Finding the right psych med or combination is usually not a trivial thing and something psychiatrists should just know straight away, due to the wide range of individual reactions to the drugs. But if something is not working, then trying to change and explore other options is the logical thing to do. Unfortunately mental health issues do not work like something like a fever, where the same simple treatment will predictable provide relief.

I don't blame mental health professional (or anyone else) for wanting to earn high money if they can do it. Of course the income is part of the motivation to do the work. I often think many of them overcharge but then I compare it with, for example, a hair color appointment... which costs similar amount of money or more where I live than a T session for me. Is it similarly or more valuable? Question of personal needs I guess.

I did have the experience with both of my therapists that they did not want to let me go when I decided it was time to end it. I listen to their reasoning but will decide what I will invest into and how long. I think if a treatment has no benefits after several months, it's good to question it and look at changing or alternatives. But it does seem like your pdoc is trying. Responses to these meds can be unpredictable so trial and error is really what it usually takes.