I was on lithium for the first 2.5 years after my diagnosis. I was also on an anti-d, but even with that I alternated between depression or a general feeling of flatness. As far as the hand tremor I was initially put on a med (I think it was called propanol) to control that. I was able to get off the propanol and as long as I stayed hydrated I didn't notice the hand tremor.

I haven't hear of the connection of the use of lithium for people with a family history of BP. I do have family history of BP, but lithium wasn't a good med for me. Each person is different for what med works for them, but lithium tends to work better for those who experience more highs than lows.

I'm on lamictal and wellbutrin now and it has worked well for me. Weight gain is not a side effect for either of these meds. Lamictal tends to be better for a person that experiences more lows than highs.