@tisme I hope you are able to schedule some time with your provider and review what medications/lifestyle changes may work to your advantage. We are our own best advocate, and being very truthful about any other health concerns we have is important. If there are questions about interactions, and you feel your provider is not able to address it completely, I have found my pharmacist is a great person to talk to, and get their input on interactions. Because I have several different things going on, and a variety of medications, everything gets coordinated, from what I take, how much, to when I take things. Even over-the-counter medications can cause issues, and more so if you have NAFLD. Knowledge is power!
Ginger

@tisme I've had remarkable success with Lamotrigine. I received a late in middle age bipolar 2 diagnosis that I feel is correct. I had been on Effexor for some years, prescribed by my GP to treat lifelong depression cycles dating back to childhood. Despite this I fell into a dangerous depression and landed in the hospital after nearly taking my life.

I began seeing a psychiatrist, something I wish I'd done years ago. Some weeks after coming under her treatment I found a peer reviewed study that described everything that was going on with me so thoroughly that it could have been my autobiography. It's a rare but known response to Effexor where the drug amplifies depression instead of treating it. Uncaught, it can be dangerous. It was for me.

There's a long story from there, but the short version is my psychiatrist suggested Lamotrigine. My depression had quickly begun easing off after I quit Effexor, while the Lamotrigine stabilized me to a degree I've never known. Since going on it I've had the best two years of my life mood wise. Basically zero depression, zero uncontrolled bouts of the rage I'd been suffering, no more daily suicidal thoughts. All of it and more simply vanished and hasn't returned in that period.

Effexor was definitely a bad call for me, but Lamotrigine turned me around to a degree I never would have imagined possible. For me it took a few weeks to get it up to an effective dose, and then a further period as it set in to reach full mood recovery. So don't give up too quickly, Hopefully you'll have similar success to mine. For me it genuinely has been a life saver.