depression
"I have been on 60mg mirtazapine with 75-150mg effexor for about a year. It helped my depressive symptoms a lot at first, but over time I've had diminishing returns. Though I find it nearly impossible to be stressed or depressed on these meds, I still remained suicidal in a "philosophical" way. It reached a point where action was required, and now I am experimenting with adding lithium to the mix. I encourage those who are not responding well enough on antidepressants alone to consider adding a low dose of lithium. My suicidal ideation has been at least blunted. Good luck all."