Lamictal xr

Hey everyone,
Wondering if anyone else has experience taking Seroquel or Vraylar in conjunction with ketamine assisted psychotherapy (KAP).
Been on 200mg Lamictal Xr for a few years and I’m noticing its effectiveness is wearing off. Tried going up on my dose but it makes my forgetfulness too severe (I am so tired of not being able to recall words!)
I am looking into switching to either Vraylar or Seroquel, but want to know how they will interact with KAP.
I take ketamine 2x weekly to help with depression, nerve pain, and the “trip” part of the experience really helps me work through the trauma that fuels my CPTSD. My concern is that Vraylar or Seroquel will severely mute those effects. Lamictal already dampens the effect of pretty much every other drug/substance (I can’t tell if I’m drunk or not when drinking, ibuprofen and gabapentin stopped working, so on and so forth). So, any experiences I can draw upon?

I have a strange issue where I go through these periods of waking up too early - like 6-7 hours after bed and it kills me because I KNOW I need sleep.
Unquestionable N2 diagnosis in 2016, dealt with a loooot of imposter syndrome and have been medicated consistently since 2021.
Basically I wake up early, crave more sleep and lie there in that weird REM/awake zone, but everytime I start to drift off my arms and legs get so uncomfortably tingly and spasm. I know this is a rem/sleep paralysis kind of thing, and doesn't feel like RLS because it doesn't last. My body just jerks awake every time I start falling back asleep and it's TORTURE. plus I get all these very confusing lucid dreams just in my room and it's allllll messed up haha.
I take Armodafinil and Adderall XR 20mg (I take that one in the afternoon and don't have trouble falling asleep bc I sleep around 1am). I'm also on Lexapro and Lamictal for BP and just stopped Wakix and Sunosi a few days ago, but this has been an issue my whole life.
Lexapro 20mg morning, Armodafinil 150 morning, Lamictal 150 morning and 100 around 2pm (it's activating for me), Adderall around 12-1
Thankfully I know to take long naps to make up for it, but it's really inconvenient and feels awful. I wake up not only feeling like a groggy human piece of garbage (lol) but I know it exacerbates everything else and makes work really difficult.
I feel like I'm an outlier here. Anyone else struggle with this?
Side bar: I'm generally very good and lifestyle treatment. I eat low carb, intermittent fasting bc it works great for me, no food 3-4 hrs before bed, strict sleep hygiene with extreme, goody blue light glasses everyone makes fun of me for and no screen time, I do meditation and yoga and exercise and all the things. So it's not anxiety or anything like that. Pls don't tell me to cut carbs haha I already do.

What combos of Wellbutrin (Bupropion) + SSRIs/SNRIs have people had success with for treating depression?
I plan on replacing Prozac once I adjust to Wellbutrin and would like to be prepared with some framework for my next session with my psychiatrist. Like a shortlist of 3-4 meds that may be good alternatives to Prozac to combine with Wellbutrin.
For context, Prozac makes me feel completely apathetic and dull.
*Edited to create a running list of responses:

• Lexapro (Escitalopram)
• Trintillex/Brintillex (Vortioxetine)
• Paxil XR (Paroxetine)
• Zoloft (Sertraline)
• Celexa (Citalopram)
• Luvox (Fluvoxamine)
• Cymbalta (Duloxetine)
• Pristiq (Desvenlafaxine)
• Viibrid (Vilazodone)
• Remeron, Remeronsoltab (Mirtazapine)
• Effexor (Venlafaxine)
• Lamictal (Lamotrigine)

TL;DR I've tried alot of meds already and nothing helped. Looking for advice or recommendations.
I'm on effexor 75mg xr in the morning. Clonidine 3x a day (it does nothing, more of a placebo) and was on mirtazipine 15mg but had to quit because it was making me wig out in my sleep. Like jerking my head side to side. And setting up in my sleep and starring forward. It also give me real bad RLS
So I've tried mirtazapine, Hydroxyzine, olanzapine, risperdone, sertraline, propranolol and a few others i dont remember right off.
My sister give ne a couple trazodone so Im going to try one tonight and see how that does me. I go to the psych Tuesday. I been thinking about asking her for wellbutrin to go with my effexor and see how she feels about nurotin/gabapentin 3x a day. She is against all controls though so probably label me as drug seeking. So anyone have any ideas as what else i could try? I been looking at lamictal, abilify, and a few others but would like some personal experiences with meds that didn't cause alot of side effects.

