So sorry to hear you're struggling...I've been there too many times as well! My mood would be Ultra, Ultra Rapid cycling with Welbutrin at 450mg and not taking a AAP. For me, I love Latuda at 120mg, Lamictal at 600mg and Lexapro at 20mg. I find taking a benzo prn helps greatly in a mixed state. Topamax or as they call it, dopamax since people feel stupid on it, didn't do anything for me but made me dumb, tired, things taste weird and some hair loss. A lot of people love Seroquel for a mood stabilizer or Zyprexa. For me it's all about finding the right dose and then finding the right med cocktail and then altering it every now and again. Best of luck and hang in there!!!