I know.... I too have always avoided Lithium like the plague due to its age and the potential side effects despite how a few docs in the past have lauded its efficacy. I was super reluctant at the hospital to try it. Before then, i tried several meds to no avail and before taking lithium at the hospital, i tried abilify which sent my anxiety level through the roof---ended up having a panic attack from it as a result. The doc said abilify can cause anxiety as a side effect.

Finally, out of desperation for relief, i gave in since nothing else was working...got taken off abilify and took the lithium. All the anxiety vanished and within days the lithium really worked. She told me it would be fast acting and i didn't really believe her. I'm used to taking ssri's with other mood stabilizers and all of them usually take a while to kick in---but i was really shocked to find how fast acting the lithium was and how quickly it stabilized me. I'm not thrilled with the side effects, but i don't want to mess with my current stability given that it's the only med that has worked after all these months of chronic depression.

Yesterday i saw my doc and told him about the fatigue. What he did was up my dosage of lamictal and might lower the lithium dosage after he sees my blood work.

Here's the thing that i didn't mention---at the hospital, since i was so concerned about weight gain, the doc there put me on topomax. When i came home with the lithium and the topomax, i didn't feel any fatigue. I finally figured out last night why i didn't while on topomax. I was on pretty high doses and in addition to it being an appetite suppresant, i discovered it also gives you an energy boost which i didn't realize was one of the side effects. Last week, my doc took me off topomax and replaced it with a starting dose of lamictal. I agreed to going off topomax due to the scary cognitive side effects which i was experiencing and had experienced in the past when on topomax. I think it's a pretty useless mood stabilizer, imo, and i was only taking it to counteract the weight gain thing with lithium...BUT it can really mess with your memory, concentration etc. I did notice short term memory loss and mistakes i kept making when typing, but then i heard horror stories of people on topomax long term and how, not only did it cause cognitive function side effects while on it, but how it continued after getting off it. This wasn't a risk i was not willing to take. Anyway, he told me that the lamictal, at higher dosages can work as the topomax did to counteract the lithium fatigue since it has anti-depressant properties. He also said that side affect will subside in time. I hope he's right. we'll see.