Reddit reviews KAL Lithium Orotate 5 milligrams | Low Serving Of Chelated Lithium Orotate For Bioavailability and Mood Support | In Organic Rice Bran Extract Base | 120 VegCaps
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Naturally Occurring Trace Element: Lithium is found in grains, vegetables & therapeutic hot springsLow Serving: 5mg of Lithium Orotate offers benefits without an excessive serving sizeBioavailable: Chelated form of Lithium enhances bioavailability for maximum uptake & utilizationKAL Quality: Comes in a base of organic rice extract; lab verified for purity & identityCustomers Say: “KAL Lithium Orotate has become an important part of my daily routine.”
TL;DR: Try adding niacin and lithium orotate, and look into tDCS or even TMS.
I can relate to what you're going through. I've been on Wellbutrin (300mg/daily) for the past 9 years, and I know it helps raise the lower floor of my depression. (I know this because, at the end of a 6-month hiatus to see if it was having any effect, I was worse than my worst days 20 years ago.) But it doesn't seem to do a whole lot more than that for me. I'm also on Vyvanse (40mg) for ADD, which it seems to help, but even though its a stimulant, it doesn't have much of a stimulatory effect on me. (This was true on a prescription for Adderall, as well; often were the times I'd take an Adderal with my morning vitamins and Wellbutrin and just go back to sleep for a few more hours.).
In addition to Wellbutrin and Vyvanse, here's what I've done or am doing that has helped incrementally with each addition. Your mileage may vary:
^1 Phenibut: only on days when the barometer is dropping appreciably below mean sea-level atmospheric pressure. I'm serious.
^2 Niacin: I learned of this one in this subreddit, I think. I titrated up to 2,000mg/day over the course of a week, and I try to take it with food in my stomach. But it has to be the regular niacin that causes the flushing the first week or so until your body is used to it, not the "extended release" or "no-flush" varieties.
^3 I only recently learned this is available as a mineral supplement. Anecdotally, 5mg is about what you get from lithium occurring naturally in some well-water supplies. My psychiatrist said 5mg isn't even one percent of the amount they give people to stabilize them in a clinical setting, but he also said I was welcome to try it if I wanted. I've only been on this for a week and a half and it may only be helping me sleep, but at least that.
^4 Transcranial Direct Current Stimulation: Did my research, including lurking on /r/tDCS, ended up getting that SSD model I linked to above. My psychiatrist wants me to look into whether Transcranial Magnetic Stimulation (TMS) would be covered by my insurance (for example, from one of these places), and I said I would, but I first wanted to try this lower-cost, easier-to-implement method of tDCS -- since they are related therapies and target the same neuron areas of the brain, basically. He told me to go ahead and give it a try.
I have to say the last week, with the lithium and the tDCS, has felt mostly different for me. I think it's everything on the list, cumulatively, probably, but it feels especially like it could be the tDCS making the bigger difference, which I've only been doing for a week now. The device could be little more than a "Placebometer 3000," but I know that I tried a lower amperage (1mA) on Sunday and then tried a different montage (placement of electrodes) on Monday, and neither one seemed to be as effective, but today, returning to the initial one I listed above, I feel back on track.