For MDD , that is also called as unipolar depression and gad , your doctor has so far tried you on various anti depressants , with little effect , but it seems that you have developed tolerance to nortriptyline , so tthere is no point in further raising the dose , as it is not going to respond at higher dose as well, so what is required here is change of drug to 2 anti depressants as you seem to be having treatment resistant depression , so i suggest that while you continue on klonopin and seroquel in present doses , but you switch over to the combination of Paxil cr or effexor XR and Trazodone .
You see, you have to take any one of the 2 drugs that is paxil cr or effexor xr in the morning only dose , since these are long acting versions , so there is no need to have a second dose , plus add trazodone at a low dose at night , which will not only assist paxil cr or effexor xr in treating depression and anxiety , but also will aid in sleeping because of its sedative action.So, after 2-3 weks your doctor shall increase the dose of trazodone at night and start decreasing the dose of seroquel which is a anti psychotic , with sedative action , which should eventually be stopped ,as, it is not required in the presence of trazodone assisting paxil cr or effexor xr for treating depression and anxiety ,as combination of trazodone at night , paxil xr or effexor xr a morning and klonopin will be good enough regime to control your symptoms of depression and anxiety .
So, i suggest that you discuss this regime with your doctor and get started on it , and i am quite sure that it will work for you , and alleviate your symptoms..
I hope this helps...
I wish you all the best...
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