Would wellbutrin and vyvanse be a good combo for narcolepsy and severe apathy w depression? pristiq (desvenlafaxine) worked but no longer

Perhaps: Have you considered modafanil or xyrem [sodium oxybate]? Stimulants like vyvanse work, and perhaps stimulating drugs like wellbutrin (bupropion) . These drugs are widely considered treatment of choice for narcolepsy. A neurology consult is in order.

Cataplexy?: I think it also depends on if you have cataplexy. Remember too that if depression is not controlled, there will be no stimulant or combination of stimulants that is likely to work. Depression trumps. So i would tend to use any antidepressant that is likely to treat your depression + non medicine treatment of depression (therapy, biofeedback, etc).