With a mood stabilizer and careful balancing I think ADs have a good role in managing bipolar. I think I was off them for 3-4 years after I was diagnosed and then when I started them it was watched carefully and my mood stabilizers were changed as needed.

6 years ago I went on Emsam, which is an MAOI. They are really stimulating so while I was in the hospital getting started on it they doubled my Seroquel from 300 to 600 and that was for about 2 years my magic potion. I went to sleep at 11 every night and woke refreshed, not manic, at 4 AM every day. I had time for hobbies and to pack a lunch. Emsam has been amazing. I still am capable of getting much more depressed on the mixed side but it's not the same as it was before.