I have been on several SSRI / SNRIs for a while now with varying degrees of success. I have always been unable to explain the agitation, anger and the cycling from being down in absolute dumps to top of the world on a daily basis. I agree with the Bipolar 2 diagnosis as it makes so much sense now.

So the P doc took me off Cymbalta as it was no longer working after 2 years and was making me very very drowsy at work and keeping me up at night. I am on Pristiq 50 mg for 2 weeks now and while I can see I am no longer tired or drowsy at work and I do sleep better at night, I still cycle enough every day to make me angry and agitated for no reason whatsoever.

I wake up very sad and depressed and once I take my Pristiq I feel a lot better in an hour or two. By the time I get to work I am severely agitated and slightly Hypomanic. The mania helps my Alpha profile at work as I get more done everyday in a high performing job than I am actually capable of in my depressed state. I can't afford to slack at work as the company and my skill set are very competitive. So no drowsy drugs for me.

I went back to the P doc today and she gave me two options to add to my Pristiq prescription - Abilify 5 mg once a day or Geodon 40mg once at bedtime. Either drug I choose is supposed to have a "Mood Stabilizing" effect I am told. However, when I read up on the internet; Abilify looks like it will energize me more and I will get more done at work. On the contrary, Geodon seems to help you sleep better and since I can't take it twice a day due to drowsiness concerns already informed by my P doc, wouldn't it leave my body by the time I wake up and then I would cycle again?

Latuda is not yet available in my country though she said it should be here soon and is a better drug for me. Lamictal/Tegretol have been ruled out due to some Steve Johnson syndrome that would be hard to detect due to my widespread Psoriasis.

Anybody here on a SSRI / SNRI + either Geodon or Abilify please let me know what to expect.