{"id":2723,"date":"2026-08-18T15:29:11","date_gmt":"2026-08-18T15:29:11","guid":{"rendered":"https:\/\/giovannimartinotti.com\/depressione-resistente-e-terapie-innovative\/"},"modified":"2026-09-12T18:05:31","modified_gmt":"2026-09-12T18:05:31","slug":"treatment-resistant-depression-and-innovative-therapies","status":"publish","type":"page","link":"https:\/\/giovannimartinotti.com\/en\/research-areas\/treatment-resistant-depression-and-innovative-therapies\/","title":{"rendered":"Treatment-resistant depression and innovative therapies"},"content":{"rendered":"<!--themify_builder_content-->\n<div id=\"themify_builder_content-2723\" data-postid=\"2723\" class=\"themify_builder_content themify_builder_content-2723 themify_builder tf_clear\">\n                    <div  data-css_id=\"8a6q560\" data-lazy=\"1\" class=\"module_row themify_builder_row fullwidth tb_8a6q560 tb_first tf_w\">\n                        <div class=\"row_inner col_align_top tb_col_count_1 tf_box tf_rel\">\n                        <div  data-lazy=\"1\" class=\"module_column tb-column col-full tb_8fhc404 first\">\n                    <!-- module text -->\n<div  class=\"module module-text tb_q3bt950   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <h1 class=\"p1\">Treatment-resistant depression and innovative therapies<\/h1>\n    <\/div>\n<\/div>\n<!-- \/module text --><!-- module text -->\n<div  class=\"module module-text tb_l9sf964   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <p class=\"p1\">Treatment-resistant depression (or drug-resistant depression) is a form of depression that does not respond adequately to at least two antidepressant treatments carried out correctly in terms of dosage and duration. It affects a significant proportion of patients and calls for new-generation therapeutic approaches.<\/p>\n<p class=\"p1\">Prof. Giovanni Martinotti works on treatment-resistant depression in both clinical practice and research, with a particular focus on innovative therapies: esketamine and brain stimulation techniques.<\/p>\n    <\/div>\n<\/div>\n<!-- \/module text -->        <\/div>\n                        <\/div>\n        <\/div>\n                        <div  data-css_id=\"90z7002\" data-lazy=\"1\" class=\"module_row themify_builder_row fullwidth tb_90z7002 tf_w\">\n                        <div class=\"row_inner col_align_top tb_col_count_1 tf_box tf_rel\">\n                        <div  data-lazy=\"1\" class=\"module_column tb-column col-full tb_4nop405 first\">\n                    <!-- module text -->\n<div  class=\"module module-text tb_zbt9100   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <h2 style=\"text-align: left;\">Prof. Martinotti&#8217;s research<\/h2>\n    <\/div>\n<\/div>\n<!-- \/module text -->        <\/div>\n                        <\/div>\n        <\/div>\n                        <div  data-css_id=\"s6q3005\" data-lazy=\"1\" class=\"module_row themify_builder_row fullwidth tb_s6q3005 tf_w\">\n                        <div class=\"row_inner col_align_top tb_col_count_1 tf_box tf_rel\">\n                        <div  data-lazy=\"1\" class=\"module_column tb-column col-full tb_hv4o450 first\">\n                    <!-- module text -->\n<div  class=\"module module-text tb_njnd417   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <p><em>My work on treatment-resistant depression combines clinical practice and research: we study the effectiveness and safety of the most recent treatments in real-world conditions, to offer a response to patients who do not benefit from conventional therapies\u2026<\/em><\/p>\n    <\/div>\n<\/div>\n<!-- \/module text --><!-- module text -->\n<div  class=\"module module-text tb_b3xt210   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <p class=\"p1\">Prof. Martinotti coordinated the Italian multicentric study REAL-ESK on the use of esketamine in treatment-resistant depression, one of the largest Italian real-world experiences in this area.<\/p>\n    <\/div>\n<\/div>\n<!-- \/module text -->        <\/div>\n                        <\/div>\n        <\/div>\n                        <div  data-css_id=\"b34x510\" data-lazy=\"1\" class=\"module_row themify_builder_row fullwidth tb_b34x510 tf_w\">\n                        <div class=\"row_inner col_align_top tb_col_count_2 tf_box tf_rel\">\n                        <div  data-lazy=\"1\" class=\"module_column tb-column col4-2 tb_qjr9064 first\">\n                    <!