Beth, have you ever been on Emsam? It's an MAOI in a patch form so less restrictive than other MAOIs. It rarely poops out if it works for you and for me it has been pretty amazing. I was on it for about 5 years before clozaril and my depression was improved a lot then; in combination it's much better. I was on everything except for some tricyclics and the other MAOIs before I went on Emsam and it's made a huge difference in the 10 years I've been on it.

Not every doctor will prescribe it but if other ADs don't work for you it might be worth a converstation with your pdoc.