Have you tried clozapine? Nothing worked for me for more than a few months of decreased symptoms until I went on it. Now I have had a few moderate episodes but no severe ones, no big mania, no big mixed episodes, no severe depressions, in just over 2 years.

It takes commitment to do blood draws weekly for 6 months, every other week for 6 months and then monthly for the duration of treatment but it's now such a habit that I don't remember not doing it. Some side effects are frustrating but that's true with all meds. Weight gain is supposed to be bad but I've gained only 10 lbs. and have lost that plus another 12 lbs.

I was scared of it but aside from a few side effects I don't even notice I'm taking it, much different than high dose Seroquel which is the only med that did much before.