Ok. So Effexor - felt great at first but made me manic horribly, bad angry sad crying not sleeping manic. Can you have a phone call with doc & ask if that could be a culprit?
If you do go off Effexor, do it as slow as possible. Brain zaps & flu symptoms for a lot of people. Also trazedone has antidepressant in it I think. I did ok-ish on that one, but bp people often can't do antidepressants. Maybe they'd also let you increase gabapentin?
Seems over the phone they might make a dose adjustment but prob not full on med change? Please consider the Effexor thing - but don't do cold turkey it would be worse hell than you're in now.