Brief Answer:
Lithium or lamotrigine can be used or re-evalution of diagnosis

Detailed Answer:
Hello Mr XXXXXXX

Thanks for writing to us.

I just gone through your query in detail. You have been diagnosed bipolar disorder at age of 14 years.You have been suffering form episode of depression since 4 months which has been improved with nexito and bupropion.

Now your problem is frequent mood changing.And you are feeling sleepiness with amisulpride.

Please understand some points.

In bipolar disorder mainstay of treatment is a mood stabilizer drug.
It can be lithium,lamotrigine or sodium valproate.
Lithium or lamotrigine is specifically used for treatment of bipolar depression. In any case if specific antidepressant medicine like nexito or bupropion is used ,it is with cover of mood of stabilizer.
If antidepressant medicine is used without cover of mood stabilizer, it can precipitate episode of hypomania or mania.

If your diagnosis is confirmed bipolar, lithium or lamotrigine is the best option for your treatment as well as to prevent relapse of depression.

Amilsupride is an atypical antipsychotic medicine. It is used in bipolar treatment when psychotic features are present.It is also used when depression in bipolar is not responding to mood stabilizer.
In your case at present no mood stabilizer is given. You are also not able to tolerate amisulpride and feeling side effects like sedation.I suggest to ask your doctor for stopping amisulpride and start mood stabilizer depending upon your history and past medicine records.

If you have not been given any mood stabilizer in past 18 years,it is not bipolar likely. Reevaluation is needed in such case by same or another psychiatrist(preferably). For reevaluation, your detail history and mental status examination as well as past medical records needed.

Hope I have answered your query,I will be happy to help further if needed.

Regards,
Dr.Chintan Solanki.

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