Trying to find answers to same thing. Have been on numerous meds for bi-polar depression. They either don't work or have had reactions (cymbalta, wellbutrin, viibryd, etc.). Fetzima with 300 mg lamictal has been helping with depression, but hasn't done anything for irritability. Doc says it's just my personality??? Therapists have been useless. No better docs around here either. Also been on adderrall for years to help with chronic fatigue.