Not sure what to do now......


New Member
Bradon is 6--we have been on this road since 2.5. 6 hospital visits since May of last year(maybe May is not our month?) and well...after 3 weeks of stability...we are on a BIG downward spiral! In fact, today is the first day I have seriously thought about Residential Treatment Center (RTC). I just dont think I can do this all summer long....I have 3 other kids to deal with as well..and he is sooo mean to them. He has not slept in 4-5 nights, and is bouncing from angry to hyper and no impulse control ALL day long. Starts as early as 4 am and doesnt end...

So....any thoughts?

by the way--we are to have a medication level check in the am.

Current medications:

Depakote 750mg BID
Topamax 50mg BID
Seroquel 250mg PM ONLY


Well-Known Member
Has he seen a NeuroPsycologist and is he getting treatment for his Pervasive Developmental Disorder (PDD)-not otherwise specified? If not, I doubt an Residential Treatment Center (RTC) can help him. The Pervasive Developmental Disorder (PDD) issues are probably frustrating him to no end and they don't know how to help him at RTCs--that's for behavioral, not neurological disorders. Pervasive Developmental Disorder (PDD) kids don't respond to normal behavioral methods either. Some respond well to antipsychotics--my son is better off medications. Trust me, he used to rage a lot; he doesn't have behavioral issues now. I would look into this before considering Residential Treatment Center (RTC) for such a young kid who is on the autism spectrum. My kid was diagnosed bipolar too. He's not. Often autism spectrum mimics bipolar and can fool even a child Psychiatrist. I'd get a fresh evluation and find out what sort of autism interventions can help him. Pervasive Developmental Disorder (PDD)-not otherwise specified kids don't really "get it" (socially or life-wise) and from experience and in my opinion I don't think an Residential Treatment Center (RTC) will attempt to help him in the way he needs it. If he has bipolar too, and REALLY has it, he should be on a mood stabilizer... JMO


Active Member
Something to consider - ANY kid, especially one with Pervasive Developmental Disorder (PDD) from my experience, who is sleep-deprived (unable to sleep for whatever reason) is likely to be a handful. We went through this with difficult child 3 when he was 5. He'd been put on Zoloft (to try to calm down some of the ADHD behaviours) and he went very strange. He seemed to improve immediately but he wasn't sleeping. As the sleep deprivation kicked in, the problems grew rapidly worse instead of better and we took him off it after about three days. But what we saw looks a lot like what you describe. And I put ALL of it down simply to difficult child 3 not sleeping.

Is there a chance this could be a similar medication reaction? difficult child 3 has a number of paradoxic reactions to medications, especially antidepressants. If he had something like that, unrecognised, and he was still on the same medications months or more later, then I hate to think what sort of chaos it would be causing in his head and in his behaviour.

Basically, continual insomnia causes the most appalling and cumulative behaviour problems.

Just a thought, anyway.

Another idea, from our local child disability group - there is a little girl we know, seemingly normal in appearance and behaviour (when she's awake) who gets really manic at times when she IS awake, and often at times when everybody else is trying to sleep. Her mother has been frantic for answers, literally for years - they finally found out this little girl has SEVERE obstructive sleep apnoea, she's scared to go to sleep because she's constantly suffocating and has appalling nightmares. When she DOES sleep, though, it's almost round the clock and she can't be roused. Very scary.

In this little girl's case, her tonsils aren't in good shape (and hence hr adenoids are probably not good either). When they looked at her adenoids they found they are seriously enlarged, contributing to the obstructive airway problems. I'm not saying your son has this, or even to the same degree, but it could be another contributing factor.

Is there a sleep disorders clinic you could contact? You can't live without sleep. Neither can he. This is urgent. You need help and I don't think it's Residential Treatment Center (RTC) that you need, at least as a first port of call.

Good luck. This is a nasty one.


Hound dog

Nana's are Beautiful
Yep. If T goes without sleep the entire house suffers. It's always been that way. And T for many years had trouble getting to sleep.

I'd pay a visit to a neurologist if you haven't seen one yet. I know, yet another doctor, but if you can find one who is familiar with autism then he can give you alot of helpful tips. I was lucky and stumbled onto one via Children's hospital when I took T to the neurology clinic. His neuro also happened to specialize in both Tourettes and autistic spectrum.

T had to use melatonin for many years to sleep. It's an over the counter dietary supplement that doesn't react with medications. (You're body makes this itself to induce sleepiness) Lucky for him this worked or else we'd have probably tried something else for sleep.

T also didn't do well with medications. They made him extremely worse.



New Member
Yes--we have seen a peds neuro--had the awake and sleep deprived EEGs and an MRI. Also saw a peds neuro surgeon who confirmed a small chiari malformation, but confirmed it had nothing to do with his issues and needed no further treatment.


New Member
A neuro-psychologist, I dont believe so. We have new appts back in our state(had been traveling out of state for services for the past year) in June. I will ask. Of course the psychologist who heads our team says he is not stable enough to add anyone new to the picture at this time.

I was interested to hear your take on the Residential Treatment Center (RTC) though..thanks. I really let the Pervasive Developmental Disorder (PDD)-not otherwise specified diagnosis lay far back and concentrate on the BiPolar (BP) first and foremost because his safety comes into play. In fact, I think we have had this discussion

And, I was under the impression the Depakote WAS a mood that wrong?

Thanks for all your help!


New Member
medications have never really helped him sleep. Even strong medications like Ambien, Lunesta, Trazadone....they all get him to sleep for a bit--then the ugliness rears its head! Benadryl is a nightmare!

SLeep apnea was a major issue...we did have his tonsils removed at 2 and didnt see much improvement...his weighted blanket is what helps some at this point.

Last night was really rough. He went to sleep fairly easy..but then was up about 2 hours later with his legs flailing out and whimpering. If we touched him he shirked away and curled into was pretty much a restless night with alot of awakenings.

Thanks for your suggestions!


New Member
Melatonin did nothing for us for several days, then seemed to acitivate him. His tolerance/reaction to medications is really strange.

Thanks for your suggestions!


Depakote is a mood stabilizer, but at high doses can cause more irritability. I'm wondering if that's what's going on. That's a pretty hefty dose for a little guy. Did the blood draw today measure his Depakote level?

For a child with both Pervasive Developmental Disorder (PDD) and BiPolar (BP), interventions for the Pervasive Developmental Disorder (PDD) are just as important as medication managment for the BiPolar (BP). I'm sure it's difficult to tell, but some of his behavior could be attributed to the Pervasive Developmental Disorder (PDD) instead of the BiPolar (BP). Maybe working with a developmental pediatrician in conjunction with a child psychiatrist would help.

A neuropsychologist does intensive testing over 8 to 12 hours so it is not really adding anyone new to the team. It is getting
a picture of what's going on from the standpoint of cognitive and psychological functioning. in my humble opinion, very worthwhile.