A few thoughts...if your pdoc doesn't agree to you weaning of the depokote and you have to do it behind her back, find a new pdoc. You will sabotage your treatment if you cannot be honest with your pdoc. I absolutely agree that it is your body, your choice so if you feel you are making a reasonable, educated change for valid reasons, you need to be with someone that respects that.

Secondly, I was reading up some on the controversy of using straight antidepressants (like the Effexor and Paxil you mentioned) with bipolar folks. There is the theory that adding meds like these to your combo will make it less effective. So, maybe one thing to ask a pdoc about is simplifying the meds you take so that they have a chance of working.

I agree that not everyone needs to be on meds at all times, but I suspect it is a minority. I tried to convince myself that I was in this minority...I wasn't. If you have a good relationship with your t, talk over this possibility over with her. Sometimes we need an objective party (not to sound cynical, but a t is likely much more objective on this than a pdoc). I know for me, I was too close to my own situation to accept that going off meds entirely was likely to result in disaster (even though pdoc warned me).

Best of luck,
EJ