The reason my psychiatrist wanted me to try them was because he said I had the worst treatment resistant depression he had ever treated. I was episodic, meaning I was in an episode, of mostly non-functional depression or I was fine when not having an episode. No medications or 3 different sessions of ECT (22 total) helped me in over 25 years. He had only one other patient he had prescribed an MAOI for and it was working. I had been seeing him (he is an amazing psychiatrist who really cares that his patients get well) about 3 years when he suggested the MAOI and I was very scared to take them but I was about out of options. I had no hope this medicine would work either but it did and worked pretty quickly. No real side effects other than weight gain. Downside is diet and all the medication interactions. I am use to the diet and it is not a problem and I have a pharmacist who knows all about the maoi and even if I might forget about an interaction she never does! The medication gave me my life back.