### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am a 57 year old female with Bipolar 2 A few  months ago my meds were lower because I was falling asleep as soon as I sat down even in conversation. I take Wellbutrin Lithium , Loranzapam, Serquel,andDepoqote and neurotin for migraines and more. Now 4 to 6 months later my lithhuim is450mg, Serquel 150 loranzapam is still at .5mg and has been for years, anyway my depression is too much and my doctor said raise lithium I said no because of double vision which went away when it was lowered. So he said up the serequel to 300mg or take Mirtazapine 30mg. I like d trilaphon which was changed to I erased it all. I am a 57 year old female with bipolar 2. I have been on Lithium ER 450mg at night which has been recently lowered from 1 at night, and one half in the morning.Wellbutrin 300mg,Ativan .5mg, Divalproex ER 500mg, Serquel was lowered from 300 to 150mg , Neurontin 800mg 3x a day. The lithium and serquel were lowered about 4 to6 months ago because I was falling asleep as soon as I sat down and even in conversations. I was also dealing with sleep apnea. Now I am too depressed and quick to anger and my psychiatrist wants to up my serquel to 300mg or to start Mirtazapine 30mg, I do not want to up my lithium due to in causes me to have double vision. I  am scared of the Mirtazapine and feel like the serquel is better because it is an antipsychtic. I did really well on trilaphone but was switched to srequel because of side affects long lasting.  Dr. left it up to me.

### output:

Hello you are on 4 moods stabilizers-Divalproex ER, Lithium and Neurontin and Seroquel, Wellbutrin as antidepressant. Incredible it is. Now mirtazapine as antidepressant and Asian for sleep. If I were to treat you, first thing I would do is stop Neurontin and lithium slowly, raise Divalproex to 1000 mg, keep Seroquel 150 mg and add nortriptyline. Each of my proposed change has a sound scientific basis. Lesser number of medicines with careful appraisal of the symptoms and appropriate to the relevant circuits in brain carries the best prognosis with minimum side effects Chat Doctor. 