hi. i've somehow managed to avoid lithium. i also ditched depakote for trileptal. for me, the trileptal takes care of agitation, (hypo)mania, etc., with minimal problems. there's a baseline blood sodium check and then another one...8, 12 weeks later I think.

I just mentioned it because lithium is rough stuff, especially over the long haul. with neuroleptics/tranquilizers on board, there's even more potential for problems.

Trileptal is far from perfect, but...I can take it with a tranquilizer, and I still don't get EPS, much less TD. Depakote triggered hardcore akathisia and EPS w/ a tranquilizer I had previously tolerated reasonably well. Lithium is known to potentiate the toxicity of the tranquilizers, so you get more EPS, more TD, more NMS, and, according to some studies, more reduction in cognitive abilities over the long haul.

amphetamines are a godsend for some people, but they can cause problems for a lot of people, too, regardless of psych history. with tranquilizers+amphetamines, some "experts" think there's a higher risk of TD and EPS (tranquilizer+amphetamine combinations were once much more common...some were even available in a single prescription preparation, back in the day...).

Glad things are going welll for you.