Have you looked into mirtazapine (tetra cyclic), vortioxetine (serotonin modulator) or atomoxetine (SNDRI). Atomoxetine has been a god send for me.

I've tried 20-some-odd antidepressants titrating off and on and usually back off again.

Mirtazapene (ATeCA) is the only one that could manage my depression. Unfortunately, it leads to severe weight gain that my health plan's formulary refuses to cover GLP-1 for because obesity is considered "a choice". It's the only one where the depression mostly goes away and the side-effects aren't life-threatening/-debilitating for me. If I forget a single dose at night or anytime I go to sleep without taking it first, I end up with almost exactly the feeling of an alcohol hangover. It's also a pretty powerful antihistamine. I also usually can't get to sleep if I don't take it. :/

Vortioxetine gave me horrific myoclonus and vestibular symptoms.

Atomoxetine is mostly for ADHD and gave me tachycardia, profuse sweating, uncomfortable nervousness, and anxiety. It didn't do shit for my ADHD or depression.

YMMV.

Atomoxetine can cause some wild mood-related side effects, just as an FYI for anyone considering it. For me, it made me perpetually pissed off, and made me feel like I had a cold. I’m jealous of people it works well for though - seems like a great drug when it works!

I stopped looking into drugs when I stopped having problems.

They work so well for some they are miracle drugs, and for others they do nothing or have negative effects. This is typical. We still don’t fully understand why or even why they work at all.