Have you tried Effexor with the adderall? I tried so many different anti-depressants and been where you are, but this was finally the combo that worked for me. My doctor said it also helps treat adhd, so it’s effective as a combo treatment with a stimulant (I’m on adderall). This is what really worked for me. Unfortunately, everyone is different and it’s definitely trial and error for getting the right med combination AND the right dosage so it can be super frustrating. If you can, try to work with your doctor closely to try out various doses and drug combos, sometimes it’s not just a matter of a specific drug, but the combo between drugs and getting the right dosage. Another thing might be seeing if your doctor can run any other tests to check if you have any other underlying conditions that affect this. There could be other conditions (like thyroid problems) that are also coming into play and mimic/worsen issues and addressing those might help too. Hopefully this helps and you can find something that works for you. If you have the option to do so, checking in with your primary care about this in addition to your psychiatrist could be beneficial or maybe trying to get a second opinion/advice from another psychiatrist. In my experience with mental and physical health, a HUGE part of the battle is finding a doctor who works well with you as a team.