This analysis was very helpful to me. In our university health center, we have used lamotrigine as our first-line treatment for most of our patients with Bipolar II depression for years, usually with very good results. We have been concerned about how to treat a few with very severe depression and suicidality; we have usually started lamotrigine with lithium and/or quetiapine, but we have recently started submitting more prescriptions for lurasidone, most of which are denied by insurance. I have recently been struggling to try to figure out what to do with the 2016 CINP guidelines. Dr. Phelps' discussion elegantly provides very helpful perspective and guidance. One problem: I can't print from this format to share this with my primary care colleagues. Is it available as an article or pdf format? I looked on psycheducation.org, but didn't find these points in a compact discussion.