As far as sexual side effects go, increasing the dose of Venlafaxine would be expected actually to improve them, not make them worse. So, that's a possibility. You are on some fairly sedating medications, which seem to be helping your sleep overall. But being tired during the day can make it impossible to work or even stay awake. I have this particular thing with my bipolar disorder. Generally, it needs to be treated in order to improve. Most people I have spoken with who are treating this problem are on either something like Adderall (dextroamphetamine/amphetamine) or Provigil (modafinil). Both have worked for me, but I prefer the modafinil, because I have fewer side effects on it than I do on the Adderall. Anyhow, you might look into this and see what you think.

We are not capable of diagnosing someone here at PC. We are just patients ourselves. You would really need to see whatever specialty in Moscow treats things like bipolar disorder to get that nailed down. You could also always look at the criteria for a bipolar diagnosis from the DSM 5 and see what you think. See if it seems to fit, The fact that you indicate you think you are maybe a bit better after starting the meds may tell you something.

At the end of the day, I don't have great advice for you, sadly. I was in healthcare for many years and I traveled the world for what I did, but I unfortunately never made it to Moscow. So, I'm just not knowledgeable. One of my regrets. Anyway, I really think you should do whatever is necessary to see a competent person, preferably a psychiatrist, to nail down your diagnosis and treatment. If that is not possible in Moscow, I would even consider traveling if I were you. It would probably be worth it in the long run. Good luck!!