Issues w/ Strattera, EffexorXR, Provigil | ADHD Information

I have been on these 3 medications for about 2 years now but I frequently experience problems with this combo. My shrink is the one who prescribed them abotu 2 years ago or so. Due to my insurance not being accepted at a public mental health clinic I can't see him any more so I get my scripts writen by my primary physician. My primary physician's name is Dr. Vinny and he is really understanding of my problems but he is not an expert on emotional, mental or learning disorders.  Dr. Vinny did tell my boyfriend that he has no idea why my shrink put me on this combo of meds or where the shrink got the idea to combine those meds because both Strattera and Effexor XR do treat a person in very similar ways. Vinny doesn't like shrinks very much because they do not really care about the people they treat but he does. (GO VINNY! YOU ROCK!)

When I was about age 14 I was diagnosed with Dysthymia (excuse the spellling) which is a type of depression. About 2 years ago my boyfriend noticed that my behavior was extremly similar to his 10 year old nephew who was diagnosed with ADHD and BiPolar. Well I requested that my shrink set me up for learning disability testing and I did go through it. I avoided taking any kind of medication on the days that I was to be tested and it was rough. After the testing was done the NeuroPsychologist who administered the testing said that he believed I did not appear to have ADHD or any kind of learning disability. Well I have to disagree and so do many of my family memebers. My shrink's solution was to put me on my 3 current medications and have me go to bi-weekly counseling/therapy. Well due to my insurance problems once again I lost my good counselor.

Let me get to the point. Curently I am on 40 MG of Strattera 2X Daily, 200 MG of Provigil 1X Daily, 75MG of Effexor XR 2X Daily. I am almost always tired even with the Provigil, (which is used to treat Narcolepsy) have frequent and often heavy mood swings, light to moderate twitching or spasming of my arms or head, moderate to heavy depressed feelings, about 1/2 or 1/4 of the concentration I had when I first started taking Strattera, 30-40% Dyslexic tendencies, 25%-50% ability to remember important things or even casual converstations  (but you can ask me what happened on yesterday's eppisode of Transformers and I probably can tell you but would have no clue what you said we were having for dinner tonight)

One things that I have found to help just a little is when I get over frustrated and emotional I will just let myself cry becasue when I am done I feel more energized and more focused. My boyfriend says that has to do wit hthe levels of Adrenaline in my body.

I don't know who to trust or what to do. I dont want to continue living a life where I am always feeling tired or like I need to be in a rubber room. I have to find a way to control my emotions or find some kind of medication to help me to be less depressed, more calm, more focused and more adult like. I look back into my past and I see nothing but hints of ADHD and or Depression. One downside to my current meds is that most of them are supposed to be extended release-like but they don't last long and when they wear off I have a serouos rambling problem.

I really could use suggestions and would like to hear from others who have been on both Strattera and Effexor XR together. I want to ask Dr. Vinny about changing my meds but I know he is not a specialist in this area so I am a little more reluctant to ask him for help.