I started Lithium early in 2009 after nothing else worked. It worked great for me. Was at 900mg but then based on symptoms and blood levels I increased it to 1200mg for a while. I self-decreased the dose because it's now interfering with my thyroid level and I'm between pocs so I talked to my family doc and he agreed to let me handle my dose titrations and he will write orders. As far as side effects, I do have the hand tremors and I will get thirsty at night after I take my PM dose but otherwise I don't have any side effects (other than it burning out my thyroid). As far as symptom control it's offered me the best control for the longest period of time. I had a 6 month period where I felt 'normal' and even had significant stressors during that time but was doing so well. I went into a depressed episode at the end of November and that worsened over the next several weeks and has no turned into a more mixed episode but I've decreased my Lithium level so that would make a little sense. Hopefully you'll have good results with it. Good luck!!