Have you had her lithium level checked ever? I hate meds, but was getting desperate for some help with my daughter, so started researching some meds on my own online, and asking other parents about meds their kids were on. The studies I read on lithium, individuals reported more manic episodes when there levels dropped. When they had the levels up in the normal range, they were much better. I did start my daughter on this, and since I got her levels in the normal range, it is so much easier around our home! She is not having all the manic episodes she use to have and I'm not as afraid for my family's safety. My daughter is only 10, but I've been pushed down stairs, through walls, bit, hit, etc...you name it, I think I've had it done. Now, though, she is laughing, hugging, just a fun loving little girl! She still has her issues, but I'll take this little girl over the one I had a month or so ago! Just a thought...