Are you in the US? My psychiatrist told me earlier this year that there was a clinical trial in the Washington DC area, where I happen to live, at NIH (National Institutes of Health) for ketamine treatment. He sent me a link to the information and if I remember correctly this was the last year of a decade long study on it. However, I decided against it because there were very strict requirements for the study - I would not be allowed to see my therapist or psychiatrist over the course of treatment at NIH because they didn't want any outside variables to affect their study, which I understand. They wanted to see the sole effects of ketamine on depression without any interference, for lack of a better term. But I felt I would not be able to go that long without therapy nor miss that much time from work. Maybe there is a clinical trial in your area? I asked him what would happen even if I had participated in the study and the ketamine worked. He said they would have provided me with ketamine in medication form or been allowed to come back for treatments.

As for TMS, almost every insurance company in the US approves it (including Medicare and the VA) but my insurance company, Aetna, has been extremely slow to come on board with it. I believe Cigna does not cover it either but I could be wrong. My psychiatrist has been fighting them in an appeal on my behalf along with an attorney with the American Psychiatric Association since February. In July they noticed Aetna buckled a little bit but they still want the patient to jump through about 10 hoops and demonstrate that ECT is not a better option, which I do not understand, because ECT would cost them a lot more. As far as the success rate of TMS, it seems to be the same as anything else - I've read personal testimonies of it working for some people and others where it did not work at all. As far as the initial treatment span of TMS, I think you have to go in 5x a week for 6 weeks and then they re-evaluate for the frequency of "maintenance" sessions.