You followed your doctor’s advice. You took the medications as prescribed, waited the six weeks for them to work, managed the side effects, adjusted the doses. And yet – nothing changed. Or perhaps things improved briefly, then the darkness returned.

If this sounds familiar, you are not failing at treatment. You may be living with treatment-resistant depression (TRD) – one of the most misunderstood and underserved conditions in Canadian mental health care.

This guide explains what TRD is, why it happens, what the Canadian clinical guidelines say, and what treatment options now exist – including rapid-acting approaches that are changing outcomes for patients who had run out of hope.

What Is Treatment-Resistant Depression?

Treatment-resistant depression is defined clinically as a major depressive episode that has not responded to at least two different antidepressant medications, each tried at an adequate dose for an adequate duration (typically six to eight weeks).

It is not a character flaw, a lack of effort, or a sign that treatment can never work. It is a recognized clinical condition affecting approximately 22% of all Canadians diagnosed with major depressive disorder (MDD). That means more than one in five people receiving standard care for depression are not getting adequate relief.

Why Do Standard Antidepressants Fail for Some People?

Most conventional antidepressants work on the serotonin, norepinephrine, or dopamine systems – neurotransmitter pathways that are well-understood but don’t explain every case of depression. For patients with TRD, research increasingly points to other biological factors:

•  Glutamate dysregulation – abnormalities in the brain’s primary excitatory neurotransmitter system, which conventional antidepressants don’t address

•  Reduced neuroplasticity – a diminished ability of the brain to form new connections, which may underlie the persistent cognitive and emotional symptoms of TRD

•  Inflammatory pathways – elevated inflammatory markers are found in a significant subset of patients with depression unresponsive to standard treatment

•  Genetic variations in drug metabolism (pharmacogenomics) that reduce the effectiveness of specific medications for specific individuals

This is why simply trying another SSRI is often not the answer for TRD. The underlying biology requires a different therapeutic approach.

The Canadian Clinical Landscape for TRD

The Canadian Network for Mood and Anxiety Treatments (CANMAT 2023) explicitly recognizes rapid-acting infusion therapy as a third-line treatment for adults with treatment-resistant depression. This means it is an officially guideline-recommended option for patients who have not responded to at least two prior treatments.

Health Canada has also approved intranasal esketamine (Spravato) specifically for treatment-resistant depression.

For the majority of TRD patients, however, intravenous infusion therapy delivers the most robust, rapid, and well-documented response.

What Rapid-Acting Infusion Therapy Means for TRD Patients

The most significant clinical feature of infusion-based treatment for TRD is speed. Where conventional antidepressants require four to six weeks to produce measurable effects, infusion therapy can produce meaningful reductions in depressive symptoms – including suicidal ideation – within hours to days of the first treatment.

Multiple randomized controlled trials and meta-analyses have confirmed this rapid-acting antidepressant effect (Murrough et al., 2013). In real-world Canadian clinical settings, including Braxia Health’s clinic where over 30,000 treatments have been delivered, the majority of patients report significant improvement following their initial six-session induction series.

Who Qualifies for TRD Treatment at Braxia Health?

Braxia Health accepts patients with a confirmed or probable diagnosis of treatment-resistant depression who meet the following criteria:

•  Documented history of two or more failed antidepressant trials

•  A referral from a community healthcare provider (family physician, psychiatrist, nurse practitioner)

•  No contraindications identified in the medical screening process

•  Commitment to the full induction series and follow-up care

Patients with bipolar depression, PTSD, and OCD may also qualify – assessed individually by a Braxia physician.

What the Treatment Journey Looks Like

A typical TRD treatment journey at Braxia Health unfolds across three phases:

•  Assessment and onboarding (Week 1): Intake appointment, medical screening, informed consent, treatment planning.

•  Induction series (Weeks 2–7): Six treatment sessions delivered over four to six weeks by an anesthesiologist. Each session is monitored 1:1 by a registered nurse. Many patients notice improvement by sessions three or four.

•  Maintenance and follow-up (Ongoing): Monthly or bimonthly maintenance sessions tailored to sustain response. Integration with your existing mental health care team.

For patients who benefit from psychotherapeutic support alongside their treatment, Braxia’s in-house psychotherapists offer psychedelic-assisted psychotherapy (PAP) – a structured model that uses the therapeutic window created by infusion therapy to support deeper psychological processing and integration.

You Have Not Run Out of Options

Treatment-resistant depression is one of the most difficult conditions in psychiatry – but it is not untreatable. The emergence of rapid-acting, neuroplasticity-targeted therapies represents a genuine clinical breakthrough for the patients conventional medicine had left behind.

At Braxia Health, we have worked with thousands of patients who came to us after years – sometimes decades – of inadequate treatment. Many have found meaningful, lasting relief through our programs.

If you or someone you love has not responded to standard antidepressant treatment, ask your doctor about a referral to Braxia Health. Our intake team is also available to answer questions before your first appointment.

Braxia Health, Mississauga, Ontario. Virtual consultations available across Ontario (other provinces coming soon). Veterans may have coverage through their benefits. WSIB patients may have coverage depending on their claim.

This content is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before making any decisions about your treatment.

Something is shifting in Canadian mental health care. For decades, people living with Severe Depression, Bipolar Disorder, PTSD, and treatment-resistant mood disorders had few options beyond cycling through medications that didn’t work. Today, a clinically grounded, medically supervised approach – psychedelic-assisted therapy – is quietly transforming what’s possible.

