I know what it is like having numerous medications and high doses shoved at me during dire times. That polypharmacy is getting more common, and I think is sometimes necessary, and other times just some desperate effort. I agree with you that mixed states are complex enough to often require an army sicked at it. However, I don't think huge cocktails are always necessary.

I actually regard my current cocktail (below) as relatively small. At one point I took Lithium, Lamictal, Tegretol Geodon, Navane, Seroquel XR, Klonopin, and Ativan all at the same time. I still want to cut out unnecessary medications even in my current smaller cocktail.

I have always wanted to see a lecture by Kay Redfield Jamison. From what she has presented in other lectures, she is only taking Lithium, and a moderate amount at the most. Is that still true? I wish I knew. She says she has "classic bipolar type 1", and yet in her memoir she describes a couple major mixed episodes. Many of her lectures to the public are just her reading from her book(s). If I was there to ask questions, she'd have some unexpected ones to answer. Not Intro to Bipolar Disorder 101 stuff.