This is a board for information. No one can tell you what to do Mel.

But being aware and prepared is always a good thing.

We discussed this on another thread...that Alan does not communicate
physical feelings easily. You agreed with this. This is a style for him.

Patients like this are difficult for doctors. Someone else might go in there and
gripe...I have diarrhea... I feel antsy...I can't sleep...etc etc.

Alan has you to massage him, give him the best diet, and advocate for him.
That is pretty rare these days!

How to ask the questions you are posing? Well ask if the doctors think 200mg of Zoloft are necessary? That is approximately what he is getting now with this combined therapy (it may be higher in an additive sense).
Also realize that people are at the mercy of post-marketing situations, where drugs are combined. Many reactions may go unreported..and do.
And realize that a psychiatrist is not monitioring Alan. A psychiatrist usually has more experience with combining drugs of the same class.

Doctors don't realize that Cymbalta is nothing but Effexor...a me-too drug.
The only difference is that it was cleverly posited to the neuro community for pain control. And you may see with some time, maybe a couple of months, Alan reaches a ceiling in benefit, and is back to where he started ... that is common too. ( and if this happens, he cannot cold turkey off it...must taper)
What can you do? Well, you watch him carefully. And you watch those doctors too!