I have what I believe to be a more genetic based depression...but who knows. I have been on many different meds over the years. I was your classic "bad" patient, I waited until I was suicidal...went to the Dr....took meds until I felt better, stopped...and then repeated the cycle..usually every year at least. No manic periods (darn) just plain old deep depression. I have now been on meds daily for about 8 years now. Zoloft lasted about 4 years and I am currently on effexor xr at 600 mgs. daily. I have loved it...but I am sure I have hit the top dose. I was also prescribed an anti-pyschotic over the years to combat the suicidality. I frankly hate the side effects..weight gain, fatique etc. so consequently I have cut back the dose of that med. I can feel myself rolling downhill again. I want to ask the Dr. for an additional anti-depressant..but am afraid he will get upset at the screwing around that I do with the other med consequently...I continue to roll and am picking up steam. My question is...do other meds, specifically the anti-psychotics "help" the anti-depressant work better (as I have heard is the case with say lithium), or are they their own animal and used to treat specific symptoms? I guess I am just looking for a rational to approach the Dr. about adding a new anti-depressant instead of upping the anti-psychotic. Thank you!