I'm old fashioned, I'm pretty much just on lithium for the mania, even though I have blended episodes and some psychotic features. It does really well for me, especially with a small does of Effexor to keep the depression and anxiety under control. Anxiety is a big trigger for me. I have been on serazone (made me hallucinate), risperidol (made me lactate and messed up my periods) and seroquell when I was in the States (seroquell was really helpfull, very much! almost as good as what I have now). The only thisn is that Efexor has made me gain weight, which has me bummed.