Well, difficult child has been so out of control, we went back to the patch for a while. Mother in law is visiting, and they bounce off each other. So far it has helped tremendously, and no rebound or appetite affect yet. I do think we need to up the lamictal as after we stopped the patch the last time I saw improvement in appetite but not in mood stability. I am confused, and psychiatrist is out of town untill 8/29. I just do not know what to do.