The GP can script you any med you like, LEXAPRO not hospital but GP yes .The reason we don't go for combos is , if your having side effects which med is it that causing them , on `1 med you no easy. INTERACTIONS is another point. You get 2 meds if bipolar AD and a mood stabilizer. The GP is your front line pdoc in all but name , if depression he goes through ssris till he finds one. Effexor not used much now nor cymbalta do to with drawl . nobody goes to mental hospital till the GP refer you , then you see a shrink nurse to see if you are worthy of going on the waiting list. YOU CAN GO PRIVATE but megga money and same docs .