I'm a 45m. Neuro thinks I have a combination of absence seizure and focal impaired awareness epilepsy where I stare without responding for a minute or two, then there is about 15 minutes of limited responses, if I do respond to questions its often one or two words. I've had several EEG scans that show no issues, CT scans to determine if its a stroke show no issue, cardio says my heart is doing great, nothing else shows any issues. I do have a TBI from 28 years ago from a car accident and have had no issues other than migraines from time to time. That was until april 2022.
Below is my log of episodes and sleepwalking as I've kept detailed notes trying to find commonalities between the events.
2022 2022 apr x1 episode 2022 may x3 episodes 2022 sep sleepwalk 2022 oct x2 episodes 2022 dec x2 episodes
2023 2023 jan x1 episode 2023 mar x2 episode crashed my car during an episode 2023 apr x1 episode start keppra 2023 may x1 episode 2023 sep x1 episode 2023 oct x1 episode (no episodes since) change from keppra to lamictal 2023 oct x2 sleepwalk 2023 nov x2 sleepwalk
2024 2024 jan x1 sleepwalk 2024 feb x3 sleepwalk 2024 mar x2 sleepwalk 2024 apr x2 sleepwalk 2024 may x1 sleepwalk change from lamictal to lamictal xr about to start zonegran
Neuro says I can legally drive since it's been over 6 months since my last episode and she does not consider sleepwalking the same as having an epilepsy episode. She says she'd be comfortable riding in the car with me.
I've been asking people if they would feel safe riding in the car with me and it's about 70/30 in favor of riding in the car. Some make jokes like, I'll ride in the car with you but I won't be on my phone that's for sure.
I work 4 miles from my house. I'm considering buying a small car such as a manual transmission miata just to go from work and home, perhaps to the grocery store and home, or to a doctors appointment and home. My thinking is, if sometimes does happen, a smaller car would cause the least amount of damage to someone else driving. You could say if that is a concern then I shouldn't be driving which is a fair statement to make.
I had one friend say I would ride in the car with you if you feel comfortable driving. The problem is, I don't remember any of the episodes. I only know about them because other people told me about them or I saw them on video. To me, I have no fear of driving, no knowledge of the events, but I also don't want to hurt anyone else else on the road nor myself.
My doctor says I can legally drive. I think I feel comfortable driving.
The question is, should I be driving?

