Hmmmm, this all has me worried! I was on Paxil for 13 years. Then, 7 years ago I went on 200mg Lamictal and 60mg Cymbalta. I was still having bad anxiety and depression and they put me on 400mg Lamictal along with the Cymbalta. This last February, my Cymbalta was upped to 120mg and I had a manic episode (didn't know that was what had been happening for about 10 years). She wants me stay to stay on my Lamictal dose and added the Lithium 900mg 3 weeks ago. She said that is the best combo for bipolar. Btw, I've been weaning off Cymbalta. So, is Lithium usually for Bipolar with psychosis? Should I not be taking both? Now, I'm anxious!