Thanks for the valuable inputs..
Well as i expected there is a problem with the timing of your drug regime , as you see wellbutrin xl can lead to insomnia so taking it at bedtime will certainly impair your sleep besides this cymbalta is known for it's sedative action so it is best to be used at bedtime so that it's sedative action can be put to use in bringing good night sleep.
Other than this you are overloaded on antipsychotic medications such as risperidone and seroquel which is not good as they come with some serious side effects of weight gain, increased blood pressure and increased blood glucose levels raising the risk of diabetes or worsening diabetes who are known diabetic cases., so i will suggest that you ask your doctor to bring you off one of them.
So i will ask you to discuss the below mentioned changes with your doctor and get them done so as to improve your sleep and overall symptoms--
1) Cymbalta 60 mg dose is to be shifted to bedtime from the current morning timing.
2) Wellbutrin XL is to be taken in the morning as a single dose of 450 mg , which as of now you have taken as 150 mg and 300 mg doses respectively , actually XL version of wellbutrin is extended release version which works well in single dosing , so kindly do this change.
3) Opt for one of these two anti psychotics - seroquel or risperidone , preferably seroquel and coming off risperidone because comparatively seroquel is better suited for manging bipolar depression plus it has sedative action which will also help you. You can ask the doctor to raise the dose of seroquel to 200 mg at bedtime for better results, but this is to be done after withdrawing risperidone.
4) Add Pregabalin (Lyrica) at dose of 75 mg to start with at bedtime and then raising the dose to 150 mg after 1 week and continuing on this drug for 3-4 weeks , this shall normalize your sleep wake cycle and then you shall come off this drug.
5) You may continue on lorazepam as it is.
Kindly discuss this with your doctor and bring about these changes , i am hopeful that you will start to appreciate improvement in your sleep and overall symptoms in a week or two after these changes.
I hope this helps.
Wish you all the best.
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