I can't speak to Zyprexa on a personal level as I've never taken it. Generally, when I've started a new med, I've been told to give it a few weeks to see whether or not it's effective for me. Meds are tricky things though. You might find out very quickly that it works great. You might find side effects. Sadly, it might not work at all.

For me, it was trial and error finding the right meds to manage my condition, but once I found them... it was a beautiful thing! I've got my two maintenance meds that I'll be taking into perpetuity, but if needed for an acute manic or depressive episode, there are other meds I can take as well. I'd wager your wife will end up with a similar setup. What those meds will be, I obviously can't tell you.

As far as the rhythms of the illness go, each person has their own particular response to it. The severity of mania and depression, whether or not you go into mania or depression or just go to baseline and even the time of year are all contributing factors to each person's presentation of the illness.

"Relapses" can happen, but the overarching theme would be management. In my experience, finding the right mix of medications, therapy, coping mechanisms, support and more can mitigate the severity of those relapses and Bipolar in general. The trouble is finding that mix.

Hope this helps! All the best to you and your wife!