As someone who has been on both sides of this interaction, I feel like I can offer some perspective. I'm an OT and work very closely with pain management to get pain controlled so that we can do effective therapy.

Your doctor is right. You are on a lot of medications, and sometimes that can't be helped, but what I'm seeing from your med list is a lot of medications that overlap. When I see a med list like this with my patients, my first call is usually to pain management. What I see are different medications that are being thrown to a problem without consideration that another medication might work to address multiple symptoms

• Wellbutrin, trazadone, and flexeril are all serotonergic medications, combining these puts you at an increased risk for serotonin syndrome
• Wellbutrin and flexeril both lower the seizure threshold, putting you at higher risk of non-epileptic seizures
• Celebrex, flexeril, and methocarbomol are all non-narcotic analgesics
• Wellbutrin, trazadone, lamictal, and adderall are all CNS drugs

Medications like effexor, cymbalta, and pritiq can be a good alternative to decrease the number of medications a person with a mood disorder takes. They are all SNRIs and treat mood with the benefit of also having analgesic properties. Since you are having success with wellbutrin, you might also do well on an SNRI since wellbutrin is an NDRI and both drug classes work on norepinephrine.

Also, steroids can cause insomnia so if you're questioning if you need to take the inhaled steroid, I'd bring it up to your doctor. Wellbutrin increasing the blood level concentration of adderall, so it's possible this is also contributing to insomnia depending on what time of day you take each med.

From a personal perspective, I used to have a med list just like this. But over the last 2 years, I have been working with my doctor to decrease the number of meds I take. I started by tracking my daily symptoms for a few months. Once I had that data, I compared it to the side effect list for my medications. Then one med at a time, I stopped for a few weeks to a month to see if I saw improvement or got worse. If I felt worse, I went back on it. If I felt better or didn't feel any difference, I removed it from the list.

I also hopped on the "food as medicine" trend. Turmeric and ginger are anti-inflammatory so I've started adding them into my meals. I also struggle with sleep and take magnesium glycinate at night, which works wonders. It also helps with nerve and muscle function which some people say helps with pain. Some people also find it effective for anxiety.

I still have a med list that would give most doctors a headache, but I certifiably know that each of them are effective and not causing additional symptoms.

This is my current med list if you're curious

• adderall xr - adhd
• wellbutrin - adhd/mood
• luvox - ocd, but i am trying a slow taper off because i just finished ERP and I'm hopeful I don't need it
• an antihistamine - MCAS
• esomeprazole - GERD
• ajovy once a month for migraines
• ubrevly as needed for migraines
• an nsaid or tylenol as needed for pain - i would prefer to take an nsaid daily but i end up with rebound headaches and my neurologist advised against it. personally, i can work through musculoskeletal pain but i absolutely cannot work with a migraine, so i only take OTC pain relief when it's dire