Hi. My son has been diagnosed Asperger's, ADHD, Bipolar, ODD and PDD. He is a very bright young man who had rapid cycling pretty much his whole life, although he didn't get diagnosed until age 7. He is now 14 1/2 and ready to start high school in a few weeks. He had been controlled fairly well for the past 2 years on Abilify, Adderall, Cogentin, Topamax, other than adding Wellbutrin in winter for depression (possibly seasonal affect disorder according to doc). For the past six months now things have been falling apart, with manic/hypomanic episodes. We have already tried increasing all of his current meds with no improvement. Recently put him back on lithium and watching closely. He has had difficulty metabolizing this in the past. I also always felt it made him more irritable and he had other side effects of incontinence, flat affect, difficulty concentrating. Risperdahl did not help, Zyprexa puts him out cold in about 15 minutes. Neurontin did nothing for him. Seroquel caused a heart irregularity after he was on it for a couple years. Don't know what to ask doc to try next. It is like living in a war zone here in my home and he starts at the high school where everything will be new and different in a few weeks. At a reduced dose of lithium he is already getting much more irritable in the morning especially, and his tremor is becoming more pronounced. Looking for any encouragement and/or suggestions of other meds that you may have had luck with. Our doc has always been very willing to listen to suggestions I have gotten in the past and at one point this is what made enabled the breakthrough for stability that we had for those two years. We will be going back to see him in about two weeks and I really want to be able to ask about any other alternatives. I asked at last visit because of past problems with lithium and depakote, but he felt we should give the lithium a try again after seeing son's behavior in office. So far it's looking like that wasn't the answer once again. Anything you have to say would be greatly appreciated. I am at the end of my rope with son being verbally and physically aggressive.