Brief Answer:
My suggestion.

Detailed Answer:
Hi,

From what I understand you are suffering from bipolar depression. Anxiety and anger symptoms could be the part of your bipolar problem.

Based on the medications you have tried, I can understand that you were already on anticonvulsant - Dilantin; Lamotrigine and Lexapro for your depressive mood; Depakote for your mood stabilization; Ambien and Lorazepam for your anxiety and sleep disturbances; and Aripiprazole is an antipsychotic.

I feel that you were on polypharmacy, which is not so advisable at your age. If I were your treating doctor, I would have considered one mood stabilizer, one antipsychotic, one anticonvulsant and one anxiolytic.

Speller and grammar checker English
As far as the lithium is considered, it is mainly used in acute conditions like in acute mania with irritability, aggressiveness, dis-inhibitory behavior and grandiosity. If your treating doctor did not prefer lithium, the reason could be either you are not in acute condition or you may have some renal problems, that made him to start on Depakote.

Lithium is the best drug even in maintenance phase. But regular monitoring of blood investigations is required to check for leucocytosis, renal failure, hypothyroid etc. This also could be another reason why lithium is not considered (He would not have started lithium considering its side effect profile).

Adderall is a stimulant. As you are already on mood stabilizer, it may not be required.

Hope I have answered your query.
Let me know if I can assist you further.

Regards,
Dr. Soujanya, Psychiatrist

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