Hey bipolarchickk-I wouldn't even consider ECT! I had 9 treatments back in 2006 and my short-term memory sucks and my cognitive and analytical skills are way worse! For me it's all about the DOSAGE! I'd ask my doc about discontinuing Topamax, lowering Welbutrin to 150mg, bumping up Lamictal to 400-600mg and try Latuda again, but at 120-160mg with at 400 calories, maybe adding Cymbalta 30mg and adding a benzo. Best of luck and sorry to hear!!!