Originally Posted by A Sense of Purpose
I'm not sure if zoloft increases dopamine, however i know that zoloft+Olanz works really well for me.
I don't feel drowsy even at the max dose of Olanz (20mg).
However, I'm a high functioning bipolar 1
Actually, believe it or not, there's evidence to suggest that Sertraline does indeed increase dopaminergic activity.
Here, for example: http://www.psychotropical.com/index....upropion-zyban
This doctor pretty much slams the science behind Bupropion's marketing.
Back to the OP's post
It really sounds that you have a good case for an unstable mood disorder. Perhaps Borderline Personality Disorder (or the more accurate Emotionally Unstable Personality Disorder). I don't know your symptoms, so I really can't judge. But you might want to look into them.
As for medications, a combination of Olanzapine and an SSRI has pretty good evidence. Olanzapine doesn't seem to be doing anything for me, but that doesn't mean it won't work for you. It's probably got some of the best evidence around for use in bipolar depression. Just be wary of weight gain.
FWIW, I would avoid Risperidone and Aripiprazole. Last psychiatrist said they really didn't help with anxiety, and Risperidone is not good for young men, for sexual side effects
Lyrica is a good drug for anxiety, and anxiety may very well "kindle" your depression. Problem is, the side effect profile. It CAN (but doesn't always) make you very dopey. If you're not used to sedating drugs, it may also make you quite tired.
Bear in mind with Lyrica: a) it's hella expensive; b) the maximum dose for anxiety (600mg) is significantly lower than its usage for pain disorders. Or so said my previous psychiatrist, who seemed to know his stuff.