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Vagus Nerve Stimulation, Transcranial Nutrapharmex Keto Magnetic Stimulation, and other newly emerging methods of direct and select brain stimulation have been shown to produce efficacious results as well. The arsenal of successful treatment also includes Ketamine IV infusion for resistant depression. Psychotherapies of varying types have been assessed as effective and often necessary methods to assist with medication therapies in the fight against refractory depression; i.e. Cognitive Behavioral Therapy, Interactive-Interpersonal, Dialectical Behavioral and yes, even Analytical in some cases, have all been proven to be potentially effective. Treatment to remission, meaning no remaining symptoms, needs to be the goal or recurrence is likely. Outcomes Nutrapharmex Keto for patients with TRD can be very varied. Relapse rates tend to be greater and swifter in patients with TRD. It is essential that these patients be assessed and treated only by well-trained and experienced behavioral