  

I have major depressive disorder, anxiety disorder, obsessive-compulsive disorder and autism spectrum disorder. I have tried sertraline, escitalopram, fluoxetine, paroxetine, fluvoxamine, clomipramine, mirtazapine, duloxetine, desvenlafaxine, quetiapine, aripiprazole, olanzapine, risperidone, lithium, sodium valproate, clonazepam, lorazepam, alprazolam, bromazepam, propranolol and pregabalin.

After trying so many medications, my OCD, anxiety and depression still make me dysfunctional. I see my psychiatrist, clinical psychologist, counselor and social worker regularly. I asked my psychiatrist to prescribe me brexpiprazole, venlafaxine and vortioxetine, but she refused. She also didn't recommend ECT. I tried rTMS and dTMS but they don't work. Esketamine and MAOIs are not available. What can I do to bring my OCD, anxiety and depression under control?

My current prescription:

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1. Fluvoxamine      100mg bd
2. Mirtazapine      45mg at bedtime
3. Aripiprazole      25mg daily
4. Olanzapine      15mg nocte
5. Clonazepam      0.5mg tds prn
6. Lorazepam      0.5mg tds prn
7. Pregabalin      250mg om and 250mg nocte
8. Sodium      valproate CR 200mg nocte
9. Promethazine      100mg nocte prn
10. Lithium      carbonate CR 400mg nocte