I think I was unclear. It is me who prefers him mildly depressed to his current super happy mood.

The pdoc wants him stable enough to get through the summer.

I know that monotherapy doesn't work well for bp. This pdoc is still not convinced Alex has bp. He agrees he has a mood disorder and is starting to realize it may be cyclical. He asked if I felt he needed an ad. I told him the long list of ads he has had and the lack of effect or cycling they have caused. Not one has really worked. I also told him his father cycles on ads. I think he may have finally ruled those out for him.

He didn't tell me why he doesn't like Depakote. I got the impression that he sees too many side effects compared to the benefits of it. I am only guessing though. I know some kids do well on it.

I forsee he will need some kind of ms along with Invega. The only other aps to choose from are Risperdal (much like Invega), Zyprexa, and Seroquel. Seroquel didn't work. Zyprexa made him gain 10 pounds in 1 week and he was unconscious for most of that week. Invega works but not enough. A higher dose makes him slow in every sense. So I think we need an ms. I am just not sure which one. I am curious if Topamax will work without the Effexor making him manic. If not, then maybe Lamictal.

Kristin
Alex 18-GAD, mood disorder, ADHD - Abilify Maintena 400mg
Matthew 16-ADD 40mg Vyvanse