What Causes Constant Tiredness While On Pristiq And Wellbutrin?

I am a 59 yr old female. I am so tired I can t get out of bed which has gone on for over 10 plus yrs. Medications Pristiq SR, Wellbutrin XL, Levothyroxine Sodium, Metoprolol Succinate ER, Clonazepam 0.5 mg tid, Carbidopa-Levodopa for RLS, Simvastatin, Seroquel XR @ hs. My thyroid and cortisol levels are within normal limits. I take Deplin as I have 2 defective genes. 5000 micrograms Methylcobalamin. I have tried natural supplements from a Naturalpathic Dr. and had a reaction, a 170 heart beat and ended up in the ER. I have tried IV therapy of vitamins to no avail. I m looking for an out of the box suggestion. Metal from some of my old fillings in my teeth. Other genetic disorders. My estrogen, testosterone are very low. My endocrinologist feels replacement therapy could cause a blood clot due to the fact I smoke a pack every 4 days. No alcohol consumption for 22 years. Can you please make a suggestion of the type of physician I should seek out. I have had to go on social security disability. Thank you. Cynthia