(Question is in bold because I gave a lot of context.)
So I started propranolol/beta blockers(10mg that I take 3x a day, he originally said to start with 2 but to go up if I feel I need it. I'm prescribed the 3x daily already, though- and on the first day when I tried two, I felt my heart rate spike again after the second dose hit its' half life, so I moved to 3.)
Just started these on Wednesday, after seeing a cardiologist & being diagnosed with "Disorder of the Autonomic Nervous System- Unspecified". (I will hopefully be getting a TTT soon to narrow it down, but one of the receptionists said that I had to wait to be called about that one... I suspect it's HyperPOTS, personally. But rn it's just ~unspecified~ dysautonomia.)
I also have ADHD, and have been taking stims(ritalin) for that for over a year now, that is also 10mg that I take 3x a day.
((The stim does not significantly affect my heart rate, though. I've struggled with the high heart rate & blood pressure since I was 7 or 8 years old, 15-16 years ago, I just kept getting dismissed because of things like "You're young, you're just out of shape. Exercise." or "Do breathing exercises." or any other invalidating excuses they could find not to treat me, that were near impossible DUE to the condition I had remaining untreated.))
So; I've been staggering when I take them, because I feel like taking both at once might impair how they work? I've been taking my ritalin first, and then an hour later I'll take the propranolol.
My questions are -- Do I need to be doing this at all? Should I do it in the other order? Should I be putting more/less time in between them?
I'm nervous to call, because not only is my cardio out of the office for a couple weeks- But also last time I had a question, the receptionist was really rude & tried hanging up on me. (The next receptionist was kind and when I mentioned this experience, she apologized and said she thinks she knows who it was- But now I'm still nervous that I'm gonna get that rude lady again... I did have someone suggest to call the pharmacist and ask, I might end up doing that.)
These aren't the only meds I'm taking- I also take Buspirone 15mg 3x Daily, Lamictal Xr 50mg 1x Daily, and Mirtazapine 22mg (1.5 15mg Pills) 1x Daily. Along with a few supplements, Vitamin B Complex, Vitamin D, and Calcium.
I also have a genetic resistance to SSRIs. I tried several in my teen & young adult(younger adult? I still count as a young adult I guess. I'm 23 now.) years. I know those are first option for mental health & also an option for dysautonomia- But they are not an option for me at all due to genetics.
I know the buspar & mirtazapine are also supposed to lower heart rate, and ritalin spikes it in some people- But I'd guess that I'd probably be doing pretty bad by now if they were interacting in a bad way?
But I'm not doing bad at all- This is the closest to normal my heart rate has been (highest it got going up stairs yesterday was 120! Usually it's 150-160. I also didn't get an adrenaline dump when I responded to an online comment, which is a first for me), and this is the ABSOLUTE BEST that my mental health has EVER been!
I just want to make sure I'm getting the full positive affect I possibly can from my medications, and that I'm doing my best to avoid any potential complications.

I never know how much info to give, so I’ll try to be quick with my background. So far I’ve been on lamictal, lacosamide, zonisamide, Keppra, and Keppra extended release. Keppra gives me horrible side effects, the Keppra XR maybe gives me less side effects although now I’m not so sure? Every medication I’ve been on has been dual therapy with Keppra, but once my neurologist tries to get me down to just one medication, I start to have seizures again.
I’ve been on Keppra and zonisamide for 6 months. We’re about to try monotherapy with zonisamide to see how it goes, I’m scared. I don’t want to have seizures, but I also need to see if this works. I’m on a low dose of Keppra anyway, so if all along it’s just 500 mg of Keppra XR that keeps my seizures at bay I’m just going to feel like I’m back at square one again.
Monotherapy is the goal for me primarily for the purpose of pregnancy. I had a miscarriage and it can’t be determined if it’s related but it’s still advised that we should try to get me down to one medication. Ugh, hate this disease so much.

I’ve been on medication combinations for bipolar 2, mood stabilizers/antipsychotics such as Abilify, seroquel, and lamictal— and antidepressants, such as Wellbutrin (made me manic & more irritable), Zoloft, and prozac.
I took abilify for about a year or two and I had a crazy amount of weight gain (40 lbs in a year & a half) which is very unlike me. My weight has always fluctuated but only by 10 lbs max. Also, i noticed that I felt foggy brained on Abilify and could no longer social as well even with my close friends. I felt like my brain was empty. No thoughts.
I stopped taking seroquel because it would make me fall asleep sooo fast and i think it may have made me feel drowsy in the morning, i can’t fully remember since it was over 2 years ago.
I took Lamictal originally three years ago (in a combination of other meds i can’t remember) and i stopped because i thought i may have had the allergic reaction rash. After I gave up on the abilify due to weight gain I started taking Lamictal again in hopes that it was possibly eczema and my psych put me on 25MG to see if that had any adverse reactions. I’ve been doing that for nearly a year, with a combination of Adderall & gabapentin.
Last week my new provider upped me to 100MG Lamictal and added 10MG lexapro. I’m still on 100mg gabapentin 3x a day for anxiety and 20mg xr adderall for ADHD. I haven’t had any hypomania since being consistent with Lamictal although I’ve had a crazy increase of anxiety with the last two years and chronic depression after drinking alcohol. Anxiety may be related to the fact i was a habitual weed smoker and stopped in those last two years.
Essentially, does anyone have any recommendations of medication(s) that work well in substitute of Lamictal? The weight gain from Abilify really affected my self image and I’ve been able to lose 25 of the 40lbs gain so I’d like to stray away from medication that causes weight gain & brings down my usually lively personality.
Thanks!

