What works better for bipolar disorder: Lithium or Depakote ER?

(a) Lithium
(b) Depakote ER

Which works better for the following symptoms - Pair letter with number.

(1) Rapid cycling (which is what I experience)
(2) Bipolar 1 - experience less of the depressive side
(3) in terms of liver/kidney safety.
(4) anger

I am currently on 500mg Depakote ER. I find that I am cycling less often, but my manic episodes are of the same intensity as before..

Should I up my dose or switch to Lithium? Supposedly my doc says up to 2500mg Depakote ER is safe...

Lithium works well for my manic type symptoms. Depakote quelled the cycling. It's possible that I could take more Depakote and stop the Lithium, but Li gives me no appreciable side effects whereas Depakote does. What works best is what works for you.

Lithium is the best at protecting your brain, so from that perspective it definitely is the best med to be on if it works for you. Since it's been used for so long, how to manage it is well known and it is one of the safest. However, Lithium is not known as being the best at rapid cycling. Long-term (i.e. 20 years) kidney problems can crop up.

Since you have rapid cycling and are already on it, I'd up on the Depakote until you have side effect problems or are near the max w/o adequate efficacy. You do have a ways to go since 500mg is a baby dose, and you can always add on Lithium or another med. Dep, however, messes with your liver (I think) and other body systems. It's not the nicests of the stabilizers in that regard, particularly for women.

Both meds require routine full blood panels to monitor for problems before they become real problems.

If anger isn't resolved with end of hypo/mania, therapy is needed.

All I know is that I have been pretty much mandated to stay on lithium for the rest of eternity. I don't do GREAT while on it, but I do a hell of a lot better ON it than OFF it. Depakote has never been mentioned. Anyway... lithium has done well for me, although the lower the dose the more manic-y I am, and the higher the dose the more numb I feel.

my husband is on lithium and it works great for him, downside is he's on 900 milligrams, so he has to take 3 pills a day ( they only come in 300 mg), his dr. paired the lithium with cymbalta, and it tackeled his anger and depression, it also spaces episodes farther apart until they disappear alltogether, lithium is pretty safe, the only side effect may be small tremors when first starting

I was put on depakote and thought it was great, I never used lithioum but found that it can be a little "dated" try both and find what works best......