Effexor XR 150 mg

To keep the crazies at bay, I take a 150 mg dose once a day of Effexor XR. That's the max I've ever taken and I'll do this for a year before weening myself off because if you just stop you will want to kill yourself. I mean that. I tried to stop taking it because my psychiatrist didn't want to stop prescribing it to me in the 150 mg dose and I went through some serious withdrawal, so if you ever go on this drug - ween when its time.
The last time I saw my pychiatrist was about four months ago. Every time I go it's the same routine. Chit chat about anything cool going on in my life... what I did this summer... what I'm going to do in the fall/winter.. It's 10 minutes of this. The doctor never asks me about my dosage or what I think about it or if I want to change dose or medication. We literally sit there for 10 minutes and after he's satisfied he's given me $40 worth of attention he refills my prescription and we make an appointment for four months later.
I see all of it as completely unnecessary but he won't call in my refill. I need to pay the $40. Whatever.