I think I need a medication change because lately I have been experiencing depression symptoms and anxiety. I’m Type 1 Bipolar and also have GAD and ADHD. I take the following currently:
300mg Lamictal 25mg XR Adderall 10mg IR Adderall Ativan as needed for anxiety
I used to take Trazadone but chose to stop taking it.
A few thoughts: I’ve been taking Adderall for about 6 years, has anyone found that a different stimulant like vyvanse helps them more opposed to Adderall?
What additional medication would you recommend adding for slight depression and anxiety?

Hi. I just started 100mg yesterday morning after being on 75mg for 3 weeks. I have ASD and I am more sensitive to meds. I also have Bipolar disorder 2 hence why I’m on Lamictal XR. I’ve noticed each time I’ve increased, I’ve had this hypo manic phase where I sleep 6 hours when I usually get 9/10 hours, I become hyper sexual, decreased appetite, maybe some anxiety and lack of ability to focus on top of my ADHD. I take Prazosin to help me sleep for ptsd & nightmares. I just had the dose increased from 2 to 5mg as well and it’s upsetting me that it is ineffective while in hypo manic episodes. The whole 3 weeks I was on 75 I had to take melatonin 5mg on top of my Prazosin, and I don’t want to become dependent. Anyways I just want to know, anyone else get hypomanic and then it dies down after a while from increasing lamictal

Hi! Diagnosed with Bipolar and ADHD, currently take 200 mg lamictal, 5 mg abilify, 30 mg adderall xr with a 5 mg afternoon booster, and recently added propranolol for physiological symptoms of anxiety… I’ve talked with my psych and therapist about actually just having ADHD (was diagnosed as a child) but the meds work for the most part (still have habits to break) so we don’t think I should change anything for now. We’ve also discussed DBT if I do come off of any bipolar meds due to low tolerance of distress….. just curious if anyone else can relate or has similar experience, or maybe take the same med combo?

I’m taking 200 mg lamictal, 5 mg abilify, 30 mg Adderall Xr with a 5mg booster in the afternoon and just recently added propranolol for physiological anxiety symptoms as needed…. Just curious. Everything seems mostly fine though I have definitely built up a tolerance for stimulants (been on a few different ones with a lot of different dosages) which is noticeable sometimes. My diagnosis’ are Bipolar and ADHD. I’ve had conversations with my therapist and psych about the possibility of me experiencing bipolar symptoms as a result of ADHD but we’ve decided if the combination is working there’s no need to change it at this time. We’ve also talked about DBT if I were to come off of anything due to a low tolerance of distress. lol I hate saying that. Anyway. I’ve been on this cocktail for 10 years. Just curious if anyone’s had a similar experience, med journey, or whatever?

I'm about to start medication for the first time ever and the psychiatrist has recommended me to start with Carbamazepine (Tegretol) + Quetiapine (Seroquel XR). I'm a type 2 Bipolar with rapid cycling and I experience depression 80% more often than hypomania and in a way more severe form. After reading online, it seems like Tegretol is usually recommended to treat mania and have seen people say that this medication makes them more depressed.
I would have expected to be recommended Lamotrigine (Lamictal) instead since it seems to target depression more heavily? I'm a bit scared to start medication now. Anybody with experience with these medications and the effect in your depression?
PS: Is it bad if both medications interact with each other? Seems to be the case with these 2.

i dont know what happened. i went to a new doctor back in january and said make everything XR. my last episode was february 13th.
im still confused because ive never gone this long being stable and i dont trust it.
every day i think this will be the day i ho into a depressive episode and then its not.
dont get me wrong im thriving and having a great time but i have no idea whats going on. its like my brain just slid into place!!!!

