this may not make any difference to you at all, but I just noticed on your other post that your signature also says fluoxetine. Were you ever on lithium without it or with something else? I'm asking because I started lithium before my bipolar dx to help with suicidal ideation. It was with citralopam. For some reason my horrible, horrible pdoc at the time decided to change me to fluoxetine and it was awful. I know now that I have both mania from it and akathesia. I was working in a place with a huge dementia unit that could always use some help and I would work all day, spend a couple of hours on the unit doing whatever, go to a store for a couple of hours because my apartment was too small and then be forced to go home where I was miserable. There was no way the lithium was going to work.

One night I was sitting at the computer and the thought "I'm bipolar and I need a pdoc who knows what they are doing" popped into my head. I did some reading and KNEW I had BP. It was so obvious. I somehow kept it together enough that night to get phone numbers online for a mood disorder clinic and a famous psych hospital. And I took myself off fluoxetine that night. I was feeling better within a few days. And I saw the mood disorder clinic's bipolar guru and was diagnosed a few weeks later with instruction for no SSRIs EVER, no ADs until seriously stabilized. It made a huge difference in how I responded to treatment.

So that might help? I'm sorry this is rambly, I just felt my meds kick in and I deleted a bunch of nonsense but this still maybe excessive. Stupid meds that make me stupid but not sleepyl....