Viibryd has been a life saver for me. It has anti psychotic properties so its not supposed to be able to make you manic. Its expensive but the only anti depressant that did not throw me into a mania plus its weight neutral. My Dr was completely willing to double my dose with out stressing.

The only issue for me is that if I miss a dose I get this wave of pain that goes from the front of my head down my spine. I feel like I'm going to die and sounds like I'm under water for a couple of seconds. It leaves me with a head ache all day. For me the waves are in a set of 3 and it lasts less then a minute total. So I remember to take it daily.

I also have an antipsychotic prn for when I have symptoms like yours so I can avoid hospital stays. Do you have an anti psychotic prn?