I finally feel like I am getting on the same page with the p-doctor...almost. A little background, my difficult child was diagnosed bipolar in kindergarten, rxed Zyprexa, at higher dosing it seemed to cause problems but was helpful at a low dose. P-doctor left the place we go to. New doctor,discontinued Zyprexa, tried stims, we tried Concerta and Adderall..makes him more aggressive, mean. The p-doctor left the practice with no timeline on when a new one would be found. Finally we stop all stims and start fish oil on our own. We had an ok(not great) 2nd grade school year. My difficult child started to talk of wanting to die during his hissy fits so I took him to another place to be examined. They added ARND to his list of dxes, didn't offer a p-doctor, gave me a script for Zyprexa short term and sent me back to the place I started at. There was a new p-doctor in place. At first I liked her but then she starts with the he has ADHD stuff and so we trial him on Focalin. This time I put it in writing in his report that he tried to shut a garage door on his older brother becausde he didn't win a game, along with other stuff and he was taken off of the stimulant. At this visit she listened to us both, I have permission to increase the Zyprexa and we will consider Lamictal if it doesn't work. She is seeing some anxiety and wants to give anti-depressants but understands and actualy agreed that they would be risky for him. I said I would consider anti-depressants after we trialed mood stabilizers and she seemed to agree. I am hopeful that the simple increase will be enough for awhile but if it isn't at least we seem to have a plan. Now if she leaves this place I will scream.