Ok so for a little background I'm a 28 year old single mom with a 8 week old, so I am freshly postpartum. Ive been struggling with my mental health for just about my entire life it feels like and I've just been raw dogging it for the most part, and numbing myself with anything I could the rest of the time (2 years clean now, yay!) But now I'm a mom and I want more than anything to be able to be healthy and present and happy and enjoy this precious stage in my babies life. Im going through a lot at home, babies father left me two weeks PP and does not help with our child so I'm constantly alone, so naturally I'm suffering with some postpartum depression. I sought out a psychiatrist and she's prescribed me 150mg of Wellbutrin XR and lamictal. I've heard Wellbutrin can cause a stimulant effect, and in a past life when I was in county jail, girls used to cheek them and then crush them up and snort them. So I'm a bit nervous about the possibility of it creating a "high" with me being in recovery. And I'm also concerned about the possibility of getting worse, or feeling worse before I feel better. I know there's an adjustment period, and I just want to know what to expect before I start them and I'm sitting here alone in my home, as the sole caretaker of my newborn suddenly overwhelmed with despair.
Did it worsen depression for anyone? And does it really act like a stimulant? Also, my doctor advised me to take it in the morning, but I've read it can make you sleepy as well, and that isn't going to work when I need to be awake to take care of my child. Is anyone taking it at night instead, and if so, does it still work during the day?
Thanks if you read all of this <3

I am 22 years old (female). Was diagnosed with bipolar type 1, generalized anxiety disorder, and borderline personality disorder. My psychiatrist has me on: Focalin (20mg xr) Cymbalta (60mg) Lamictal (150mg) Vrylar (1.5mg) Naltrexone (60mg) (for impulse control not for drug abuse). I keep telling him I think I’m on too many. And he said “you need all of them”. I’ve been seeing him for 5 years so feel like he knows me well and probably knows best. But I wanted to ask for anyones opinion on this. Is this too many meds? I feel a lot better mentally on the meds. But I also get extrmely exhausted after taking them (besides the focalin which I take in the morning). I’m worried about long term effects too. Of taking of all these meds. I definitely need meds becuase I don’t do well mentally off them. But just want an opinion on if this is too many. Thank you!

So to preference, I’m diagnosed bipolar & ADHD & I have severe anxiety. I know my anxiety is worsened by my other conditions, but the paranoia and anxiety is just so much for me. I’m self aware so I KNOW that I’m just being anxious & paranoid but I cannot get over it. I’m in therapy, have been in therapy, and the whole positive affirmations to combat anxious thoughts isn’t working.
Lately I’ve been having panic attacks so my Dr prescribed Klonopin (.5 mg). It’s been so great and I’ve been so chill but I know it’s addictive and not a daily medication.
I’ve tried most SSRIs in the past, they never seemed to work for me. I feel like I do need something stronger, but do they even have a medication like Klonopin, that works but is non addictive?
What has worked for y’all?

