Hi Mary Alice - I really like the track record of Effexor XR™ (venlafaxine). This antidepressant seldom "poops-out", it's dose/response curve is more or less linear (ie. increasing the dose results in increased action, whereas with the with the SSRIs there is a plateau dose, above which any increase in dose will not result in any more activity.

Electroconvulsive Therapy (ECT) is by far the safest and most effective antidepressant we have. It is grossly underused. It is the antidepressant of choice in pregnant women and the old-old (>90 yrs).

The MAOIs and to a lesser extent the TCAs are still decent antidepressant. It is their side effect profile that is their failing. The SSRIs were supposed to be non-toxic TCAs, but with the increase in safety came a decrease in efficacy. Again showing that the better treatments always seem to be the most toxic.

If you have any specific questions I will try to answer them.

- Cam