Not Sure Which Treatment Is Right?
The right treatment depends on your diagnosis, prior treatment history, medical safety, and goals. A consultation is the first step.
Treatment Options
Interventional Psychiatry Services
Evidence-based treatments for treatment-resistant depression, OCD, and complex mood disorders. Each treatment requires careful evaluation, safety screening, and individualized planning.
TMS for Depression
Transcranial Magnetic Stimulation (TMS)
FDA-cleared for MDD and MDD with comorbid anxiety symptoms
TMS is a noninvasive neuromodulation treatment that uses magnetic pulses to stimulate targeted brain regions involved in mood regulation. It does not require anesthesia or sedation, and patients return to normal activities the same day.
Key Points
- Noninvasive: no anesthesia, no sedation, no implanted device
- FDA-cleared for major depressive disorder and comorbid anxiety
- Typically 5 sessions per week over several weeks
- MagVenture TMS system, also FDA-cleared for OCD
- Covered by most major insurances including Medicare and Medicaid when criteria are met
- Common side effects: scalp discomfort, headache, temporary facial twitching. Generally mild.
Candidacy
Patients with MDD who have not achieved satisfactory improvement from prior antidepressant medication in the current episode. Candidacy requires psychiatric evaluation, medical screening, and safety review.
Esketamine
Esketamine (Spravato)
FDA-approved for treatment-resistant depression and MDD with acute suicidal ideation
Esketamine (Spravato) is an intranasal medication administered in our REMS-certified clinic under direct clinical observation. It is FDA-approved for treatment-resistant depression and for depressive symptoms in adults with MDD with acute suicidal ideation or behavior.
Key Points
- FDA-approved under the Spravato REMS program
- Administered in our certified clinic, not dispensed for home use
- Two-hour post-dose monitoring required by REMS protocol
- Patients cannot drive after treatment. A transportation plan is required.
- Typically covered by insurance when REMS and plan criteria are met
- Risks include sedation, dissociation, and blood pressure changes, monitored by clinical staff
Candidacy
Adults with treatment-resistant depression (inadequate response to at least two antidepressants) or MDD with acute suicidal ideation or behavior. Requires psychiatric evaluation, medical screening, REMS enrollment, and insurance coordination.
Ketamine
Ketamine Treatment (IV and IM)
Off-label use for treatment-resistant depression in carefully selected patients
Ketamine is administered by IV infusion or IM injection in a monitored clinical setting. It is used off-label for treatment-resistant depression in carefully selected patients who have not responded to other treatments.
Key Points
- Administered by IV infusion (40 minutes) or IM injection in our clinic
- Monitored by clinical staff throughout treatment
- Patients cannot drive after treatment
- Off-label use. Very rarely covered by insurance.
- Risks include dissociation, sedation, blood pressure changes, nausea
- Schedule and dosing individualized based on clinical evaluation
Candidacy
Carefully selected patients with treatment-resistant depression who have not responded to other treatments. Requires psychiatric evaluation, medical screening, substance use history review, and safety assessment.
Ocd Tms
TMS for OCD (MagVenture B80 Coil
FDA-cleared adjunct treatment for adults with obsessive-compulsive disorder
McLean NTC offers TMS for OCD using MagVenture B80 technology. The B80 coil is FDA-cleared as an adjunct treatment for adult OCD, targeting the bilateral dorsomedial prefrontal cortex. OCD TMS does not replace ERP or medication. It is an adjunctive option for patients with persistent symptoms.
Key Points
- FDA-cleared adjunct treatment for adult OCD using MagVenture B80 coil
- Targets bilateral dorsomedial prefrontal cortex
- Noninvasive: no anesthesia, no sedation
- Does not replace exposure and response prevention (ERP) therapy or medication
- Coverage varies and is reviewed case-by-case with insurance coordination
- Candidacy requires OCD diagnosis, prior treatment history, and safety screening
Candidacy
Adults with OCD who have persistent symptoms despite appropriate ERP therapy and medication management. Requires psychiatric evaluation, OCD severity assessment (Y-BOCS), prior treatment review, and insurance verification.
VNS for Depression
Vagus Nerve Stimulation (VNS)
FDA-approved adjunctive long-term treatment for chronic or recurrent depression after 4+ failed antidepressant trials
VNS uses an implanted device to stimulate the vagus nerve and is FDA-approved for chronic or recurrent depression in adults who have not responded to four or more adequate antidepressant treatments. McLean NTC provides evaluation, LivaNova coordination, and post-implantation psychiatric monitoring.
Key Points
- FDA-approved for chronic or recurrent depression after 4+ adequate antidepressant failures
- McLean NTC provides psychiatric evaluation and VNS candidacy assessment
- We coordinate with LivaNova for prior authorization and neurosurgical partner identification
- Implantation is performed by a neurosurgeon in a hospital operating room, not at our clinic
- We provide post-implantation psychiatric follow-up and VNS stimulator adjustments
- Coverage reviewed case-by-case. Improving but complex. Our team coordinates with insurers.
Candidacy
Adults 18 or older with chronic or recurrent major depressive disorder who have not had adequate response to four or more adequate antidepressant treatments. Requires comprehensive psychiatric evaluation, medical review, and coordination with LivaNova and a neurosurgical partner.
Psychiatry
Medication Management and Psychiatric Evaluation
Comprehensive psychiatric evaluation and medication management for adults and older adults
McLean NTC provides comprehensive psychiatric evaluation and medication management for adults and older adults with depression, OCD, complex mood disorders, and related conditions. Dr. Haq’s geriatric psychiatry expertise is particularly valuable for older adults with complex medical histories.
Key Points
- Comprehensive diagnostic evaluation including treatment history review
- Medication management for depression, OCD, and complex mood disorders
- Geriatric psychiatry expertise and specialized assessment for older adults
- Measurement-based care using PHQ-9, MADRS, GAD-7, and Y-BOCS
- Coordination with referring clinicians when appropriate
- Covered by all major insurances we accept
Candidacy
Adults and older adults with depression, OCD, complex mood disorders, or diagnostic uncertainty. Particularly valuable for older adults where distinguishing depression from cognitive impairment, delirium, medication effects, or medical contributors requires specialized assessment.