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When a new musical ends up on Broadway, chances are it’s been road-tested either in an out-of-town tryout or an Off Broadway warm-up.

Next to Normal” took an idiosyncratic path to the Rialto: It got both.

The $4 million tuner, opening April 15 at the Booth Theater, first played Gotham in an early 2008 run at Second Stage that raised commercial expectations. But the show made an unusual detour to a regional, Arena Stage in Washington, D.C., for a wintertime run that helped give creatives time to significantly rework the material.

The New York return of the ambitious, small-scale musical, a six-actor show starring Alice Ripley as a woman battling bipolar disorder, caps a development process that has seen creators Tom Kitt (music) and Brian Yorkey (book and lyrics) rethinking and retooling for about a decade.

It also lands the show in a Broadway season that has no shortage of large-scale new tuners (“Billy Elliot,” “Shrek the Musical,” the upcoming “9 to 5”) and revivals (“West Side Story,” “Guys and Dolls,” “Hair”) that could threaten to overshadow an intimate show with a more indie sensibility.

Such underdog fare has been scarce this season: So far, the list includes the summer’s long-departed “[title of show]” and “The Story of My Life,” the short-lived two-hander whose quick demise at the Booth opened up the venue for “Normal.”

But creatives of the show, including helmer Michael Greif, and producer David Stone — who scored a Tony-winning hit with the similarly small-scale “The 25th Annual Putnam County Spelling Bee” — are hoping the improvements made over the atypical development process will lend “Normal” some unusual staying power.

“At Second Stage, we agreed we didn’t quite know what the show was yet,” Yorkey says. “The process has been making it more and more about the characters, and less about a bunch of ideas.”

The storyline follows Diana (Ripley), a wife and mother whose manic depression unsettles her relationship with her family, played by J. Robert Spencer as her husband and Jennifer Damiano and Aaron Tveit as her teenage children. (Ripley, Damiano, Tveit and Adam Chanler-Berat, also reprising his role on Broadway, all appeared in the Second Stage and Arena incarnations.)

“Next to Normal” originated in the late 1990s as a 10-minute musical that was a first-year final project for the BMI Music Theater Workshop, in which Yorkey and Kitt were enrolled.

Early full-length incarnations were seen, circa 2002, in concert readings at the Villager Theater near Seattle and in Gotham at the Cutting Room. A grant in 2004 prompted further work that led to a summer 2005 stint in the New York Musical Theater Fest.

Stone saw the show at NYMF and brought it to the attention of Carole Rothman, a.d. of Second Stage, the org where “Spelling Bee” originated. After more developmental sessions, Greif (“Rent”) was brought onboard in 2007 to helm the Off Broadway run, steering the growth of the piece more toward the characters’ emotional lives.

At NYMF, the tuner was called “Feeling Electric,” after a title song involving electroshock therapy — one of the treatments Diana experienced.

By the time it played Second Stage the musical had been renamed “Next to Normal,” but the song “Feeling Electric” itself, a rock anthem about electroshock, remained. That number, along with a tonally confusing segment about Diana’s mental breakdown in a Costco, became two of the jarring elements most often cited by New York critics and auds.

The creatives didn’t disagree. “Some of the things we had talked about were echoed by what the critical community was telling us,” Greif says.

The Costco number was cut during the Second Stage run, and the success of that decision prodded Kitt and Yorkey to re-evaluate everything about the show.

Because Stone had partnered with Second Stage to move “Spelling Bee,” legiters were eyeing “Normal” as another potential Rialto candidate. “There was a lot of commercial expectation it would transfer,” Stone says. “By going out of town, it seemed like we would take any expectations off the table and just do our work.”

Kitt and Yorkey did the bulk of rewrites during the run-up to the Arena engagement, with a total of nine songs either dropped or replaced by entirely new tunes. Among the casualties: former title track “Feeling Electric.”

Strong critical reception to the reworked version that opened in December at Arena helped restore the tuner’s Broadway momentum.

While creatives have continued to fine-tune the show between Arena and Broadway, marketing in Gotham plays up the elements that make the tuner stand out on the 2008-09 slate — notably its subject matter and intimate emotional focus.

“The show fills a need among the season’s musicals,” Stone says. He adds that sales are pretty good, given that the musical is a largely unknown property despite its prior incarnations.

With opening night fast approaching, the natural question for the creators becomes: Is it finished?

“I think so,” Kitt says.

“For now,” Greif adds.