What about reducing meds and adding a non-medicinal approach, such as (maintenance) rTMS? I have no idea whether this is what you're looking for or if your insurance covers it, but thought I'd mention it anyway. TMS is supposed to have similar benefits to ECT (though with somewhat lower effectiveness), with few if any side effects. It's known to work for depression and there's also some evidence it can treat/prevent mania (which would make sense to me since ECT can do that also).