Tried several SSRI/SNRIs with little positive outcome. Questions about venlafaxine and ritalin, or just ideas?

Diagnosed with ASD, ADHD (which a psychiatrist later said was uncertain), GAD, social anxiety, MDD, and some psychs have suggested BPD or AvPD.

Been unhappy my whole life basically but the last year it has gone worse. A new symptom the last year is anhedonia especially anticipatory anhedonia. Currently I’d say that anhedonia and GAD are my main problems.

I’ve been on 4 SSRIs, duloxetine, and some other ineffective ADs, in addition to trials with ADHD meds. After a long break from SSRIs, my GP started me on 37.5 mg venlafaxine 4 weeks ago. It’s not going well. I’m very sensitive to many psych meds. On venlafaxine, I have a constant jittery and uneasy (“electrical” ish) feeling in my body, my thoughts are more scattered (which was already a problem), I wake up with my heart racing in the morning, and difficulty with orgasm. I know four weeks is early. But I was already hesitant to try yet another SSRI/SNRI after many failed trials, and I think there’s a considerable nocebo effect at play. I hate myself for accepting another med in more or less the same class, and I’m demoralized.

The only thing that can ease my anxiety is 5mg ritalin (and benzos but can’t get them). The effect varies a lot however. Sometimes it can change my whole outlook on my life, so that everything seems uncomplicated and straightforward. Sometimes it doesn’t work that well, but it always quits my mind to some degree. But I doubt my GP will refill the script given my ADHD diagnosis has been cast into doubt by one psych.

Has anyone had the same jittery experience with venlafaxine? Or the same effect of ritalin?

I’m ready to give up the venlafaxine. I just can’t do another six months with dose adjustments only to give up which is what happened with the other SSRI/SNRIs (except escitalopram many years ago but it pooped out eventually).

I’m considering asking for pregabalin, I’m at a point where I at least need to get rid of my anxiety quickly. Would ideally like an MAOI given my positive response to ritalin (and the inferred positive effect of dopamine) but I’m pretty sure I’d never get it.

I feel very hopeless and demoralized. Any input is appreciated although this may be more of a vent.