I'm trying to find some relief for my bipolar depression. I've tried anti-depressants with no luck and have just stopped Vraylar due to an increase in anxiety and intrusive thoughts. I'm currently on Lamictal 300mg. I also have comorbid GAD and ADHD as well as maintenance insomnia.

My psychiatrist wants to tackle the depression before trying to treat the anxiety. She has given me a few medication options to try along with their benefits:


Trileptal mood stabilizer --- mood and anxiety

Wellbutrin antidepressant --- mood and ADHD

Caplyta atypical --- mood and sleep (possibly anxiety) 

Latuda atypical (mood, sleep, and anxiety) 

Lithium mood stabilizer (mood and anxiety)


I'm nervous about the atypical antipsychotics due to the seriousness of some of the side effect risks such as TD and Metabolic issues. Plus my insurance may not cover them. She said the Wellbutrin may increase my anxiety but would be beneficial for my ADHD symptoms. I'm skeptical if another mood stabilizer would actually help with the depression. Has anyone had any luck with 2 mood stabilizers for alleviating depression or any of the above medications? I'm at a loss and a little overwhelmed with my options.