Hi. My BPII most often presents itself with depression. Like most of us with this disorder it is the symptom that initally made me seek help. I went through trials of Zoloft, Effexor, Lexapro, Remeron, and Paxil. All of them would poop out really quickly or not work at all. The effexor did send me into hypomania, though. After I was correctly diagnosed my pdoc added an antipsychotic. First it was Risperdal added to the Effexor and I finally found what it was like to not be in an abyss. After some side effects after a year and a half on Risperdal, I was then put on Zyprexa. I did not fall back into depression with the med change. I did however put on 10 lbs in 2 months on the med. I suggested to my pdoc that I try Abilify and that has been working well at 5mg for the past month.

My attempts on lithium were not fruitful as an adjunct to the antidepressant. I know antidepressants can be controversial in the treatment of BPII but I can not imagine not being on them.

My current treatment is Abilify 5mg and Effexor 150 mg. I have not cycled since last spring.

I encourage you to continue searching for options if the lithium does not work out for you. Good luck.