I'm on trileptal, effexor (originally pristiq until costs increased), wellbutrin, and abilify as far as psych meds are concerned. The effexor helped the depression originally and I was fine with just trileptal and effexor for years. But the effexor killed my libido and it became obvious at a certain point in time, so a previous pdoc added wellbutrin to compensate. But as life got rocky, both meds have since been increased at different times and for different reasons. From my experience, if you've been on something long enough, in this case the effexor they don't want to take you off of it, they just add to the cocktail, hence the addition of the abilify.