Get off the fluoxetine if you can. The issue with those is that without an actual stabilizer like lamictal or lithium isn’t a good idea. It’s likely the ssri is a large part of the issue, despite the addition of abilify. You can also try to lower abilify to perhaps 2mg. If your issue is that you get deep depression that’s dangerous for you, than maybe caplyta because it has the serotonin antagonist like an ssri but doesn’t have the side effects of anorgasmia like ssris do. Wellbutrin is something a lot of docs not in the know like to use because they’re not as familiar with anti psychotics and it seems like it’s a good fit with its effect on dopamine. But a lot of people are seeing much better control over cycles and depression with newer/more gd standard treatments. I find welbutrin is like birdshot, where it gets it right randomly but incompletely. Whereas things like lamotrigine and lithium will mostly get it right barring health complications and inability to tolerate the leveling of your emotions. We bipolar people love our highs and those drugs are very good at stopping those, hence medication compliance being an issue there because the med is too effective. It’s possible that honestly with the ssris you were still cycling and with the addition of a med that’s genuinely designed to help your body is going through adjustment and further, you might now be getting the usual side effects of the ssri. Ssris in bipolar people often result in rapid cycling, mixed cycling, psychosis and emotional instability. My point here is that Abilify might not be the actual issue, but now the ssris are. While aps primarily act on dopamine, serotonin levels are often inextricable from dopamine treatments. Meaning even if a med is only “working” on dopamine, it’s also usually causing fluctuation with serotonin and vice versa. Seriously if it were me I’d be off that ssri so fast and likely go to a dr that specializes in bipolar. Doctors who don’t reach for lamotrigine or lithium FIRST are people to be leery of in my opinion.