It really depends on what symptoms are predominant (mania, agitation, depression, etc.) I'm agitated depression (mixed) and have found very little for relief after at least 40 meds, ECT. Had a brief breakthrough w/Paxil ('96) but wore off by 2000. I've tried several things that gave lots of relief for only 7-10 days (zyprexa, ritalin). Tegretol evened my moods and racing thoughts well but side effects were intolerable. Lamictal, lithium, depakote, nardil, zoloft, navane, trilafon, mellaril, haldol, stelazine, wellbutrin nothing.