Have you been told you’ve tried “everything” for depression—yet you’re still struggling? You’re not alone. For many Virginians, standard treatments like SSRIs, SNRIs, and even talk therapy fall short.
This is called treatment-resistant depression (TRD)—but it doesn’t mean you’re out of options. At Stillpoint Integrative Psychiatry, we offer advanced, whole-person strategies for TRD through both in-office visits in Harrisonburg and secure telehealth throughout Virginia.
What Is Treatment-Resistant Depression?
TRD is typically defined as depression that hasn’t improved after at least two antidepressant trials at adequate dose and duration. But we believe that definition misses something important: why those treatments didn’t work.
Was the medication wrong for your brain chemistry? Were metabolic or inflammatory factors overlooked? Were trauma, sleep disruption, or nutritional deficiencies contributing?
We don’t just “try the next pill.” We step back and reframe the problem—so we can design a better solution.
Beyond the Basics: Innovative Treatments We Offer
Here are just some of the advanced approaches we use for patients with true TRD:
🧪 Phenelzine (Nardil): A Powerful Option Often Overlooked
One of the most effective antidepressants ever developed, phenelzine is a monoamine oxidase inhibitor (MAOI) with powerful benefits for melancholic depression, anxiety, and rumination. While underutilized today, it can be transformative—especially when modern antidepressants have failed.
We offer safe, personalized phenelzine initiation protocols, including food education and medication tapering plans when switching from SSRIs.
🔄 Memantine Augmentation: Supporting Brain Plasticity
Memantine, an NMDA receptor antagonist, is showing promise in treating TRD—especially when layered alongside serotonergic medications. It supports glutamatergic balance, cognitive clarity, and emotional reset.
🧠 Dopaminergic Adjuncts: Pramipexole & Beyond
For patients with severe apathy, low drive, or depression with Parkinsonian features, we may consider options like pramipexole to target dopamine pathways. These approaches are rarely used in standard care but may offer relief when motivation and reward processing are blunted.
🧬 Genetic and Metabolic Testing
Using pharmacogenomic testing and targeted labs, we identify metabolic slowdowns, nutrient absorption issues, and medication sensitivities. This helps reduce the guesswork and builds a tailored foundation for treatment.
🌿 Integrative Support: Supplements & Lifestyle Strategy
We combine the best of psychiatry with functional strategies to support your physiology:
- L-theanine, NAC, and magnesium to calm and support the nervous system
- Inositol and lithium orotate for mood stabilization and obsessive thought patterns
- Omega-3s and anti-inflammatory protocols
- Sleep and circadian rhythm optimization
Why Patients Across Virginia Trust Stillpoint
We serve clients throughout Virginia via secure telehealth, including Charlottesville, Roanoke, Lynchburg, Richmond, and Northern Virginia. For those near Harrisonburg or the Shenandoah Valley, we offer in-person consultations in a calming, private office environment.
Our patients choose us because:
- We take time to understand your full history and physiology
- We offer advanced tools—not just the standard checklist
- We blend psychiatry with integrative methods for deeper results
Hope Is Closer Than You Think
If you feel like you’ve exhausted your options, it’s time to partner with someone who offers more. Whether you’re interested in a careful phenelzine trial, adjunctive therapies like memantine, or a full integrative overhaul, we’re here to help.
Reach out today to schedule your consultation—available both in-office and via telehealth.
Stillpoint Integrative Psychiatry
🌿 In-office visits in Harrisonburg, VA
🖥️ Telehealth psychiatry available across all of Virginia
