Welcome to HCM Sunil, I have read your query carefully and from that it is apparent that you have chronic depression like symptoms (as you are never completely symptom free ) since first you had them at age of 19 yrs. You were started on flunil 20 mg twice a day, which gave you some relief, but you continue to have some side effects, and many lingering symptoms of depression. You have not mentioned any thing about your change of treatment or if you ever visited the psychiatrist again and discussed your problem with him? It is usual to see cases who have had some partial response to medicine initially and then they just continue with the drug and never think that better options are available. Flunil is a good medicine but at the same time has some side effects amongst which sexual dysfunction is also present. there are so many new medicine present in the market and they have minimal side effect profile. The question also does not mention anything about your medicinal background, which is needed to see what new medicine can be started. I have seen patients like you responding very nicely with sertraline, or may be paroxetine or venalafaxine... These new drugs wil not only remove depression but also your pains and memory problems. To decide the medicine we need to know the patient condition in detail, about his physical condition and may be also get some blood test.... You have had partial response to medicine, and are able to continue with your work, this suggest that may be with another drug you will have good response ( better than the current scenario). Ideally one should try to keep the patient on one single drug and so, had I been treating you, I would not add anything to Flunil but change the medicine.This is the usual and correct practice whenever feasible. Hope the reply is useful feel free to ask more queries Dr. Manisha Gopal