 However, the more antidepressants an individual had already tried, the less likely they were to benefit from a new antidepressant trial.Some off label antidepressants are low dose ketamine and highly serotonergic catecholamines (including very controlled use of MDMA in the treatment of PTSD and crippling depression/anxiety).For lethargic syndromes, dysthymia, or caffeine-resistant amotivation, a dopaminergic stimulant such as methlyphenidate, or even 2.5 mg dextroamphetamine can be helpful.