I was off ADs for a long time because they triggered manias. Depakote got me stable enough that I was able to try ADs again. I was on imipramine with it for a long time with a dose I could adjust as much mood dictated. Then I got on Seroquel and eventually off of Depakote and with a moderate dose of Seroquel XR was able to start Emsam, an MAOI which I've done really well with. I do have to lower the dose when manic but it's nothing like ADs before it and doesn't seem to de-stabilize me. It just doesn't help if I start to slide.