At Braxia Health, Canada’s first clinic to specialize exclusively in rapid-acting infusion treatments for mood disorders, we’ve delivered over 30,000 treatments to patients at our clinic in Mississauga and virtually across Ontario. This guide answers every question we hear from new patients: what it is, who qualifies, what the experience is like, and what to expect when you walk through our doors.

What Is Psychedelic-Assisted Therapy?

Psychedelic-assisted therapy is a clinically supervised treatment model that uses carefully dosed, rapid-acting medications to produce a therapeutic window – a period of neurological flexibility in which the brain becomes more receptive to change. This window is then supported by psychotherapy and integration work to produce lasting improvements in mood, cognition, and emotional regulation.

In Canada, the most widely available and clinically validated form of this treatment uses a medication that has been approved by Health Canada as an anesthetic and is used off-label for the treatment of mood disorders – a use now supported by Canadian clinical guidelines (CANMAT 2023) and a growing body of peer-reviewed evidence including multiple randomized controlled trials.

It is not a recreational experience. It is not experimental. It is a structured, evidence-based medical treatment delivered under 1:1 nursing supervision by a team of physicians, psychiatrists, and psychotherapists.

Who Is a Candidate for This Treatment?

Psychedelic-assisted therapy at Braxia Health is designed primarily for patients with:

•  Treatment-resistant depression (TRD) – typically defined as two or more failed antidepressant trials at adequate doses

•  Major depressive disorder (MDD) with inadequate response to standard care

•  PTSD and complex trauma – particularly where conventional therapy has plateaued

•  Bipolar depression (assessed case-by-case with psychiatrist oversight)

A community healthcare provider referral is always required before treatment begins. This ensures we have a complete clinical picture of your history, current medications, and care team – and that you remain supported after your course of treatment.

What Happens During the Intake Process?

The first visit to Braxia Health is an assessment, not a treatment. Here’s what to expect:

•  Intake form and history review: After completing our intake assessment forms, a physician will review your medical history, current medications, prior psychiatric treatments, and reasons for seeking care.

•  Physician assessment: A Braxia physician (often a psychiatrist) meets with you to confirm eligibility, explain the treatment options available to you (intravenous infusion, sublingual oral, or virtual at-home program), and answer your questions.

•  Informed consent: You’ll receive a detailed explanation of what the treatment involves, expected effects, potential side effects (most commonly mild dissociative sensations and brief cardiovascular changes that resolve quickly), and the structure of your treatment course.

•  Treatment planning: Together, you and your care team design your induction series – typically six sessions – and discuss whether psychedelic-assisted psychotherapy (PAP) integration sessions are recommended.

The Induction Series: Six Sessions That Can Change Everything

The most common treatment course at Braxia Health is a six-session induction series delivered over six weeks by an anesthesiologist. Each session is monitored by a registered nurse (1:1 throughout), takes place in a private, calm clinical room, and lasts approximately 45-60 minutes for the treatment itself, plus preparation and recovery time.

The majority of patients begin to notice improvements in mood within hours to days of their first treatment – a response time that is simply not possible with conventional antidepressants, which typically require four to six weeks (Murrough et al., 2013, JAMA Psychiatry). For patients in acute distress or with active suicidal ideation, this rapid-acting effect can be life-changing.

After the induction series, not all patients require maintenance treatment, but many choose to continue with periodic sessions to help sustain their response over time. This is personalized to your needs and monitored by your Braxia physician.

What Makes Braxia Health Different?

We’re often asked what sets Braxia apart from other mental health providers. A few things stand out:

•  Canada’s first and most experienced clinic in this treatment category – with over 30,000 treatments delivered since our founding

•  Safety protocols developed by one of Canada’s leading psychiatrists in this field

•  1:1 nurse monitoring throughout every session – no exceptions

•  Three delivery options: intravenous infusion (IV), sublingual oral (in-clinic), and sublingual oral (virtual at-home program for Ontario residents)

•  In-house psychotherapists for integrated psychedelic-assisted psychotherapy (PAP)

•  On-site pharmacy – compounding, dispensing, and clinical trial support under one roof

•  The only clinic in Canada offering this treatment for adolescents through a supervised sublingual program

Is This Treatment Covered by Insurance?

This is one of the most common questions we receive. Currently, most provincial health plans do not cover this treatment for mental health indications, though physician consultation fees may be covered under provincial health plans. Veterans may have coverage through their benefits, and WSIB patients may have coverage depending on their claim. Some extended health plans provide partial coverage. Our team will help you navigate your options.

The physician consultation and intake process at Braxia Health is free of charge, regardless of whether you decide to continue with treatment. We are committed to transparent pricing and will provide a full breakdown at your initial assessment. We also offer guidance on financing options for patients who need flexibility.

Virtual Access Across Ontario

Braxia Health’s virtual sublingual program makes this treatment accessible to Ontario patients who cannot travel to our Mississauga clinic. Virtual consultations, remote monitoring, and ongoing care coordination mean that patients across Ontario can access the same clinical standards without leaving home. The virtual program is currently available in Ontario, with other provinces coming soon. Please note that the virtual program is not available to adolescents.

Taking the First Step

If you’ve been living with depression, PTSD, or a mood disorder that hasn’t responded to conventional treatment, you don’t have to keep waiting. The evidence is clear. The treatment is available. And the team at Braxia Health is ready to support you.

To get started, speak with your family physician or psychiatrist about a referral to Braxia Health. You can also contact our intake team directly to ask questions before committing to an assessment.

Braxia Health is located at 1100 Dundas St W, Unit 7-8, Mississauga, ON. Virtual consultations available to Ontario residents (other provinces coming soon).

This content is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before making any decisions about your treatment.