My mother 67, has been on antidepressants for 40 years. Last couple of months meds fluvoxamine 150 mg, zolpidem 10 mg for sleep, wasn't working, doc added 50 mg des venlaflaxine, too many side effects so discontinued.
Recently, new doc, 2 weeks ago changed to mirtazapine 15 mg at night and welbutrin XL 150 mg in morning. Fluvoxamine is now totally stopped and she is still taking zolpidem 5 mg, mirtazapine is not enough for sleep.
She is extremely restless specially in morning, complains about "head feels like a stone" weird dreams, extreme anxiety, and compulsively thinks she will not get better.
Lately started lorezapam 1 mg in morning to manage anxiety.
Last night she woke up at 3, no sleep, trembling legs, numbness in limbs along with restlessness.

She is 6000 miles away from me in third world country in a small city where finding a good doc is very hard.

My question is, is this combination not working, is it too much dose, or serious side effects, or it is normal and we should wait for 4 weeks?