difficult child just turned 11 last week, and had a pretty stable 18 months since his five months stint in residential in 2007-2008. By stable I mean no physical violence towards people and no auditory hallucinations. We've had the usual impulsive behavior, food gorging/hoarding, lots of lying, and unless I'm looking right at him, he does whatever he wants with no regard for the rules. But he hasn't hurt anyone or threatened to hurt anyone, so I'll take what I can get. But he's been spiraling down the last several weeks. Lots of regressing back to crawling on the floor barking like a dog, spitting, eating paper, kicking and stomping and throwing, screaming that he hates everyone and wishes he was dead. Got in school suspension for spitting on a classmate last week. There have been a couple of triggers/stressful situations he's been coping with; his sister had surgery, and his absentee parent who hasn't seen the kids in over a year called with the news that his wife is pregnant. But he's not coping well at all, not utilizing any of the coping skills he learned in therapy or in the hospital. Just regressing back to the really scary behaviors that had me convinced a few years ago that I would never reach this boy. Anyway, I think it's possible he needs a serious medication adjustment. He's been on Seroquel for three years and the seroquel and adhd medication are the two that have had the most meaningful and positive impact on his behavior. I'd go so far as to say difficult child was downright feral before the Seroquel. But I think over time it's losing its impact. He's not sleeping as well at night, seems restless and anxious for much of the day, then giddy and uninhibited, short tempered and completely inflexible thinking from about 5pm on. He sees his psychiatrist tomorrow and I've been doing some reading about using Seroquel at night for the sedating properties and a smaller dose of Abilify during the day. Has anyone tried this? I'd love to hear about your experiences or other thoughts or ideas. One note of interest is that I don't want to put difficult child on a mood stabilizer. He's been on Thorazine, Depakote and Trileptal in the past and I actually found him *more* violent and impulsive when on a mood stabilizer. I don't remember if my sig is accurate; he's currently on 70mg Vyvanse in the AM, 200 mg Seroquel XR in the evening, 1mg Tenex 3x a day, and 30mg Remeron at bedtime (which I do not think is helping at all, and plan to ask about discontinuing). His dxs are schizoaffective disorder, ADHD, and Reactive Attachment Disorder (RAD).