I've been on both. Lithium ER for a total of about 6.5 years. Depakote for over a year. I have to say that both were very side effect evil for me. Lithium was weight neutral for me, though I know that's not always the case, but I developed hypothyroidism, had cystic acne, polyuria/polydipsia, tremors (until I was put on a med that helped), and then it eventually affected my kidneys. That's why my pdoc took me off. I also questioned how effective it really was for me. It seemed a little helpful the first time I took it, but not enough without more meds added on. The second time I took it was a huge cocktail. When I was eventually taken off of it I only experienced positives. My moods were fine, all of the side effects went away, except the hypothyroidism and kidney damage, which is here to stay. My cognitive functioning improved when I went off, too.

I call Depakote "DepressionKote" because though it was great at calming 3.5 years of mania (along with Invega), I went into a 1+ year long depression. I had to have ECT, then they put me back on Depakote and Invega and I became depressed again. My nephew had the same experience. Both my nephew and I gained a lot of weight. I gained at least 30 lbs. When I was then switched to Lithium again, plus Geodon, I went on a diet and easily lost 35 lbs.

Now I take Tegretol XR (1400 mg) as my main moodstabilizer, along with a small dose of Lamictal (100 mg) and a somewhat large dose of Seroquel XR (600 mg). Tegretol XR is very side effect friendly, but it seems best for mania. The Lamictal and Seroquel XR are helpful for my depression. Seroquel XR is also helpful for my mania. I've stayed out of the hospital for almost 8 years now, but have had mood episodes that required medication tinkering. I'm afraid my Seroquel XR could potentially be increased again in the future. That's a bummer because it makes it difficult for me to lose weight, and makes me gain some. Tegretol XR and Lamictal are weight neutral for me.