I have been prescribed everything from Valium in the 70's, tricyclics in the 80's, SSRI's SNRI's in the 90's and have been taking venlafaxine for the last 10 years or so. Most worked for a few years and then became ineffective over time. My psychiatrist tried to prescribe me lithium when my children were little, when I first met him. I have never seen him since I always am seen by a young Dr on his team who then goes away and consults him(!) he now suggests adding Aripiprazole 5mg to the Venafaxine but refuses to prescribe bupropion. I think he's just playing it safe and doesn't care at all. Why he'd away and just speak through members of his team. I suspect he thinks he's far too important to bother with actual patients. I've now said that he can't help me and so he should write me off, I can't carry on anymore.