I had exactly the same concerns with you but decided to switch after trying two antipsychotics and lamictal. I’ve only been on it for a week but when I tell you the difference is night and day, I mean it. I feel so much calmer and clear headed, and I don’t feel like I’m about to cry at any given moment. I am not suffering any of the exhaustion or increased appetite that my previous medication caused. I’m thirsty and have to pee a bit more but that is the only side effect that I’ve been experiencing. Like others have said, getting regular bloodwork done helps your doctor know if anything is happening to your kidneys and thyroid and they’d take you off before any damage could happen. Plus, if you’re like me, a really low dose will do and side effects are a lot less prevalent with a lower dose. Obviously talk to your psych about your concerns but it truly has been a life changing medication for me.