Hi EJ have found the thread, as a new user it takes some working out when you post things but I tend to get there in the end. I suffer with bouts of depression and anxiety. I am usually able to carry on working throughout even though it becomes difficult and I have to push myself. It helps me doing this. This last period of depression/anxiety has been the worst I have ever had hence the change in meds. I went up to 40ml of citalopram and found i was having one good week then one bad week so it just was not helping. After discussing with my GP the choice I had was Mirtazipine or duloxetine, we went for the mirtazipine as he felt it would be better suited and here I am. Day 7 today of taking the med and I am still getting the awful zaps through my body from the withdrawal of citalopram and feeling heavy/tired and not myself with the mirt. I just hope in the next week these effects start to wear off. I cannot leave the house at the moment due to feeling this way. i did phone the GP and he said my take 2 weeks before I start to feel better. Mentally I have no depression or anxiety which is a good sign. Sounds like you have had alot of treatment in the past and been through an awful lot, makes my problems sound so trivial. You are very brave and its good you have a good psychiatrist. Jo