Is there a pdoc at the PHP? Maybe you could talk to him about Emsam. He's probably going to be more comfortable with it than a pnurse. That's the trick with MAOIs, finding providers comfortable with using them.

You don't have to decide about ECT today. I always want to figure everything out before it happens but it's really not helpful. I've had a suitcase on my couch for a month to prove this....

I think you'll know what is right when the time comes.