If all ssri's (max doses) & venlafaxine have failed to decrease dep (duration 14 yrs) would bupropion be an obvious next option? any ideas? #hopeless

Possibly: Best answer ,come from those familiar with your case. Recalcitrant depression is being treated with other methods such as ECT, alpha stim, ketamine infusions, as well as single or mixed pharmacological methods

Possibly: Although - may have the wrong diagnosis (other medical disorder - I note issues with low iron and this would be one immediate thing to test- or other mental health disorder - in which case may need different treatment) and generally tend to work with a psychiatrist here as if depression treatment likely to be complex and need multiple medications and psychological therapy. See GP for tests/refer