When I was 20, I was diagnosed with dysthymia. Anxiety was a major symptom. I was sucessfully treated for abou five years with prozac. About two years ago, I started effexor. Within a week, I was hypomanic. That lasted for about two months. Then my good mood began to fade, earlier and earlier in the day. I still had anxiety as a symptom. Next I tried moclobemide. I had a hypomanic reaction to that for about four months. My anxiety vanished and had not returned. Again my mood faded, but this time I went into a deep depression. I responded to various drugs combinations - reboxetine and moclobemide, celexa and moclobemide. But the response lasted a couple monhts at most. When I get a response it happens quickly, within an hour to a week of the first dose. Moreover, I can feel the response in my head. It is a pulsating sensation. I have now had ECT which temoprary lifed me out of the depression, but now it has come back. I am on Parnate and Seroquel, and lithium. I had a quick hypomanic response to seroquel (first day, a few days) and a quick response to lithium (with first dose, lasting a day). When I was responded, I could feel the pulsating in my head about an hour after the dose. What do you reccomend for treatment? Please help.