• currently on Lamictal ER 250mg & Adderall XR 20mg

41m. Have felt like I’ve been “off” my whole life. Was started on Effexor XR (venlafaxine) in early 20’s for GAD/depression and was on it for quite a long time. I was newly married, stressed about finding a job and chalked it up to that. I was on it up until about 6 years ago when I took a Genesite test and was determined that Pristiq (desvenlafaxine) was a better fit for my DNA makeup, so I switched to that. At one point I was on Lamictal but not because of a BP2 diagnosis. I cannot recall what that really did and eventually discontinued. Last year I was also on Wellbutrin (150mg) along with my Pristiq (50mg) and felt much better late summer 2023 so decided to come off my Pristiq. I also used weed regularly and don’t have the best relationship with alcohol, but as I’ve read, for many, it really helps quiet down the noise and anxiety and makes me feel good so I kept using it. I just don’t have an off switch. In retrospect, I highly regret those decisions, but I can’t change the past, I can only do better moving forward.
Fast forward to October 2023 and I essentially stopped being able to sleep. Probably averaged 2 hours each night for an entire month. I was married to my second wife (we had been married for almost 2 years but together for 6), we each have two kids, she had just beat breast cancer and the stress of everything was at a peak in combo with the medicine switch and substance usage. Very early in November I voluntarily checked into the mental health hospital (psych ward, though I hate using that phrase) and was there for 4 days. They gave me some sleep meds and started me on some Mirtazipine. I was officially diagnosed with MDD without psychotic features. When I got out is when things started to get really bad. On top of everything else, I felt extreme shame and guilt for even letting it get to the point of admitting myself. I felt like I was letting my wife, kids, parents, siblings and work down. I do believe I went into full blown psychosis and a week later, readmitted myself to the hospital and I spent about 2 weeks in. When in I was given Trazodone to sleep, Mirtazipine, Gabapentin, and Olanzapine. I really struggled to communicate and advocate for myself with the doctors and was essentially “locked” in my brain. After meeting with the head psych doctor, he recommended me for ECT treatment. Unfortunately, I wasn’t of sound mind and just agreed to it without much discussion. I ended up with 4 treatments before I discontinued the treatments because I felt like it was frying my brain. Perhaps it did help some and snapped my psychosis, but I essentially lost the entire month of November memory-wise. On top of that, my wife told me she was getting an apartment right after one of my ECT sessions. 10 days after I got out of the hospital, she told me she wanted a divorce. In retrospect, I’m sure she was scared, confused, nervous and ultimately, she did what she felt she had to do. I still love her madly but do believe there will be no reconciliation. I’m still trying to figure out how to seek closure and apologize for everything to her, but I have not gotten there yet.
Follow all this with a recent formal diagnosis of ADHD (February 2024) and started Vyvanse 30mg and that seems to have really helped with focus, motivation and executive disfunction. I think I’ve lived with it my whole life after reading and learning more about it, and I’m glad to be able to get treatment for it.
I recently started back with a new therapist weekly to help me unravel all that has transpired and to REALLY get to the root of all my struggles. I very much relate to the concept of cycling and going from what I now believe to be Hypomanic stages and then also spending a lot of time in the depressive phases. Sometimes it seems daily, other times it’s week to week. If I look back on my life, I can see many other times where I was driven, focused, had a very elevated mood and felt like I could do anything, followed by unexplainable crashes, irritability, isolation and generally just living in my head, withdrawn and confused as to how I was one way for a while, and switched to another “version” of me. I wasn’t effective at communicating it often as I didn’t know how and felt shame and guilt that I couldn’t just be normal. My second wife was always even keeled, motivated, organized and loving and in my head, I always thought I would be dragging her down with my moods, so I masked the best way I knew how. She was supportive to an extent, but I think she kind of just wanted me to get fixed, not realizing that there is no easy fix for this, and you don’t fight mental illness like you fight breast cancer.
I’m not entirely sure why I’m writing this, and not sure if I’m in a mild form of Hypomanic phase now as I blurt all this out for this community to read. I just felt the need to get it all out there and maybe someone can relate or identify with things I mention. I feel strongly I need to get back with my psychiatrist and perhaps explore a formal diagnosis of BP2, but also, I’m scared of that and not sure how easy it would be at this point in my life while also having ADHD.
I’ve always been a high performer in my two careers and been with my second place for 11 years and even given a portion of ownership because of all my contributions. I feel like at times the possible Hypomania has been a blessing, but also realize it can be a curse and during the depressive phases, I struggle quite a bit. I’m a huge overthinker and ruminate about a lot of my past, wishing I could change things. When I’m the real me, I feel like I’m intelligent, loving, caring, kind and gentle. Other times, I don’t feel those things and it can be disconcerting to put it mildly, but I know that isn’t the real me. Maybe you can relate.
Anyways, thank you for reading and feel free to comment with perspectives, suggestions, etc. This is a throwaway account, as I’m still in the early stages of unraveling everything and because I do believe the stigma is real, unfortunately.
Take care.
EDIT: My new therapist is the one who suggested BP2 after him hearing all this. Prior to that, nobody has ever mentioned it being a possibility.

