I've always been hesitant to use ADs, partly because of the risk of mania and the limited evidence of effectiveness in bipolar, and partly because the side-effects are scary to me (in general, any meds with sexual side-effects are a no-go for me, and I'm also afraid ADs will make me too "flat"). I feel more comfortable taking my chances with lithium, Lamictal, or even ECT. I did try bupropion, once, but all it did was make me very irritable and give me insomnia, high blood pressure, and tachycardia. I went off that med as fast as I could.