For years, many, many years I did excellent on Nortriptyline, a second-generation tricyclic antidepressant.
In 2005 the medication started to poop out even though we increased the dose. If your on this med many physicians require blood work to check for therapeutic blood levels and even with labs showing good levels the med quit working or something changed.
In November of 2005 I had a major melt down and ended up taking early retirement from my job.
After that we did the antidepressant two step and I danced with many of the SSRIs and ended up on Cymbalta for a year or so but nothing every really worked like the Nortriptylinne. I had reactions to Imipramine and to Serzone both causing me to end up in ER, one an overnight hospital stay.
I just did a slow wean off of the Cymbalta and it has been 2 months now. I feel like if I could just find a med at a low dose that would even things out I would be better.
For now I use Trazodone 100mg at HS which helps with the insomnia and Buspar for anxiety.
I understand how difficult it is to keep on trying to find a miracle medication but for me it seems I must work through the issues without an AD per se.
I hope that you are able to find a good combo of medications that work for you.
Take care and gentle hugs