Hi, Changing medicines is not a trivial thing. You can do it only after trying one for at least 6 months in its higher dose. First of all I would try to understand better your condition. From what you tell me, it sound more like a Borderline Personality Disorder, and thus it needs a totally different approach. You will nees to take a mood stabilizer (lithium or valproic acid, depending on your medical history), antipsychotic (aripiprazole mosr likely) and a SSRi, but the most important thing is therapy. You need help to understand what is the cause of your anger, low self-esteem or self-harmin impulses. You need yo learn to control your anger and anxiety, to learn how to value yourself and your strengths, and you need to learn how to build healthy relationships. Still, I cannot help you because I haven t met you and my reply is based in just a few sentences you wrote about yourself. Maybe the best step is to change your psychiatrist and also search on your own about BPD or other conditions that may resemble more your symptomatic pattern. I hope I have helped you. Wish you good health and peace of mind, Manoku Eni M.D.