i'm 71 yr. old female, diagnosed about 35 yrs. ago w/bp2 (hypomania no depression) and was always under the care of a psychiatrist. for those 35 yrs. years i was only on 450mg lithium (very low dose) which seemed to work and always had regular blood work...long story short, over time, i first had thyroid issues which require taking thyroid meds for life; then it was my parathyroids, over-producing calcium (if my old memory serves me correctly) from the lithium and had to have parathyroids removed; and finally about 2 yrs. ago i had kidney (creatine issues) caused by long-term use of lithium so quit lithium entirely....very little was known about long-term effects of lithium 35 yrs. ago, and essentially blood work was for lithium level toxicity (i was always low on that since i only took 450mg daily); never gained weight but had to urinate frequently when i took that first dose in the a.m.; always needed to drink water and not actually restrict salt intake...guess lithium worked for me, but it did do damage and i'm sure psychiatrists are more informed today than 35 yrs. ago; do your own research and good luck.