Have you tried each possible combination of all these meds and each possible effective dosage?

The effect of one med is hard to tell, but when combining meds, it's pretty much impossible. Your reaction to any one med changes day by day and that for each med, and even if they don't chemically interact, their immediate effects interact in unpredictable ways, both the biochemistry and psychologically.

I'd suggest (and you may have done just that) using not more than 2 meds at any one time for at least a year, unless it clearly doesn't work and no anxiolytics (at all).

But if it works, even by a miracle, or you and your psychiatrist have been really careful and thorough (40 years is a long time, I admit, and it must've been awful), it works...

Hopefully you can change your user name soon.