I SO recommend a MAO inhibitor. They're under-prescribed because of the dietary restrictions one must follow to avoid a "hypertensive crisis". Generally: wine, fermented and smoked foods (for example, salami, pastrami, some cold medicines, smoked cheese and fish...and more).

Nardil (one of the few MAOs)is the only medication that completely relieved my long-standing treatment resistant depression. Ever so sadly, I turned out to be prone to a side effect - extreme HYPO-tension! I had just titrated up to the dose that worked for me, when this side effect began and I was forced to discontinue it.

MAOs have saved the lives of friends (on and off line), though, and if you haven't tried it, you're letting yourself down. (Note, my saying: "If you can't do without pastrami, you're not really depressed!")

FWIW MAOs increase your available dopamine (as opposed to most antidepressants basically based on increasing serotonin). I decided long ago, that my brain lacks dopamine rather than serotonin. Yes, I've tried buproprion with microscopic (if any) response. I'm on my way to the gym - vital for my physical health as I'm otherwise almost completely sedentary. However, I'll bet its. increasing my endorphins - effect of dopamine - is equally important. SO hard to force myself to it (as with everything) but it's my primary therapy for all my systems.