Megumi D replied: "IF you have bipolar d/o, and you are also taking Effexor (or any other SSRI antidepressant such as Prozac, etc.), it can cause you to go into an agitated state, especially at your age. You might need an "atypical" antidepressant, such as Wellbutrin, for the depressed phase of your b/p d/o, because they have less of a tendency to cause the agitation than the SSRIs. I am NOT in a position to prescribe meds for you, because I am not treating you, but it does sound as if you need another medication, a "neuroleptic", such as Abilify, Risperdal, etc., to help stabilize you and decrease the agitated, angry mood. You may need another mood stabilizer (which is what the Lamictal is) such as lithium or Depakote, or an increase in your dose of Lamictal to help stabilize you again. A lot depends on what has been tried before, your personal health, before anyone can say for sure, even your psych MD. With b/p disorder, unfortunately, medications that worked well for a while sometimes stop working or need to have the dosage adjusted, for reasons that are not all clear. The doctor who prescribed your current medications needs to know the effects of the medications on you. What you are describing is NOT what s/he had in mind to do when you were given the meds! As you know, if you have b/p, it is typical for it to "swing", and that's what's happening now. It COULD very well be that the Loestrin is causing the fluctuations--hormones can definitely affect the meds as well as your disorder. Unfortunately, the only person who can tell you for sure, or at least with a higher degree of confidence, is a psych MD to treat you, who prescribes the meds in the first place or a psych MD that you should see regularly for medication monitoring. S/He should be informed of your situation right away. No one here, not even the doctor who gave you the meds, can be precise about what is going on for you without seeing you in person. I hate to add it to the list of people who have said it, but you do need to see a doctor. If you don't have a regular psych MD that you see for the bipolar d/o, you definitely should try to get one. They can make all the difference between being able to live a relatively stable life and going through the excesses that you are experiencing now. I know this not only as a clinical psychologist but as the mother of a 10-year-old son with bipolar d/o. It can be a very difficult disorder to treat but it IS possible to become stable on medications without a lot of bad side effects too. I really hope that you can get someone to help you through all of your medication problems. You deserve to live a more stable, happier life and not have all of these problems, which only make you feel worse about yourself."