Lithium is the best med I have ever been on for bipolar. Before Lithium I was incredibly unstable, wild and often had a very intense gaze as I was in a constant mixed state and VERY suicidal. Lithium has brought me stability like no other drug has. I still have episodes but I am not so out of control during them. Due to side effects (weight gain, shakes etc) I tried going off it and BAM I was in another wild mixed episode and very suicidal so I went back on Lithium ASAP. I also find Olanzapine (Zyprexa) really helpful for racing thoughts and agitation. I have just started Lamotrigine but I think it has helped my depression. Not sure about the Pristiq though, maybe it has helped the depression or maybe it has made me hypomanic. I will have to wait and see.