instruction: hello doctor I recently was on cymbalta minimum dose but did not feel better I felt worse and was told to up the dose then I took 120 my still felt bad so I abruptly stopped this and it triggered discontinue syndrome and hypermania I have not felt the same since I am not suffering so much now from hypermania after a month or two I am lamictal and when needed on seroquel on current medicines I feel blank unstable unable to think normal and some frustration anger thinking concentration and speech affected at times I feel I need to go back to antidepressants my brain needs that and boosts mood and taper off appropriately like effexor or lexapro I have had success but lexapro cause stomach issues and effexor is good but can cause weight gain or if working in the night it can cause mood swing I believe my current issue is just because of cymbalta induced hypermania I did get psychosis from led do you think I should taper off lamictal to effexor low doses
output: hello welcome to icliniq com considering the history of mania even if it is drug induced it is not advisable to start effexor alone in my opinion so I would suggest you discuss with your treating psychiatrist regarding starting seroquel regularly as it also acts on depressive symptoms or starting low dose effexor along with lamictal as mood stabilizer I hope this helps