Have you ever considered Ketamine?
That would not involve inpatient, and if it works for you, the results are immediate from what I've read. No waiting 4-6 weeks to see if a med works.

It is so new, I'm not sure many insurances cover it.

In all fairness, I have to admit I have an intense interest in it. However, it is not offered in my neck of the woods, and I probably couldn't afford it if it was.