I've been in a mixed state almost constantly since getting out of my depression. Or in some ways I think my depression itself was sort of mixed, definitely not classic or pure depression. It was at times an agitated, anxious depression. The depression symptoms have pretty much all been resolved with rexulti but the restlessness, anxiety, paranoia, intrusive obsessive thoughts, etc still remain. The pdoc has said it's possible I have comorbid anxiety, ocd and/or ptsd if the symptoms remain even if my bipolar symptoms have become stable but I cant tell if its comorbid conditions or a mixed state, they're pretty similar from what I've read, and I dont think the pdoc can tell either so it hasnt been decided if its comorbid or still mixed state. I guess I'm trying to figure it out some myself and have ideas to present to him next week. Also, I've noticed the anxious, edgy, restless feeling has been present even after my depression lifted using rexulti but the panic attacks have stopped. The pdoc cut my lamictal out saying it can be too activating, can an antipsychotic also be too activating? I know rexulti is supposed to be considered activating compared to the antipsychotics that cause drowsiness, but you'd think something that stops manic episodes wouldn't cause a mixed episode....but definitely something to talk to the pdoc about. 

Anyway, I've thought about switching antipsychotics if he thinks it might be part of the problem and have wondered about vraylar. Anyone here take it or know anything specific about it? I've read side effect profiles and stuff but just wondering about personal experiences. My deal breakers are pretty tough to satisfy but I cant take extreme weight gain (type 2 diabetic) or extreme drowsiness. Give me other suggestions on AAPs if you like yours.