@Exoskeleton. I'm sorry you're going through this. It's such a tough spot to be in...It sounds like we're in a similar boat-although, I just started lithium this week so don't know how it's going to go yet. My pdoc essentially went back to the drawing board and prescribed me this because, even though my last pdoc did, he wants to see if it could help now. @Sophia23 mentioned combining it with lamictal-lamictal is one of the meds I'm on and, despite the constant med change routine I continue to be on, lamictal was still a game changer. And, it is one of the rare meds I've managed to get to the needed dose without any side effects. I hope you can find the relief you are looking for soon!