This is supposed to be used as a last resort and when it is used that way I think it is a great drug. It does require some extra committment; the first 6 months there are weekly blood draws and the 2nd 6 months every other week. After that it is monthly as long as you are on it. Honestly this takes about 5 minutes per month most months and is no big deal at all. I did have to find the fastest lab during my first months on it but that made it much easier.

Side effects for me are weight gain (but I lost all of it plus some with metformin), drooling at night, bed wetting (so I wear an incontinence pad and then it's not a big deal), and fatigue.

Benefits are the closest to stability I've had in my life, no hospitalizations since I was discharged from starting it, a tiny increase kicks mania down completely in a couple of days, I don't need a high dose to do well.

Totally worth it for me. I love it.