I have major suicidal ideation with attempts, which are the hallmarks of my treatment resistant depression. I take effexor xr, welbutrin xl, abilify, seroquel for sleep and klonopin for anxiety. That has been my med routine for the past 16 years and it has worked somewhat. But now I have added ECT every 2 weeks, and will be adding a low dose of clozaril. TRD is the pits!!!