"started on 30mg for about 3 months, not much help.  upped to 60mg, no help. now on 90mg for one month and my depression is even worse that it was. i slipped into a major down a few days ago, one of the worst i&#039;ve had in years and have yet to bounce back from it. i have had mild brain zaps here and there since going to 90mg.  anyway, i am guessing my psychiatrist will try something different.  i have tried lexapro (helped me for many years, then seemed to stop working). wellbutrin (made me very irritable), and pristiq (did nothing except lower my libido and give me a little bit of energy)."