major depressive disorder. It is also FDA-approved for OCD and smoking cessation, and its use for conditions like PTSD is considered off-label, meaning it is used clinically but hasn’t received FDA approval for that specific condition.

With the 2026 federal plan to reduce long-term SSRI use, many people ask what alternatives are available. In a July 2026 opinion piece for Stars and Stripes, Dr. Ruchir P. Patel, M.D., FACP, explained that TMS is a drug-free, FDA-approved option to consider, especially for veterans, first responders, and others with treatment-resistant depression. He does not suggest stopping medication altogether but believes patients should have access to alternatives already available, covered by insurance and Tricare, and FDA-approved instead of waiting for new treatments.

This is why TMS appeals to people who prefer holistic or integrative health approaches. Since TMS does not use medication throughout the body, it attracts those who want to avoid side effects and dependency linked to long-term drug therapy while choosing a treatment that is evidence-based and supervised by a doctor.

TMS is not the right treatment for everyone, so we encourage you to consider it along with medication and therapy rather than as the first option. Anyone considering TMS should talk with a medical doctor before deciding.

Accelerated TMS shortens treatment by giving several sessions each day instead of one. The TMS Institute of Arizona uses a protocol based on Stanford’s SAINT research and a MagVenture device. This option is usually for people who want quicker results or cannot attend daily sessions for six weeks.

Esketamine, known as Spravato, is an FDA-approved nasal spray for people with treatment-resistant depression. It works differently from SSRIs by affecting the brain’s glutamate system instead of serotonin. Because it can cause dissociative side effects, it is given under medical supervision. For more information, see Esketamine (SPRAVATO®) for Treatment-Resistant Depression: Facts vs. Myths.

Typically a last resort treatment, ECT remains one of the most effective treatments for severe, treatment-resistant depression, but it requires anesthesia, is typically performed in a hospital setting, and carries a risk of short-term memory loss. A full description of ECT is available in ECT vs. TMS Therapy: What’s the Difference?

tDCS uses a gentle electrical current instead of magnetic pulses. At the TMS Institute of Arizona, tDCS is offered as at-home maintenance therapy to help maintain results after TMS or Accelerated TMS, rather than as the main treatment for depression.

Sleep, exercise, and nutrition all affect depression symptoms and should be discussed with your doctor along with any main treatment. While these factors do not replace medical care for moderate to severe depression, they can support recovery.

The right depression treatment depends on factors like symptom severity, previous treatments, insurance coverage, and preference for medication or non-drug options. Your doctor can help you consider these and create a plan that may include multiple approaches.

At the TMS Institute of Arizona in Scottsdale, Dr. Ruchir P. Patel, M.D., FACP, and his team offer TMS, Accelerated TMS, and tDCS for depression. Dr. Patel is triple board-certified in internal medicine, sleep medicine, and obesity medicine, with fellowship training in TMS therapy. All treatments are supervised by the clinical team. TMS is covered by most major insurance plans and Tricare for FDA-approved conditions like depression. If you are considering treatment, you can ask for a patient case history and insurance coverage details.

This post is for educational purposes only. Every patient is unique. Please consult with Dr. Weiner or your healthcare provider for personalized medical advice tailored to your specific needs.

Additional reading:

• HHS Launches MAHA Action Plan to Curb Psychiatric Overprescribing (HHS.gov, May 2026)
• The drug-free depression treatment Washington should be talking about, Dr. Ruchir P. Patel, M.D., FACP (Stars and Stripes, July 2026)