I am also on Lamotrigine 250 mg's. I take it all at night and take 137-175 mg of Effexor in the am. My T and I have been changing my dosages and times for about a year now, and I think we've hit on pretty much the right combo. This has helped my rapid cycling a lot. Adding propranolol (I might have murdered the spelling of that) for anxiety seems to be doing well too.

If constipation was a reason to drop down in dosage, I had the same issue, but taking a capsule of Flax Seed Oil in the morning cured that. You can buy a big container of it (maybe 2+ months supply) in the RX or a big box store for about $6. It supposedly has other health benefits too, but I can't remember what they are right now.