I started out at 50 mg. There was a little difference but I started having symptoms again so my dosage was moved up to 100 mg. I just saw my P-doc and it was moved up to 150 mg. I found out that after a little while, the effectiveness started to wear off. I also got another mood stablizer added on top of the Lamtical. I am hoping that this will do the trick. I think the P-doc took me seriously when I went into my appointment in full blown mania. Agressive, angry, and talking a mile a minute. Something had to be done. I do wonder if it does get any better. I am so tired of being preoccupied with this thing. I am currently getting ready for the CPA exam and my concentration needs to be there and not with the ups and downs.