So here's what he said (and I'm thinking it may be time for a new psychiatrist-not sure): Seroquel 50mg am and 100mg at bed Lamictal taper over 7 weeks up to 100mg (but he is concerned that it works best on depression and difficult child is mainly manic) Lithium continues 300 twice a day, at least until we see him again at the end of May. He actually wanted me to increase the lithium again in addition to the increase in seroquel and adding Lamictal--I was like the tremors, bed wetting, fogginess, and headaches are not acceptable, he said "and this is?" pointing at difficult child hiding under the chairs in the office saying that she hates me. He also says he thinks it was probably the Abilify, but I don't think it was just the abilify. I just feel like he has no idea with this is like--to be the parent of a difficult child. I mean she is 8 years old!! She should not have noticable tremors!!! That's just not okay. Bipolar or not she is still a little kid!! There has to be another way. And psychiatrist...well, honestly and I know it's wrong, is a man and maybe he can't understand being a mother at all. I got her to bed tonight only taking 1 hour instead of the 1 1/2 of last night. This morning was the worst yet--constant physical management to get through every single step of the morning. I am really hoping for better days!!