observations, just anything except people who have only used 1 antidepressant themselves and got a desired response but if you've seen the 1st one given work on an extremely severe case that is acceptable. Also I don't want to be rude but I'm not looking for the "everyone responds differently" answer as we all know that but more often than not an SSRI isn't going to cut it alone for severe cases, 1 augmenting drug is ok to add with it. My personal opinion is 1 Remeron+Nuvigil, 2 Effexor+Remeron(22.5mg or less) 3 Cymbalta+Pramipexole. Just wanna know other peoples opinions