If she is still raging after being on 2 mg of Risperdal, plus .5 PRN, I think the Zoloft is a problem. I really do. I know about the anxiety issue. I wonder if they are willing to try Lamictal. Problem there is it takes a while to kick in, which you already know. Of course, any mood stabilizer takes a while to kick in. I would rather see them try that than Lithium or Depakote merely because there is more potential for side effects for those two meds than Lamictal, although there is the slight possibility of the rash. If it is titrated very slowly, this can usually be avoided. If she is still taking the Adderrall, again, I feel this could be activating. That would be the first suspect, then the Zoloft. I cannot believe they do not know this at the hospital. Sorry but that seems crazy to me that they don't seem to know what to do! Just my two cents. Certainly worth discussing with the doctor. I would ask them to delete the Zoloft and Adderall and see how she does. She should be better just with the Risperdal and nothing else. It would be interesting to see how that effects her. If that is not the case, I am out of my league here with med suggestions. I would at least ask to leave her only on the Risperdal and Klonipin for now and see what happens with adding Lamictal after a short time. If she is having anxiety, the Klonipin alone should knock that out, in my opinion.

Sigh...I am so sorry to hear about this...let us know what you decide!

Hugs and prayers being sent your way...
Heather
Mom of Alexa, Sweet (sometimes) 16
Abilify (10 mg), Lamictal (200 mg), Concerta (36 mg), Allegra 180, Topamax at night only (100 mg) Seroquel at night only (200mg)
Attends alternative education school (Ohio)
Diagnosed 9/05 Bipolar NOS