Well I've had severe depression for years and I'm running very short on options here. Here's what I've tried:

SSRIs (Prozac, Zoloft, viibryd, celexa, lexapro)
SNRIs(Effexor, cymbalta)
NDRIs (Wellbutrin)
APs and AAPs (ability, seroquel, lithium, Latuda)
Mood stabilizers (lamictal)
Benzos (all except Valium)
Stimulants (Ritalin, adderall, vyvanse, concerta)
Nonstimulants (straterra)
Tricyclics (desipramine)
MAOIs (emsam)
Ketamine (intranasal)

In addition to meds I've also had a failed round of TMS... so, as you can see, not a lot left to try I've tried various combinations of those meds with almost no reaction good or bad to any of them.

I did find out that my genetic test said emsam would need to be a higher dose, but in order to do that or try a different one, I have to be off adderall, the only med that helps, even if marginally.

The way I see it the only things left to try are another maoi at the right dose, and ECT.

Failing ketamine really hit me hard I'm really not looking forward to etc or an maoi, and I'm hitting the end of the road so getting scared that pretty soon I'll have nothing left to try just wondering if anyone has any ideas?