Medication: Bipolar, anxiety and headaches.

Hi people!
I'm a 25 year old male from Norway. I'm not really sure in what category to post, but I think this one is the most fitting.

I'm wondering if anyone could give me some pointers on what medication to try next.

Relevant information.
Diagnoses:
Bipolar disorder type 2 rapid cycling, generalized anxiety disorder, migraine and cluster headache.

Current medication:
350mg Lamotrigine. Zolpidem prn.

My anxiety levels have gotten worse over the last year, and I got the GAD diagnose just a few weeks ago.
Currently waiting for a spot in a metacognitive therapy group and a mindfulness group.

I mainly want some medication for the anxiety, but a wonder drug to cure them all would be preferred..
My psychiatrist wants me to try the anti-psychotic Ability though I'm really sceptical about anti-psychotics.

And I stay away from anti depressants because of the bipolar disorder. Because of the potential for addiction benzodiazepines is out of the question.

Can anyone please give me som advice? Feel like I'm running out of options.

Have a nice day.
Cheers!

Oh. I forgot to mention that I have tried a low dose of both quietiapine (Seroquel) and chlorprothixene (Truxal) for anxiety- though hesitant.
Had to stop them both. They gave me a whole day "zombie hangover", and some really really bad muscle pain.

Benzos are standard treatment for anxiety AFAIK and a life saver for many people.
Beta blockers are also sometimes used for anxiety.
If you had psychosis in the past, an anti-psychotic might help. If I was stable without one, I wouldn't start one. Some have nasty side effects. Can't prescribe, but might consider upping Lamictal with your pdoc a bit if you're unstable. I think some people also take Lithium with Lamictal which is considered the "gold standard" for bipolar by many doctors. Good luck finding the right candy!

I heard Topamax is used for migraines, but I also heard it is awful because it essentially makes you stupid. They call it "Dopamax". Like, horrible memory loss and the inability to form sentences. My NP refused to give it to me.

For anxiety, benzos are usually prescribed, but since you mentioned possible addiction, that would be a no-go because people do get hooked on them and/or abuse them. I just had an appointment with a new pdoc and he refused to give me them (despite using Klonopin as needed for the last 3 years). He prescribed me Buspar, which is not a benzo, and you take it daily as opposed to as needed.

Antidepressants also work for anxiety, but like you said, they have the possibility of triggering mania (which is why I'm not allowed to take them).

z7z suggested asking your pdoc to up the Lamictal, but since you are already on 350 and the max dose is 400, I don't think that would make much of a difference. My NP said you could take more than 400 mg, but when I was in the hospital the pdoc there said anything more than 400 would be pointless because it wouldn't be any different than taking just the 400.

As for anti-psychotics, I get you. I have been on many and they were all awful. So many side-effects, the worst for me being an incredible amount of weight gain, which in turn, gave me some health problems. This is the heaviest I have ever been and for 2 years I have been trying to get it off and it won't budge (I gained an additional 30 lbs while trying to get rid of the original 30 lbs I gained). It took me all year to lose 14 lbs which is ridiculous. Saying I am miserable would be an understatement.

But I would suggest looking into Buspar for anxiety, which is what I'm going to do before I decide to even take it. Good luck to you!

Buspar and Imipramine helped manage both my depression and anxiety. I quit alcohol completely and cut down on caffeine and sugar.
Treatment for blood pressure variations also helped the headaches.
Best of luck to you.

A small dose of Lyrica (pregabalin) has helped me with anxiety. Buspar had no effect. A low dose antipsychotic like Zyprexa can also help without necessarily inducing side effects. I also couldn't tolerate Seroquel and got mania and agitation from antidepressants.

Lithium is what works best for me. I have unusual side-effects that I find difficult to live with, but many people can tolerate it. It seems to be the 'default' mood stabilizer for Bipolar. I think lithium is a good choice for rapid cycling too.