Not entirely sure how effective ECT is with manic symptoms, but if you/ your pdoc find evidence to back it, I’d say go for it. If I were stuck in an episode (not rapid cycling but in an actual episode and told ECT can bring me out) I’d do it again in a heartbeat. No akathisia, no weight gain, no risk of liver or kidney failure, no prolonged qt intervals, no diabetes. So I need a ride to the treatments and can’t drive a few days a week annd get some headaches, and need a gps the other days, big whoop.