I don't know much about ADHD/ADD but I know a bit about Bipolar.
If you think the abilify is worth a try then you should try it. After all, it might help. I was on it for a while. It is apparently a very 'clean' drug that is good for not having many side effects. The only side effect I had was an increased appetite. Out of all the drugs I have been on that was the best.
Hope I've helped a tiny bit.
C:

Hi. Welcome. Sorry to hear you are struggling with your son. I feel your pain. I have a 5 yr. old son and a 9 yr. old son, both diagnosed with bipolar disorder (bpd). Your son sounds like a carbon copy of my two boys. Nobody would believe the chaos unless they live it.

Many of the behaviors you describe are those of a child with bpd. Get back to a good pediatric psychiatrist - an M.D. They can do an evaluation for you. What ever the problem is it is a relief to have a name for "it".

Our pediatrician told me he wanted to put my son on risperdal when he was five. I am an RN and knew something about the medication and was not happy with that suggestion. I took my son to a group that did an evaluation but I was not convinced they fully understood what was going on. I finally found a psychiatrist who specialized in pediatrics. I did my own research. I knew before I ever got to the psychiatrist what the diagnosis would be. I was ready for the blow but I had hoped I was wrong. Alas, I was not wrong but we started meds. right away. Guess what was the first line med? Risperdal. It was like a miracle! The rages that lasted for an hour or more, the aggression, the anger, the night terrors (horrid, vivid, gory dreams), the reckless behavior, the sadness and despair... it all started to dissipate. Other meds were added, taken away, more added, doses adjusted all in an effort to reach the illusive nirvana called stability.

Shortly after I had the older boy in to the doc for his diagnosis my youngest son turned 3. Less than a week after his 3rd birthday he picked up a plastic toy screw driver and tried to stab me with it. He was like a demon! He was so angry, aggressive and then like a zombie. No emotion. He was not catatonic just walking like in a trance. I was so frightened I called the psychiatrist. I asked her what were the chances of having two children with bpd. The response was "extremely high" with bpd on both sides of the family. Both my husband and I have a brother that are mentally ill. I am sure both of them have bpd but neither will seek help. Their lives are messy and they live under their potentials. Another sad story.

I can only tell you that what you see now will not go away. If this is bpd the symptoms will worsen. The behaviors will progress. Children present with bpd differently than adults. They are usually cycling between manic and depressed moods frequently - several times a day. Their poor brains are so overloaded. They become very irritable and aggressive.

Get to your doctor and get some help.

I will be glad to share more information with you. I will be glad to listen to you and your wife. I have been there and this is a crisis most of us are ill prepared to face and deal with. I wish I had a penny for every tear I have shed. Support is so important for you. Let me know if there is anything I can do.

My prayers and thoughts are with you!

Just be careful about the meds. There aren't really any bipolar medications out there that have been approved by the FDA to use on children. Abilify is relatively new. It worked fine for me for a couple of years, then built up in my system until I was being poisoned. After being told things like, "I think you are having some sort of seizures," to stuff like, "I think you may have a brain tumor behind your eye," I insisted that it was medication-related and I was right. That reaction to Abilify is so rare, I don't know of anyone else experiencing it. (My doc even had to notify the FDA and drug company.)

The main point is to just be very careful and very observant when it comes to putting your child on meds that are meant for adults. It works for a lot of kids; some, not so well. Thankfully, all the meds that my son are on work just fine for him, and his main medications are approved for use in older children.

Also, consider the possibility of something other than bpd or ADHD. Maybe oppositional defiant disorder? (Don't know much about it, though.) It could be something you haven't thought of or a combination of disorders. I hope all works out well with you and your son. Just be sure to find a good pediatric psychiatrist.

Designlady does bring up a valid point about medication use in the pediatric population. Atypical antipsychotics are not FDA approved for use in children, true. There are guidelines that psychiatrists use for dosing based on body weight. There are guidelines used for maximum dosing of these medications as well. This is not guess work. Many medications are used in ways that are "off label" and not approved by the FDA for that use. Anticonvulsants are used to treat migraine headaches and mood disorder but they are not FDA approved for that use. This is not illegal.

Unfortunately, there is no one size fits all medication for any mental disorder. Frequently it is a trial and error basis that the meds are given. If it works, great. If not you move on to something else. Some meds treat one aspect of a disorder well in most of the population but it is not 100%. Any psychiatrist that treats pediatric patients on a regular basis will be well versed in the medications of choice for a specific disorder.

As designlady said, this picture looks a lot like bpd but it may be another disorder. I encourage you to seek out a pediatric psychiatrist to perform an evaluation on your little boy. Most doctors are of the mind that early intervention offers the best chance of a good outcome with any disorder.

All the best! Let us know how things work out.