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If you don't mind posting more details about the medical issues of your wife...

I am not in the medical field at all.

But one thing is certain, if you want to take the guesswork out of figuring out what medication your wife needs to be on, you need your medical doctor and your psychatric doctor on the same page.

I can tell you that I feel pretty certain coming from someone that deals directly with bouts on ongoing mania that medical health trumps psychiatric health.

What your wife feeds her body has more an impact than any certain medication can have. The choice of fuel that stokes the fire matters more than the octane in which it is transposed.

More or less all psych meds are uppers or downers. But what you fuel your body with determines which direction the original application is going.

GL and let me know if you have any questions. I'm not an MD but I can certainly give you thoughtful guidance and possible techniques that may alter how your wife feels daily.