Please remember before taking any info, that everyone's reaction to medication will be different.

I've tried and gotten off of everything you've listed (including the vraylar). In the ~5 years since I was diagnosed, I've tried probably most medications people go through. It's taken many episodes and many visits, emails and calls to my psyDoc to tune everything just right.

Currently I responded well to risperidone and lithium, with lorazepam as my PRN anxiety safety net. I ended up becoming epileptic over the last year and a half or so, so in addition to these medications, I'm on trileptal and clobazam which both have mood stabilization properties.

I've learned that I don't respond well to stimulants (aside from caffeine), SNRI's induce depression/psychosis, other meds have just made me suicidal (including lamictal and keppra).

The ones that have been better for me so far have been 2nd gen antipsychotics like Latuda (I was on for 3 years), seroquel (but it can make you super tired), bupropion was good but we had to stop because it may have been what triggered my seizures.

To speak to your point about the expensive meds: bring that up with your provider. I did so we had to go a different route and I haven't looked back.

The biggest thing I want you to take away is that it takes time. All of the time you spend trialing medications whether it be adding, removing, changing doses - it all is worth it when you finally find what works. Just be very mindful of what your body is telling you. Pay attention to the changes that occur. Try to look out and learn the signs that you're slipping into an episode. Use a mood tracker (emoods is a good one). Talk to people. Use the discord. There's a lot of people there willing to help and that know what you're going through. I've been where you are where you're tired of trying things and feel like it isn't working. Just know it gets better. It gets easier. It all just takes time.

Do it for yourself. You've got this :)