-- module text -->\n<div  class=\"module module-text tb_v523561   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <h3 style=\"text-align: left;\"><span style=\"color: #16233b;\"> Esketamina<\/span><\/h3>\n<p class=\"p1\">Esketamine is a medication (nasal spray) approved for treatment-resistant depression, administered exclusively in a clinical setting under medical supervision. It works through a different mechanism from conventional antidepressants and with a faster onset of action. Prof. Martinotti&#8217;s research has documented its effectiveness and safety in real-world clinical practice (REAL-ESK study).<\/p>\n    <\/div>\n<\/div>\n<!-- \/module text -->        <\/div>\n                    <div  data-lazy=\"1\" class=\"module_column tb-column col4-2 tb_t6a6116 last\">\n                    <!-- module text -->\n<div  class=\"module module-text tb_1rl6396   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <h3 style=\"text-align: left;\"><span style=\"color: #16233b;\"> Brain stimulation (TMS)<\/span><\/h3>\n<p class=\"p1\">Transcranial magnetic stimulation (TMS) is a non-invasive technique that modulates the activity of specific brain areas involved in depression. It is performed on an outpatient basis, is generally well tolerated, and represents an option for patients who do not respond to medication.<\/p>\n    <\/div>\n<\/div>\n<!-- \/module text -->        <\/div>\n                        <\/div>\n        <\/div>\n                        <div  data-css_id=\"6765212\" data-lazy=\"1\" class=\"module_row themify_builder_row fullwidth tb_6765212 tf_w\">\n                        <div class=\"row_inner col_align_top tb_col_count_1 tf_box tf_rel\">\n                        <div  data-lazy=\"1\" class=\"module_column tb-column col-full tb_uouk432 first\">\n                    <!-- module text -->\n<div  class=\"module module-text tb_xmnx229   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <h2 style=\"text-align: left;\">Frequently asked questions<\/h2>\n    <\/div>\n<\/div>\n<!-- \/module text -->        <\/div>\n                        <\/div>\n        <\/div>\n                        <div  data-css_id=\"focf817\" data-lazy=\"1\" class=\"module_row themify_builder_row fullwidth tb_focf817 tf_w\">\n                        <div class=\"row_inner col_align_top tb_col_count_1 tf_box tf_rel\">\n                        <div  data-lazy=\"1\" class=\"module_column tb-column col-full tb_1skf817 first\">\n                    <!-- module text -->\n<div  class=\"module module-text tb_bqq9817   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <p class=\"p1\"><b>Q. When is depression considered &#8220;resistant&#8221;?<br \/>\n<\/b>A. Depression is considered resistant when symptoms do not improve adequately after at least two different antidepressant treatments, taken at the correct dosage and for the correct duration.<\/p>\n<p class=\"p1\"><b>Q. How does esketamine work?<br \/>\n<\/b>It is a nasal spray administered in a clinical setting under medical supervision. It acts through a different mechanism from conventional antidepressants, targeting the glutamate system, and can work more rapidly. It is not a treatment to be used on one&#8217;s own.<\/p>\n<p class=\"p1\"><b>Q. Is transcranial magnetic stimulation painful?<br \/>\n<\/b> A. No. It is a non-invasive and generally well-tolerated procedure, performed on an outpatient basis without the need for anesthesia.<\/p>\n<p class=\"p1\"><b>Q. Can treatment-resistant depression be treated?<br \/>\n<\/b> A. The lack of response to initial treatments does not mean there are no options: it is precisely for these cases that innovative therapies such as esketamine and brain stimulation have been developed, expanding the possibilities of treatment.<\/p>\n<p class=\"p1\"><b style=\"font-size: 15.84px;\">D. Altra domanda<\/b><\/p>\n    <\/div>\n<\/div>\n<!-- \/module text -->        <\/div>\n                        <\/div>\n        <\/div>\n                        <div  data-css_id=\"bfrj488\" data-lazy=\"1\" class=\"module_row themify_builder_row fullwidth tb_bfrj488 tf_w\">\n                        <div class=\"row_inner col_align_top gutter-none tb_col_count_2 tf_box tf_rel\">\n                        <div  data-lazy=\"1\" class=\"module_column tb-column col4-2 tb_acpt488 first\">\n                    <!-- module text -->\n<div  class=\"module module-text tb_rlhy739   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <h2 style=\"text-align: left;\">Related publications<\/h2>\n    <\/div>\n<\/div>\n<!-- \/module text --><!