I’m bipolar II and have been on virtually every med out there. The anti-convulsants, acting in the capacity as mood stabilizers, are the first line of treatment. Lithium is absolute last resort and is typically used for Bipolar I which differs from Bipolar II in that the up periods are manic rather than hypomanic. The majority of medicated bipolars are probably on Depakote, but Lamictal is easily the best drug. With Depakote, you’ll lose a good deal of hair, gain weight, and will have to have your blood level checked every now and then to make sure the blood levels are in a therapeutic range. Lamictal has virtually no side effects, and seems to put in a higher bottom on the downswing. It is superior in virtually every way. The only caveat is that you may be one of the .2% that develops a serious rash as a symptom of Stevens-Johnsons syndrome, which can be fatal if allowed to continue. Bottom line is you titrate the dose upwards and if a rash appears you stop.
Many doctors don’t prescribe SSRI’s for a Bipolar patient as it can trigger manic/hypomanic episodes. If the Lamictal isn’t helping the downside enough, I think it’s worth it to try an SSRI, or Wellbutrin, because in many cases, they won’t trigger such episodes. I’m on Lamictal, Zoloft, and Wellbutrin and have been doing great.
See a psychopharmacologist. If they don’t prescribe Lamictal over Depakote, ask them why. If they cite the rash as the reason, ask them about titrating the dose.
If they still disagree, it’s probably because they aren’t clinically familiar with Lamictal. Go find another P-Pharm. I’ve received many a thanks over the years telling people to switch from Depakote to Lamictal.
Any questions, let me know.