I have been on lamictal for years, never had effexor, lithium didn't work for me and about killed my son. Went from normal glucose range to 700 and something in less than 3 months. Nurse actually told him she has never spoken with someone with sugar that high. That range causes diabetic coma. He came off the lithium and his glucose became normal again. So I suggest if diabetes run in your family, talk to your pdoc about the risks, Lamictal rash is a thing and it can be serious. The med rollercoaster is a beast and where it stops no-one knows. The issue is, no one cocktail is standard. Be compliant and honest with your pdoc, this will help you find your cocktail more efficiently. Best of luck hun.