It's widely used in Italy. The price should come down eventually. There's no good reason to combine SJW and Prozac. Regarding Kava, many people combine it with antidepressants to add an anti-anxiety effect. There have not been any problems reported from such combinations, but we don't know for sure that it's safe to combine them.
Acupuncture is often quite effective.
You might try adjusting the dosage of the pills. There are other possibilities too, but it's complicated. It can manifest in many different ways. Sleepiness can be part of it, although sleepiness can also be caused by many other things. For reasons that no one understands, DHEA sometimes seems to help lupus quite a bit.