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My difficult child trialed Lithium last year and was monitored with blood draws.  It did not work for him (no side effects though) and at the time he was also on Abilify.  He is currently on Depakote, 7.5 of Abilify, Straterra and Tenex.  He has done better on the Depakote and still is monitored with blood draws.  He actually looks forward to them - go figure!