Well, i would suggest that parnate shall be avoided in her case as it can cause a lot of side effects such as anxiety or nervousness , irritability , anorexia and subsequent weight loss , insomnia , mydriasis , tachycardia , hypertension or hypotension , hyperthermia , increased perspiration , muscle tremors , sexual dysfunction consisting of anorgasmia , and orthostatic or postural hypotension , and this would be the last thing she would want to fall into.
So, i would suggest that she first gets her dose of tegretol increased , as it is a low dose which has been placed on , and needs increase in the dose to stabilize her mood .
Also, wellbutrin needs to be switched over to wellbutrin XL , which is a long acting version and would control her depressive symptoms.
Also, she has been placed on 2 anti psychotics such as geodon and seroquel , which may be causing anti psychotic overload and thereby uncovering depressive symptoms , so i suggest that one of these two anti psychotics is withdrawn , preferably geodon .
So, kindly discuss these changes in her drug regime with her psychiatrist and get her switched over to the new revised regime and hopefully this will control her rapid cycling bipolar symptoms.
I hope this helps..
I wish you all the best..
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