It causes me to rev up and have uncomfortable surges of emotion (in my case, sui), so maybe some people react to it with increased emotional lability? In the past, I took it to boost AD's to get me out of the depression and also keep from going off the rails at the same time (which ADs do). This time around, I have a new pdoc and she had me starting it without an AD, but because it will take so long to get to my target of 200 mg, I'm starting lithium.

It's so different for everyone. A good pdoc can help adjust and find the right combo or approach without making things worse.