One other thing that you may do is, create a file with the same name as the dll that is optimized but with ini extension and add the following to it:
[.NET Framework Debugging Control]
GenerateTrackingInfo=1
AllowOptimize=0
This will tell the JIT not to optimize your variables.
Note that you still need the pdb, so you will end up with something like this: yourDll.dll yourDll.pdb yourDll.ini
This works specially well in scenarios when you don't have access to re-generate the dlls with debug option.
http://www.hanselman.com/blog/DebugVsReleaseTheBestOfBothWorlds.aspx