Lithium was my first mood stabilizer; I started it before I was even diagnosed with BP as a potential boost to my failing AD. It worked well for me but after a few years I had toxicity and after that I was sensitive to it and got toxic easily. I had 3 total toxicities. One landed me in the medical hospital. Another probably should have but the hospital that knows lithium is a long way off and I was so sick I just didn't go. (Don't do what I did). The first was carefully watched at home and wasn't nearly as bad as the 2nd and 3rd.

I tried to quit a few times but lithium really helped me and I'd stop and then immediately feel so bad I wanted back on. After the 3rd time I was done though and that time I got off without issues.

Side effects otherwise were typical for lithium: hand tremors, thirst, frequent urination. I also had diabetes insipidus which means that body stops hanging onto electrolytes. Usually they stop it if that happens but because it was so important to my cocktail at that time they put me on a med to remind my body I did need sodium and I saw a nephrologist annually. I also developed hypothryoidism and will be on a med for that forever. It's not a big deal though, just a little pill once a day.

I did try it one last time when I was severely mixed and had been for months, just before I went on clozapine. My pdoc wanted to be sure we had tried everything before committing to the clozapine. It did nothing and the dose had to stay low because of my history. If another situation arose like that I'd try the tiny dose but I hope it never does.