I echo the others: Please find a new pdoc. Internal med and family practice doctors just don't have the knowledge base to manage a problem as complex as bipolar disorder. Mine sent me to a psychiatrist for that same reason, and even though I was pissed when he did it, I'm glad now that he did.

Smart docs realize when they're in over their heads. I'm not sure your primary care provider does, if he's willing to prescribe for your bipolar.

And believe me, a conservative pdoc can be your best friend. Self-medication is almost never a good idea for us BPers. Even as a registered nurse, I know my condition is too complicated for me to be running around treating myself, because like everyone else I lack insight when I'm in the middle of a mood episode.

My pdoc is quite conservative---we never change more than one thing at a time, and he researches everything very carefully before he prescribes for me. He listens to me and takes me seriously, both as a patient and as an RN; but his is the final word when it comes to my medications. (He wouldn't even let me increase my Celexa dose back in December when I was depressed....dammit, I like my hypomanias and he knows it, which is why he only lets me have 15 tablets at a time that I have to cut in half. The man is entirely TOO good at his job.)

You seriously need a pdoc who keeps your best interests in mind when s/he treats you, not a PCP who has no real idea of what they're doing or why. I wish you luck.