I really hate playing the medication game. I know I'm not alone in this. It's even harder when you aren't familiar with a new psychiatrist. I don't know if I should trust this guy or run screaming from his office. I had all 3 difficult children tested by a neuropsychologist at the end of July and this is what he thought: difficult child 1 (11 yrs):ADHD, Asperger's, Major Depression he put "maybe bipolar" Behavioral Observations: mood was dysphoric, affect seemed mildly labile? (what is that!?) Visual Motor Skills he scored in the 18th percentile which put him at a 8 yrs 4 mth age. difficult child 2 (10 yrs):ADHD, mild mood disorder difficult child 3 (7 yrs):ADHD, Asperger's, sensory and developmental delays that in his words were "indicative of an austistic spectrum disorder", and he felt some ODD traits as well I gave his reports to the new psychiatrist and the new psychiatrist believes that you must balance the moods out prior to taking care of ADD/ADHD. I AGREE with this part. However, he seems to think all 3 difficult children are bipolar. This, I DO NOT agree with. I can see it in youngest and oldest, but not middle. The new psychiatrist thinks many of middle difficult children ADHD symptoms are actually bipolar. I guess he could be right, I don't know everything there is when it comes to both DXs. Okay, now to the medication game. Last year, all school year, here are the medications my kids were on at different times, with all different levels, but the highest level is what I posted. Youngest difficult child-25 mg Seroquel, 50 mg Zoloft, 40 mg Foclin Middle difficult child-25 mg Seroquel, 50 mg Zoloft, 20 mg Foclin, 40 mg Straterra Oldest difficult child-200 mg Seroquel, 200 mg Zoloft, 80 mg Straterra Youngest difficult child was also on an extremely strict diet for what the old psychiatrist diagnosed as "reactive" hypoglycemia. Well, we had him go through another glucose test with the GP and he says he doesn't see hypoglycemia or diabetes, but if he were leaning towards either, it would be diabetes. I'm waiting for husband to get him into a pediatric endocronologist. But as far as medications went for him, his behavior got better than worse. Middle difficult child went from being a sweetheart who would do anything for anyone, to a total jerk. He would get mad at the simplest things and get loud. His fuze was the size of a matchstick. Speaking of his fuze, I just heard him go off on one of his brothers in the other room. husband is home so he handled it. As for his grades, they improved dramatically and he went from struggling in class to very high A's in everything. Oldest difficult child was still arguing with teachers. Very disrespectful at school. He would leave places the teacher sent him and everyone in school would be looking for him. He would get in arguments or shoving matches with other kids. He and his brothers hardly ever got along. However, he was getting good grades. Not high A's, but middle-low A's and high B's. Over the summer we took all 3 off of everything. But even after removing middle difficult child from medications, I didn't get the same old kid back. School is now 6 weeks along. Middle difficult child and oldest difficult children grades are lower than usual. Very low B's. Which makes me think that the Risperdal isn't enough. But I also think it was the Staterra that was causing middle difficult child to have such a short fuse. Well, guess what psychiatrist added? Straterra! 40 mg for middle difficult child and 80 mg for oldest difficult child. He also upped the dosage of Risperdal for all 3 boys. He wants youngest difficult child on .5 mg in the morning and at night. Middle difficult child on .5 mg at night. Oldest difficult child on 1 mg at night. Oldest difficult child is also more argumentative with me and his teachers since starting risperdal. Middle difficult child is actually more off task and also disrespectful to teachers at school since starting risperdal. Youngest difficult child is still having trouble staying on task at school. His teacher thinks he shows more signs of ADHD. The psychiatrist doesn't. He thinks he needs more risperdal to balance out his moods. This new teacher is much more structured than any other my youngest difficult child has ever had. He isn't having the same behavior problems he has had in previous years. I don't know if I should attribute this to the risperdal or her structure. At home this weekend he broke down in tears because his sister didn't want him to play a game with her and middle difficult child. Last Thursday he broke down in tears because he moved the ottoman on top of his foot, but he had his shoes on and the ottoman isn't heavy. I put a bandaid on his knee because he has been picking at a scab for more than a month now and I want him to stop so it will heal. Well, as soon as he got the bandaid, out came the drama. The scrape is more than a month old and he started limping when he got the bandaid. I think he's picking at the scab to keep the boo boo so he gets sympathy. He picks at it at night and I asked his teacher to watch for it during the day. I think I'm going to start putting a HUGE bandaid on it at bedtime and taking it off in the morning. I'm not sure if it will heal under the bandaid, but I don't know what else to do. I have no idea what to attribute any of his improvements to. I feel like I'm nit picking because compared to his past behaviors, this isn't much. I mean, he's not chasing kids around with scissors. He's not urinating on anyone in the bathroom. He isn't exposing himself at school. I guess my issue is I have no idea what is working. The structure or the medications. If its the structure, then he doesn't need the medications. But how exactly do you make sure he always has this type of structure at school? And why on earth was his bad behavior so bad just because it wasn't structured? It's not normal to chase others with scissors, urinate on others or expose yourself, is it? My 2 PCs never did these types of things. But why suddenly is youngest difficult child not doing it? And if he is still having problems with staying on task and focusing, is upping the risperdal going to fix this or does his teacher get another month of him out of focus and off task? I'm babbling. If you made it through you deserve a reward.