I'm in the boat with you. It is so great to know you have a great pdoc and you are working towards beating this low you are in currently. I'm in a limbo state right now and have an appt to see my pdoc on wed. My meds are no longer working either. I am also on Effexor 225 mg and 2 mg risperdal. I am feeling no motivation and agitated, anxious, racing thoughts all at the same time. I am going to ask my doctor about adding on lamictal to see if that may help with the depression and rapid cycling I am having. I hope you find a combo that works for you soon. huggs