Not that I can help much because I an not familiar with state insurance, but I can tell you about serequel XR. It works for alot of people to control mania, but the higher the dose the more of a zombie you will have. I know this for a fact because I was a serequel addict so to speak. I took more then double what your dd takes and was so out of it and all I thought about was sleep, being alone and basically after a point use it to escape the world. That was my experience and after winding up in the hospital and them redoing all my medications, I am now a usually pretty stable functioning person. Your dd seems to be showing similar signs to my reaction, so I would definately get with the psych and tell them she is not functioning and is still have frequent manic attacks. One thing though, your dd is an adult so she really needs to get in there and let them know what is happening if she hasn't given you approval to speak for her. They will want to talk to her and she needs to be honest. You didn't mention if she is active in her treatment or if she feels like this a problem. I personally never say it as a problem. I was escaping everything and could care less and neglected everything. If she wants to up the dosage with the results that your dd is having, I would have a sit down and or find a new doc with a new approach. I can tell you that living without being a zombie and being more stable is possible. My old pdoc just wanted to up the dosages, especially of the antipsychotics. My new pdoc has me on a whole new program, so finding the right doctor is the key. I am a new person, good mother, great wife, and a "normal" person or at least what can be expected. If you get someone to get her off the serequel, don't be surprised if she tries to get it back. Thats why I say I am a serequel addict. I would take it in a heartbeat. My son has his locked in a safe so I can't get it. It is like my heroin. But that is me. It has helped alot of people. Hopefully others will share their experiences with you. Best advice...get with the pdoc about a change and if you don't get satisfaction look elsewhere. There are lots of meds that in my opinion that are less damning. My psych team at the University Of Chicago says the first line of defense for a bipolar is a mood stabilizer like Lamictal and an anti depressant if it doesn't cause mania. Everyone has a different combo that works for them...here is my combo
100mg Zoloft (anti depressant)
400mg Lamictal (mood stabilizer)
Ambien CR (to sleep)
before the looooong hospital stay I was on huge doses of 11 different meds. It's funny how I fought the docs about taking such a small amount of medication after having taken so much for so many years. But let me say, new docs, new meds make for a very happy new person people haven't seen in years.Don't know if I helped any but you need to do whatever you can to help your dd. Be persistent and united. Don't be afraid to speak up and disagree. It is your right and your dd's right. Good luck
If We Couldn't Laugh, We Would All Go Insane :)