EDIT: The main ones I am considering are fluoxetine (Prozac) and vortioxetine (Trintellix) because of their longer half life, but based on the Genesight results, I could also try desvenlafaxine (Pristiq), levomilnacipran (Fetzima), vilazodone (Viibryd), duloxetine (Cymbalta), or fluvoxamine (Luvox). Unless I want to try a tricyclic, which is tempting after seeing they’re used off-label for some of my physical chronic health issues! I need to check if I can get an updated list since mine is from 2021, though, and I know there are new meds not mentioned and possibly some no longer available. I’ve had much better luck with brand name meds also, so I know newer ones are less likely to have generics (my insurance will pay if no generic is available).
To preface, I am diagnosed with autism, adhd, and c-ptsd. I exhibit many OCD symptoms, but my doctors feel they’re better explained by my other conditions. I’ve more recently begun tackling treatment of my symptoms through an OCD lens because intrusive thoughts are one of my most debilitating symptoms, and the ADHD medication and autism diagnosis have practically eradicated my depression and anxiety. Yet issues that could fall under OCD still remained. I also have chronic health issues, like POTS, hEDS, and likely MCAS.
Currently, I take 150mg Zoloft and 15mg Dyanavel XR (amphetamine). It’s been working fantastically for nearly 2 years, with just some minor dosage adjustments as my tolerance increased. Unfortunately, while my intrusive thoughts are under control with Zoloft, at the current dosage my skin and nail picking has gotten out of control, as well as other things that I worry may be OCD-like symptoms or side effects. I have been getting “stuck” in what I’ve come to understand as compulsions much more frequently, and it’s really impacting my daily functioning. Also, my memory is even worse than usual, as well as my ability to manage my time or even conceptualize it, and I’ve become incredibly avoidant. I feel intense dread just trying to reply to a text, and it can take me a month or more to send a reply. I also feel like I have blinders on to everything that is bothering me or that I care about. I don’t feel numb, but more like it just isn’t processing. I know when these feelings are from autism or ADHD, and they play a role, but it feels different this time and has gotten worse without any typical triggers in the last 4-6 months, which is why I’m thinking medication.
I am wondering if I might have luck with something like Prozac or another medication that helps OCD symptoms? I’ve had pharmacogenetic testing, and nearly everything falls into the “moderate” list. I’ve taken Effexor, Wellbutrin, Seroquel, Buspar, Abilify, Lamictal, Tripleptal, trazodone, Strattera, Concerta and some others I’m forgetting. All either did nothing, had bad side effects, or stopped working after 6 months. I know from the genetic testing that I have the mutations that mean I produce serotonin but can’t seem to access any of it (I think it’s “reduced serotonin expression”), and I burn through dopamine faster than I can make it. I’ve also tried some OTC things, but they were either ineffective or couldn’t be tolerated. And I’ve done both neurofeedback and TMS treatments. Greatly benefited, but insurance would only pay for a certain amount.
I’m just so tired of this battle, and I don’t want to change meds if it’s going to make things worse, since it has taken almost a decade to find an adequate combo. But I’m scared of staying the same as well, because it’s impacting my job, caring for my health, my friendships, and staying on top of responsibilities.
I appreciate any advice or words of encouragement. I’m going to talk with my doctor soon, but I need help getting my thoughts in order and what I might want my next moves to be.

Hello, I have been extremely worried about labs that have come back. I cannot see my doctor anytime soon due to her being extremely backed up so I was wondering if anyone could provide some clarity or opinions.
Demographics: Female, Latina, 24 y.o., obese (5'6" + 293 lbs), USA
Diagnoses: type 2 diabetic, bipolar 1, PTSD, ADHD, BPD
Medications: Ozempic, Metformin, Lipitor, Vraylar, Lamictal, Zoloft, Gabapentin, Adderall XR
Lifestyle: I currently walk frequently for work and go to kickboxing classes 3x/week. I tend to eat not overly unhealthy but could improve my diet.
Labs (abnormal): WBC: 13 HGB: 11.6 HCT: 40.2 MCH: 24 MCHC: 28.9 Platelets: 627 Neutrophyls: 9.51
Labs (normal range): RBC, MCV, RDW, lymphocytes, monocytes, eosinophils, basophils, immature granlocytes, RBC
Thank you in advance.