I feel with mixed episodes it is so hard to get the meds right.... at least for me. Seroquel sometimes helps on a high dose. For me, I also stay away from Depakote, because of the weight gain, although it seems to be a good anti-manic. Lamictal works to a point in conjunction with other meds. I have to stay completely away from SSRI antidepressants and Wellbutrin, or it will send me into a terrible dysphoric mania. Usually I find I can get some relief from mixed episodes, but I have to ride it out, and eventually it runs its course. Sometimes my pdoc will put me on two antipsychotics at once, although this is generally discouraged based on side effects like QT prolongation (never experienced any issues with it though). It helps a little bit with mood stabilization, although I still struggle.

I was never on Latuda, but I'm afraid to take it since I hear a lot of people get more restless on it than Seroquel that I'm taking. Benzos help too, like Klonopin, but I have to be careful not to go overboard with them when in a mixed state.