Besides Paxil and Prozac, there are also Effexor and Wellbutrin; I've heard
of people who take one or the other of those and (in some cases) augment
with occasional doses of a meso(cortico)limbic dopamine enhancement of
one sort or another.
I don't have a whole lot of info on Deprenyl, but it apparently has
serotonin and dopamine effects. I am curious about this, but haven't
pursued it much yet.
Now, the donwsides certainly can include changes in thinking,
affect flattening, changes in sleep patterns, libido, etc. Combine
those with old (and _effective_) habits learned during the old
chemical regime, and it's clear that hillclimbing the hedonic
landscape is fraught with pitfalls. As one acquaintance put it, "Some
people call it my manic phase... I like to call it 'getting things
DONE!'". :)