Lynn this is my son's medication protocol info if it helps you:
Daily 300mg Lamictal, 17.5 Abilify, 1mg Risperdal (split in half, morning and night). Then he takes PRN up to 1mg of Risperdal if we see an agitated depression/manic state emerging. What the doctors have told us is that the more episodes of mania/mixed states he has, the more he will have (if that makes sense). And, the instances of mania lead to the depressive states. So, it's a vicious cycle. Their opinion (based on studies, not on guessing) is that knocking back the manic states as quickly as possible (and of course trying to prevent them with PRN medications) will lessen incidents of all mood dysregulation.
To give you some hope: this morning as my son was taking his medication he said to me "mom the medication seems to be really working lately. Like I'm taking the right amount." I can't tell you what a big deal that is. And he's eleven years old. If he's thinking about it everyday and noticing, I can't imagine what your 18 year old daughter must be going through. It took since January of 2016 to get that kind of response mostly because we had to go up so slowly with the amount of Lamictal but also because his first doctor wasn't aggressive enough with the antipsychotics.
There are side effects like we've talked about but he is now able to show up for life, basically. I really wish you and your daughter the best.
