Brief Answer: Hi Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 51 year old male • Known case of Depression • History of poor response/tolerance to venlafaxine, adderal, bupropion and buspar. • Complaints of: feeling overwhelmed, weak and anxiety. Buspar is not suitable for you because of tinnitus. In your history you have been on some good medicines already, with good response history. But same time you faced some problem and side effect like: - Venlafaxine made me happy but useless and only sleepy - Adderall made me tense but helped - Buproprion was great but too tense It is very important to review treatment history in chronic cases of depression. Every medicines have its own side effects, but side effects like tension, excessive sleepiness, acidity and headache usually subside with careful drug dose titration, monitoring and with time (usually 3-4 weeks). It is also better to start medicine on which you have responded well, rather than trying new one. It will be good if you describe doses of venlafaxine/bupropion, duration of use, nature and duration of side effects, so that I can help you better. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards,

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