Switching to Vraylar for Mixed Mania - Thoughts?

I'm very similar to you in that regard (BP 1 with a history of full mania but present mostly as BP2 with long depression and rarely hypomania). I'm actually on Vraylar right now (I think now for the 3rd time). I'm on 1.5 mg which is the recommended dose for depression (max 3 mg, higher doses generally for mania). I like it. Its side effects are pretty benign. No weight gain. Akathisia is pretty common at first so watch out for intense restlessness (your doc can prescribe you something like Cogentin or Artane to help with that if it happens). The first time i took it i did have some rather annoying RLS-like symptoms at night. It takes a VERY long time to build up in your system because it has such a long half life, so it's good that you're already on something like lithium to keep you stable. Endearing tales huh? 😂 I'll say that I've been on just about every atypical antipsychotic except a few and many of the first generation antipsychotics. Of these, I've found that the best ones for my mood (primarily depressed) are Caplyta, Stelazine (an oldie but a goodie), Abilify (which unfortunately causes compulsive spending behavior in me and caused me to rack up over $12,000 in credit card debt), and Vraylar (in that order starting with the best first). Caplyta actually got me out of the deepest rut of my life when i was in horrible circumstances at home during the lockdown of COVID and got me working again. I'm kind of thinking about going back on it if I get depressed again after the ketamine infusions I'm doing right now (have my last infusion next week). So if Vraylar doesn't work for you, I would definitely recommend giving Caplyta a try.