Our expert says:
I haven't come across much use of the specific AD combinations you describe, and I'm not sure what precise chemical rationale lies behind them, but they seem to have worked well for you in the first combo, and not so well in the second example. If this combo is not working well ( and from what you say, it isn't ) I don't understand remaining on it for 7 months - generally 2 to 4 weeks is enouygh to see whether an AD treatment approach is working or not. If it hasn't worked in a month or 2, it isn't going to start working at 7 months.
Maybe the use of the Remeron was to help the sleeping in a sedative way, with the Luvox being relied on to be the main AD. The fact is at this time, this combo is NOT working acceptably, and oher methods should have been chosen a while back. As entirely untreated depressive episodes tend to lift after 9 months o so, 7 months is way too long to persist with an ineffective treatment plan.
I would expect your doc to discuss with you the reasoning behind any such combination of meds, and what exactly each component was expected to achieve.
Discuss the lack of results this time, and discuss other alternatives to try.
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