I too am sorry your having such a time.
Here is an idea that might help you with the lethargy and it doesnt involve anymore meds and no prescription needed.
It was suggested to me years ago when I was having such a time with falling asleep in walking states on methadone that a good solid dose of B-12 would do the trick. I have not ever been a biggy on alternative meds since I was a medical prof. for 30 years but it was worth a try.
I went to a local drug store that carried a large variety of vits and mins and aked for help from the pharmacist and he directed me to a B-12 that was dissolvable sublingual. I took it in low dose as reccomended and titrated up until it working and I was no longer falling asleep with my hands in dishwater and waking up 15 minutes later not even realizing I had been asleep,anyone on methadone can atest to this is possible and probable. I still years later swear by my B-12 and have found to have far more energy I thought possible and rarely do I fall asleep on my feet. I do have regular every 3 month labs to make sure I am not getting too much B but so far even at this dose I have not had a problem. The Doc says our bodies are pretty good at getting rid of excess. It seemed highly unlikely to me this could help at first but after talking it over with my PM it made far more sense in the how it worked. Especially those of us with acid reflex or on some kind of digestive meds even tums can cause us not to store certain vits and mins as normal folks.
Hope you find some answers soon as well as relief.