Interventional Psychiatry for Treatment-Resistant Depression

The treatment is a rapidly acting therapeutic option for adults living with Treatment-Resistant Depression (TRD) — a form of major depressive disorder that has not responded adequately to two or more conventional antidepressant medications taken at an adequate dose and duration during the current depressive episode. At Karunya Health in Rippleside, Geelong, the medication is delivered as a clinically supervised nasal spray under the expert oversight of Consultant Psychiatrist Dr. Jossy Antony.

Unlike traditional antidepressants, which can take weeks to produce noticeable effects, the medication works through a different neurological pathway. It targets the NMDA receptor in the brain, triggering a cascade of glutamate release that stimulates the rapid growth of new synaptic connections — a process known as synaptogenesis. This mechanism can produce meaningful symptom relief within hours to days, rather than the weeks required by oral medications. For patients who have endured prolonged, debilitating depression with little reprieve, this accelerated response can be transformative.

Treatment at Karunya Health follows a structured clinical pathway. It begins with a comprehensive psychiatric assessment to confirm eligibility and rule out contraindications. Patients then enter an induction phase, attending twice-weekly sessions over four weeks, during which the nasal spray is administered in a calming, monitored treatment room. Each session lasts approximately two hours, with patients remaining under clinical observation to manage any dissociative sensations or side effects. This is followed by a maintenance phase, where session frequency gradually reduces based on individual response and clinical judgement.

Safety is the cornerstone of our practice. Because the medication can temporarily affect perception and alertness, patients must be accompanied home by a responsible adult after each session and must not drive for the remainder of the day. Our clinic has been purposefully designed as a sanctuary — with acoustic comfort, dimmable lighting, eye masks, and curated soundscapes — so that each patient feels held and nurtured throughout their time with us. A dedicated team of skilled nurses provides attentive, compassionate monitoring during every phase of treatment.

Access to this treatment requires a formal referral from a General Practitioner or treating Psychiatrist, along with complete medication history. Patients covered by Medicare, DVA, WorkCover, and select private health funds may be eligible for subsidised treatment. If you or someone you care for is living with treatment-resistant depression, we invite you to speak with your GP about a referral to Karunya Health — where compassionate care is grounded in safety.