I personally had Lamictal cause elevated mood and lead to mania, which is not that unusual. I would think that Lamictal AND an antidepressant, without an antipsychotic, is really the very worst thing that one can do to your medication regimen given your past episodes. I hope you receive a prescription for an antipsychotic PRN as soon as possible, so that you are prepared. In that light, I second tecomsin's mention of Zyprexa. You do not need to be on it for maintenance - the drug gives awful metabolic side effects - but it is a lifesaver as a PRN medication. I would not leave the pdoc's office without a PRN prescription for it next time you go. This, especially given that you are blessed with the benefit of insight at the beginning of such states, so you really will be equipped with the tool to quash incipient mania while you still possess insight and a critical eye.