Hey there! I feel your pain. Going on the psychiatry carousel can be a wicked drain. As you've mentioned, you have to experience potential side-effects, the medicine not working or getting worse than when you started. So, it's my opinion that this is really something that you want to work out with a specialist who knows you and your history. We can advise on the safe use of drugs, how to withdraw etc., but I think it might be unethical to recommend medications for a condition as complex as this.
I will leave this open, but I would appreciate it if people could just share their experiences as opposed to actually giving medical advice. I'm totally out of my element on this, but have you heard of this drug called Cariprazine (Vraylar)? It is an atypical antipsychotic with the typical claim of improvement over previous drugs in the class. From what I have read, a lot of people have reacted well to it and it's being investigated as a treatment for Major Depression. That might be worth a try. It is used for mixed episodes of mania and depression.
Quetiapine (Seroquel)? Another atypical antipsychotic. I have personally taken it for sleep a handful of times and never noticed any side-effects that I would call overtly negative. I believe Quetiapine is well-known for its tolerability.
Carbamazepine (Tegretol) I guess this is more of an adjunct treatment, but apparently a lot of people have found success with it. Perhaps you could incorporate this and the quetiapine. I think no matter what, it's going to be a lot of trial and error finding the right treatment.
SSRI's and other antidepressants have been demonstrated to increase depressive symptoms and cycling. Can I ask how often you are hypomanic? Are you functional when you are in an episode? Do you use and drugs? I hope some of this helps, but it's kind of a shot in the dark from me
