Looking at your signature and what I see here, your pdoc seems to be the kind of doctor who always adds and never removes. Is this true?

Also, aren't Effexor and Wellbutrin SNRIs? I see that Effexor tackles depression AND anxiety, while Wellbutrin only tackles depression. So, even though your pdoc's logic is flawed, I can see why he wants to up your Effexor. You said you had anxiety problems, so his first thought was to up your Effexor instead of giving you a new medication for your anxiety. (It's not a good idea to up your dose like that, I know... but I'm just explaining his logic.)

Why doesn't he get rid of the Effexor and use something like gabapentin or propranolol? You're already on one SNRI. Why be on 2? I think that's something you definitely need to talk to him about because it sounds like you could drop the Effexor and maybe get Ativan or Xanax PRN.... Or if you feel the need to take an anxiety medication every day, ask about gabapentin and propranolol

just my 2 cents