I have a ton of experience but not much advice.

I have been trying different meds and combo's for 20 years. Some don't work at all, some work kind of OK, I find one that works pretty good and it poops out.

The one I am currently taking has worked better than anyone I have ever taken. Fetzima. A newer SSNRI. It has been two years and I am now at the highest dose. Not a magic pill but has worked quite well over all.

I am also afraid I am running out of options.