Where you taking the nortriptyline, sertraline, mirtazapine and Zyprexa at the time you crashed, or were they added later?
I was on 100mg of Sertraline when I crashed. I had been taking it for over 10 years so it pooped. I decreased from 100mg down to 50mg in about 7 days. I then was tried on Venlafaxine and dolusepin which I couldn't tolerate. The whole time this was going on I was on Valium, which was increased 2mg every month or so. I was on Mirtazapine for sleep. I was then prescribed Respiradone, that's when I decided to get a second opinion from a different psychiatrist.
Are you being treated by a GP or psychiatrist? If a GP, ask for a referral to a shrink asap. If by a psychiatrist get a new one, also asap.
Clearly, none of the meds is working so it is time to have a rethink. This nonsense of just adding more and more meds in the hope one of them will do something needs to stop.
I'd also be asking why Valium and the Clonazepam were added long-term when you weren't even close to taking the maximum dose of any of the other meds. Foolishness.
The second psychiatrist changed me to Clonazepam, upped the Sertraline to 200mg and the Mirtazapine to 45mg and I was climbing the walls with anxiety, I couldn't tolerate it. So a tapered back down. I then had 5 sessions of ECT while in hospital for a month which did seem to help. So now I am on 15mg Mirtazapine, 50mg Sertraline, we did try to taper right off the Sertraline but I started having early morning waking and panic attacks, so we went back up to 50mg. 100mg Nortriptyline. 2.5mg Olanzapine (I think this is because I have OCD thoughts) and 1mg twice daily of Clonazepam.
BTW-there is evidence that benzodiazepines significantly reduce the effectiveness of antidepressants by blocking hippocampal neurogenesis which is what produces the antidepressant therapeutic response (see:
Boldrini M, 2014;
Nochi R, 2013;
Sun Y, 2013;
Wu X, 2009;
Stefovska VG, 2008).
IMHO, the nortriptyline and sertraline doses need to be increased, or alternatively, they, and maybe also the mirtazapine, be dumped in favour of another antidepressant. Either clomipramine (Anafranil), or if more noradrenaline/norepinephrine inhibition is desired then desipramine (Norpramin) would be good choices. Clomipramine is fairly sedating so you shouldn't need the mirtazapine, which I assume is only taken as a sleep aid. If necessary take up to the maximum dose of whichever is chosen, perhaps even a little more (but especially for desipramine demand plasma levels be checked a couple of times at the beginning to ensure they don't exceed the therapeutic range as the dose recommendations for this med may have been set too high).