I think it is reasonable to at least try without an AP. I tried every AAP there was except Zyprexa and Seroquel in the course of 2 years or so in the mid-2000s. Zyprexa we saved back because I have a scary family history with diabetes and after working at a place where the pdoc used Seroquel to snow people I was terrified of the drug. So except for a few months on Geodon before getting EPS I was only on stabilizers for quite a few years with a few days of APs that failed. Finally in 2007 I had to try Seroquel (no more reasonable stabilizers left?) and I found out that it did not mean being snowed. When XR came out I begged to go on it and was on it before the pharmacies were even stocking it and that turned things around for me. I then got off Depakote and onto Emsam and had my first fairly stable months ever. So that story does end with the AP making it better but I did ok without one for quite a long time too. I was working full-time. I was off on disability twice and then again when I started Seroquel. I didn't get fired from a job until I was on Seroquel so my work may actually have been better before Seroquel (or I had better jobs; take your pick. i actually think being fired twice was partially related to those 2 jobs I wasn't supposed to be full-time but they needed someone full-time and couldn't find someone for the 8 hours I didn't work so it was dumped on me and then I couldn't keep up well. plus I was not a perfect employee. And one job had a long hx of firing people and replacing them with cheaper new grads which I obviously did not know before working for them). But anyway, rambling. Point is that I did ok and you might too. Especially if you can control anxiety.