Lithium is an excellent,med. and has the longest track record. Depakote,has gained popularity,only because it works faster,for mania,zombifying many (I didn't like it and was switched)people.
My pdoc and previous one,claimed that many pdocs have resorted to that for quick response,or in a sarcastic way,less work for the podc. sometimes.
Depakote also requires blood work,monthly than less often over time,cause it can effect the liver.
Actually, Lithium has been deemed to be much safer than Depakote,especially with long term use.
But it needs to be the patient's and the pdoc's decision as to what route to go.
Lamictal,though it's been mentioned it has dangerous side effects,I must defend this,for it is extremely rare,and should not make one afraid to try it if all else fails,it is especially beneficial to Bipolar-II patients,who have more depressed episodes vs manic. Lithium,is excellent for Bipolar-I patients (which my brother is) I've seen the difference.
I think so many people tend to dwell on the negatives of medications and forget to see the positives.
It is sort of sad,cause one may be denying themselves of a possible,positive outcome.
I've tried Topamax,even my pdoc agreed it wasn't for me,and personally he said it is not as great as it was first to be,but is used by some with good results. Drawback,one may need to have various meds in adjunct.
I liked Lithobid (time release version of Lithium)but it wasn't really addressing the depressive part of me,for I really only had one or 2 mild hypomanic state,which now realized may have been due to the use of diet pills (amphetimine) and a family deal. Even AD's alone and along with the Lithobid helped with the deep depression,so pdoc asked me if I'd be interested in trying Lamictal, and it's great for my issues.
Lithobid was excellent in addressing my agitative state,which actually has diminshed.
And there has been no change in any bloodwork,when I see my GP for my checkups,and I never had any negative results from the Lithobid.
The Hashimot's thyroiditis/hypothyroidism is more of a heredity thing with the women on my parent's both sides.
Also is common in women 30 and older, 1 out of every 10 women develop this.
Another thing to look into,is thyroid function,for that alone can be mistaken for depression/mania,and then all the time like what happened to me and so many others,doc's keep handing out all different AD's,GP's are not qualified to replace a pdoc, so all the different AD's naturally would never address my thyroid issue.
Sorry, I tend to ramble,but want to stress to everyone here, "do not fear trying meds and treatment,with compliancy they can help so much,even in miracle proportions for some."