I suppose one needs to be free and clear of substance use before further evaluation and testing to rule out bipolar disorder can be considered? Our son needs to be evaluated further since he has had periodic extreme behaviors (I have already posted about all of this previously). Stopping his Vyvanse and sertraline awhile back seemed to help (checked with psychiatrist first). The only prescription medication he is on presently (just started a few days ago) is trazodone for sleep issues and it seems to be helping him. I read the information that came along with it and am watching him carefully (side effects, etc.). He claims to be and it appears to me that he is not presently using. Today was a good day for us and I enjoyed some time spent with him earlier this evening.