Hello, I have been Dx with major depressive disorder and been Rx'd the gamut of SSRI's and to no avail: couldn't dose high enough to demonstrate any efficacy but at the expense of side effects (dry mouth). I have been taking duloxetine for nearly 6 months with no noticeable benefit. My Dr recently switched me to fluoxetine 20mg a month ago ("same class, different pathway"), still no noticeable benefit. Now what? Dose titration (up to 60mg qd) as mono-Tx or add an adjunctive Tx? I think the approach is mental health 101. No etoh usage, and lunesta 3mg qhs. No other Rx's. Please advise.