-- module text -->\n<div  class=\"module module-text tb_psyh547   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <ul class=\"ul1\">\n<li class=\"li1\">Real-world experience of esketamine use to manage treatment-resistant depression (REAL-ESK study) \u2014 J. Affective Disorders, 2022 \u2192 DOI 10.1016\/j.jad.2022.09.043<\/li>\n<li class=\"li1\">Treating bipolar depression with esketamine \u2014 Bipolar Disorders, 2023 \u2192 DOI 10.1111\/bdi.13296<\/li>\n<li class=\"li1\">un lavoro su TMS\/stimolazione cerebrale, se si vuole rappresentare anche quel filone\u00a0<\/li>\n<\/ul>    <\/div>\n<\/div>\n<!-- \/module text -->        <\/div>\n                    <div  data-lazy=\"1\" class=\"module_column tb-column col4-2 tb_lspn665 last\">\n                    <!-- module text -->\n<div  class=\"module module-text tb_b9s8721   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <h2 style=\"text-align: left;\">Related media<\/h2>\n    <\/div>\n<\/div>\n<!-- \/module text --><!-- module text -->\n<div  class=\"module module-text tb_fiwi721   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <ul class=\"ul1\">\n<li class=\"li1\">Odeon \u2013 Eccellenze Italiane: servizio sul disturbo depressivo resistente<\/li>\n<li class=\"li1\">eventuali interviste RAI sul tema<\/li>\n<\/ul>    <\/div>\n<\/div>\n<!-- \/module text -->        <\/div>\n                        <\/div>\n        <\/div>\n                        <div  data-css_id=\"i2kq721\" data-lazy=\"1\" class=\"module_row themify_builder_row fullwidth tb_i2kq721 tf_w\">\n                        <div class=\"row_inner col_align_top tb_col_count_1 tf_box tf_rel\">\n                        <div  data-lazy=\"1\" class=\"module_column tb-column col-full tb_vufb721 first\">\n                            <div  data-lazy=\"1\" class=\"module_subrow themify_builder_sub_row tf_w col_align_top tb_col_count_1 tb_aky7522\">\n                <div  data-lazy=\"1\" class=\"module_column sub_column col-full tb_9b02522 first\">\n                    <!-- module buttons -->\n<div  class=\"module module-buttons tb_jmld837 buttons-horizontal solid   squared\" data-lazy=\"1\">\n        <div class=\"module-buttons-item tf_in_flx\">\n                        <a href=\"https:\/\/giovannimartinotti.com\/media\/\" class=\"ui builder_button tf_in_flx accent-color squared\" >\n                                                Go to the Media page \u2192                                        <\/a>\n                <\/div>\n            <\/div>\n<!-- \/module buttons -->\n        <\/div>\n                    <\/div>\n                <\/div>\n                        <\/div>\n        <\/div>\n                        <div  data-css_id=\"air2575\" data-lazy=\"1\" class=\"module_row themify_builder_row fullwidth tb_air2575 tf_w\">\n                        <div class=\"row_inner col_align_top tb_col_count_1 tf_box tf_rel\">\n                        <div  data-lazy=\"1\" class=\"module_column tb-column col-full tb_0njq575 first\">\n                    <!-- module text -->\n<div  class=\"module module-text tb_734s575   \" data-lazy=\"1\">\n        <div  class=\"tb_text_wrap\">\n        <p class=\"p1\" style=\"text-align: center;\"><strong>Other research areas:<\/strong> <a href=\"https:\/\/giovannimartinotti.com\/en\/home\/research-areas\/psychedelics-in-psychiatry\/\" target=\"_blank\" rel=\"noopener\">Psychedelics in Psychiatry<\/a> \u00b7 <a href=\"https:\/\/giovannimartinotti.com\/en\/home\/research-areas\/addictions-and-new-psychoactive-substances\/\" target=\"_blank\" rel=\"noopener\">Addictions and New Psychoactive Substances<\/a><\/p>    <\/div>\n<\/div>\n<!-- \/module text -->        <\/div>\n                        <\/div>\n        <\/div>\n        <\/div>\n<!--\/themify_builder_content-->","protected":false},"excerpt":{"rendered":"<p>Treatment-resistant depression and innovative therapies<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":2652,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2723","page","type-page","status-publish","hentry","has-post-title","has-post-date","has-post-category","has-post-tag","has-post-comment","has-post-author",""],"builder_content":"<h1>Treatment-resistant depression and innovative therapies<\/h1>\n<p>Treatment-resistant depression (or drug-resistant depression) is a form of depression that does not respond adequately to at least two antidepressant treatments carried out correctly in terms of dosage and duration. It affects a significant proportion of patients and calls for new-generation therapeutic approaches.<\/p> <p>Prof. Giovanni Martinotti works on treatment-resistant depression in both clinical practice and research, with a particular focus on innovative therapies: esketamine and brain stimulation techniques.