When I began The Chemistry Experiment, there were about twenty options out there for me to try. I was a wuss and quit at six. I said "no" to a fifth SSRI/SNRI, and rejected the whole class of MAOIs (Monoamine Oxidase Inhibitors) -- which were just too tempting to use as a backup plan. Instead I headed east, and Chinese herbs got me through almost two years. Later I returned to an antidepressant that hadn't been effective before, but at least it did no harm. This time it helped. Was this because I was taking Xiao Yao San as well? Who knows. But now it doesn't work any more anyway.
Meanwhile, there is a new strategy called augmentation. If one med doesn't work, try combining two, an antidepressant with an anti-psychotic, anti-convulsant, mood stabilizer, atypical anti-psychotic. Suddenly the number of possibilities is up to forty. That doesn't actually give you 1600 potential combinations, because if you combine MAOIs with most of the others, it'll kill you. Most days, that doesn't seem like a good thing. Anyway, the number of potential trials has increased exponentially, and I am nowhere near the end of the chemistry experiment.
Meanwhile, there is a new strategy called augmentation. If one med doesn't work, try combining two, an antidepressant with an anti-psychotic, anti-convulsant, mood stabilizer, atypical anti-psychotic. Suddenly the number of possibilities is up to forty. That doesn't actually give you 1600 potential combinations, because if you combine MAOIs with most of the others, it'll kill you. Most days, that doesn't seem like a good thing. Anyway, the number of potential trials has increased exponentially, and I am nowhere near the end of the chemistry experiment.