Lithium is a miracle drug -- ask any person with bipolar disorder (like me) and they'll tell you what it has done for them or a bipolar they've known. Newer drugs like valproic acid (Depakote), Tegretol, and antipsychotics like Geodon or Risperdal have been tried; but for something like 2/3rds of the bipolar population lithium is king for mania control.

That said, Lithium is extremely toxic as metioned above and MUST be used in conjunction with a psychiarist's supervision and very frequent blood tests. Tests frequently include not only a "lithium level", but also tests for thyroid (TSH) level and control to rule out hypothyroidism, somewhat common in people on lithium maintenance. Also, many times a doctor will include a creatine level, a marker of renal ability. Fasting blood tests are an annoyance, but time spent at the lab is better than lapsing into coma, seizure, possible brain damage, and death from a through-the-roof lithium level.

In my case, and in most cases I suspect, the use of alcoholic beverages while on lithium is prohibited. This has not impacted my social life (at 24) but for some this might be a hinderance. Alcohol disrupts the effect of lithium, which the body cannot handle at the same time as alcohol.

I suffer from involuntary tremor in my hands, which can be controlled through certain supplemental medications that I choose not to take. I am less concerned with cosmetic issues. The jury is still out on renal dysfunction and permanent damage with the lithium alone, so I am not eager to take yet more medications if I can live without them. All in all, lithium has given me my life back, even if I will never be able to properly handwrite again.