<\/p>\n<h2 style=\"text-align: left;\">Prof. Martinotti's research<\/h2>\n<p><em>My work on treatment-resistant depression combines clinical practice and research: we study the effectiveness and safety of the most recent treatments in real-world conditions, to offer a response to patients who do not benefit from conventional therapies\u2026<\/em><\/p>\n<p>Prof. Martinotti coordinated the Italian multicentric study REAL-ESK on the use of esketamine in treatment-resistant depression, one of the largest Italian real-world experiences in this area.<\/p>\n<h3 style=\"text-align: left;\"> Esketamina<\/h3> <p>Esketamine is a medication (nasal spray) approved for treatment-resistant depression, administered exclusively in a clinical setting under medical supervision. It works through a different mechanism from conventional antidepressants and with a faster onset of action. Prof. Martinotti's research has documented its effectiveness and safety in real-world clinical practice (REAL-ESK study).<\/p>\n<h3 style=\"text-align: left;\"> Brain stimulation (TMS)<\/h3> <p>Transcranial magnetic stimulation (TMS) is a non-invasive technique that modulates the activity of specific brain areas involved in depression. It is performed on an outpatient basis, is generally well tolerated, and represents an option for patients who do not respond to medication.<\/p>\n<h2 style=\"text-align: left;\">Frequently asked questions<\/h2>\n<p><b>Q. When is depression considered \"resistant\"?<br \/> <\/b>A. Depression is considered resistant when symptoms do not improve adequately after at least two different antidepressant treatments, taken at the correct dosage and for the correct duration.<\/p> <p><b>Q. How does esketamine work?<br \/> <\/b>It is a nasal spray administered in a clinical setting under medical supervision. It acts through a different mechanism from conventional antidepressants, targeting the glutamate system, and can work more rapidly. It is not a treatment to be used on one's own.<\/p> <p><b>Q. Is transcranial magnetic stimulation painful?<br \/> <\/b> A. No. It is a non-invasive and generally well-tolerated procedure, performed on an outpatient basis without the need for anesthesia.<\/p> <p><b>Q. Can treatment-resistant depression be treated?<br \/> <\/b> A. The lack of response to initial treatments does not mean there are no options: it is precisely for these cases that innovative therapies such as esketamine and brain stimulation have been developed, expanding the possibilities of treatment.<\/p> <p><b style=\"font-size: 15.84px;\">D. Altra domanda<\/b><\/p>\n<h2 style=\"text-align: left;\">Related publications<\/h2>\n<ul> <li>Real-world experience of esketamine use to manage treatment-resistant depression (REAL-ESK study) \u2014 J. Affective Disorders, 2022 \u2192 DOI 10.1016\/j.jad.2022.09.043<\/li> <li>Treating bipolar depression with esketamine \u2014 Bipolar Disorders, 2023 \u2192 DOI 10.1111\/bdi.13296<\/li> <li>un lavoro su TMS\/stimolazione cerebrale, se si vuole rappresentare anche quel filone\u00a0<\/li> <\/ul>\n<h2 style=\"text-align: left;\">Related media<\/h2>\n<ul> <li>Odeon \u2013 Eccellenze Italiane: servizio sul disturbo depressivo resistente<\/li> <li>eventuali interviste RAI sul tema<\/li> <\/ul>\n<a href=\"https:\/\/giovannimartinotti.com\/media\/\" > Go to the Media page \u2192 <\/a>\n<p style=\"text-align: center;\"><strong>Other research areas:<\/strong> <a href=\"https:\/\/giovannimartinotti.com\/en\/home\/research-areas\/psychedelics-in-psychiatry\/\" target=\"_blank\" rel=\"noopener\">Psychedelics in Psychiatry<\/a> \u00b7 <a href=\"https:\/\/giovannimartinotti.com\/en\/home\/research-areas\/addictions-and-new-psychoactive-substances\/\" target=\"_blank\" rel=\"noopener\">Addictions and New Psychoactive Substances<\/a><\/p>","_links":{"self":[{"href":"https:\/\/giovannimartinotti.com\/en\/wp-json\/wp\/v2\/pages\/2723","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/giovannimartinotti.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/giovannimartinotti.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/giovannimartinotti.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/giovannimartinotti.com\/en\/wp-json\/wp\/v2\/comments?post=2723"}],"version-history":[{"count":26,"href":"https:\/\/giovannimartinotti.com\/en\/wp-json\/wp\/v2\/pages\/2723\/revisions"}],"predecessor-version":[{"id":3121,"href":"https:\/\/giovannimartinotti.com\/en\/wp-json\/wp\/v2\/pages\/2723\/revisions\/3121"}],"up":[{"embeddable":true,"href":"https:\/\/giovannimartinotti.com\/en\/wp-json\/wp\/v2\/pages\/2652"}],"wp:attachment":[{"href":"https:\/\/giovannimartinotti.com\/en\/wp-json\/wp\/v2\/media?parent=2723"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}