best meds

for the last 17 years i have been on anti depressants, under a doctors care.  i have tried numerous including prozac, wellbutrin, cymbalta, savella, zoloft. for the last 6 months i have been on savella 75 mg daily, wellbutrin 150 mg daily, and lyrica 150 mg daily.
i take the supplement flax seed oil, omega 3 combination, take a daily mutil vitamin, and ambien at night.  recently i have been so overwhelmed and aggitated.
i have had chronic pain for the past ten years. ( i had a choledochal cyst removed and a rou and y, and two cysts in/on my liver). now i have massive adhesions that cause tremendous pain. the mayo clinic advised me against any more removal of adhesions unless an absolute must. i take hydrocodone for pain when needed.  if that doesn't control my pain i end up in the er.
my question is two-fold.  i know i need an anti depressant, what i don't know...does the savella aggitate my feelings of overwhelmness and sleep problems.  if so any suggestions for an anti depressant.  my general practioner feels both the serotoin and the other anti depressant benefit me best.  
second: my pain plays a huge role in my depression.  it is constant. (obvioulsy it is bearable at times).  i injured my sciatic nerve 2 years ago as well, and my hips go numb when i lay on one side to long.  i research constantly trying to find the best solution.  i have concerns about the side effects of the pain meds as well as the anti depressants and lyrica.  
what suggestions do you have?  i would consult with the gp before changing any meds.
thank you

[Roger Gould, M.D.]

you have a difficult set of problemsto deal with and as you know by now there is no right magical answer but only a trial and error experience-based decision.  There are so many anti-since on the market and so many diverse claims that it's almost impossible to give you a recommendation.  If I were you I would go back to some medication that has worked for you in the past.  Your be very cautious about pain medication and that is appropriate.  Any of the antidepressants you are taken can become stimulants.  The best medicine for you is that little medicine as possible so you can keep a clear head.  thats the direction I would go

[boogieman]

Hello. The effectiveness and potential side effects can vary from person to person. I've also been on many different antidepressants since 91 and I'm still trying to find the right combination. As far as the hydro, there is of course a risk of dependence, but also liver toxicity from acetominophen which is a common ingredient in pain meds such as vicodin. Hope this helps and take care, GM