It's not bad - I had the shakes when I first started taking it, and you HAVE to take it with food or it'll go through you like a freight train, but it's not as bad as some of the stuff I've been on, and it works better than most, especially with the lamictal. (At least I don't hear the voice of God - or go dancing naked down the street in the velvet moon light, just in front of the cop car )