Major Depressive Disorder (MDD) is a condition that affects approximately 12% of the population [1] and recurs at a rate between 50-85% regardless of treatment [2]. Treatment resistant depression (TRD) is considered if patients
do not show alleviation of depressive symptoms after at least two trials of antidepressants from different pharmacologic classes [3]. Current antidepressant therapies which modulate serotonin, norepinephrine, and dopamine are based on the monoamine hypothesis, but the mechanism of MDD is now known to be more complex [4]. More aggressive treatment options including ketamine infusions, deep brain stimulation, and magnetic seizure therapy [5, 6] have also been applied in attempts to influence the unknown areas of our understanding of depression.

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