clearing meds out of bi-Polar childs system is this good??

I have a 10 year old who has been in the hospital since May of this year.  He is Bi-Polar.  It has been my wishes for some time now that they dry him of all of his meds while in the hospital and start him over again to find the correct medications for him.  I have been told by the theripist that this is not good for my child that this will just set him up for failure.  I am fearful that he is on a awful lot of medications.  Right now I am really not sure exactally what they have him on I know they just reintroduced Lithium to him.  He is now started to urinate on the floor again and agrivating the other children to the point of escallation.  He is not doing very well and they are now talking of sending him home when he is doing worse than what he was doing before he was put in the hospital.  I am very concerned that we are setting him up for failure by not addressing what needs to be done.  The theripist just seems to be ready to rid himself of this child and We are once again being told this stuff he does is deliberate and we should just put our foot down.  When we first put him in the hospital the theripist informed us that it requires more than just the parents to care for children like mine and that he needs 24 hour care.  I really dont know how they expect us to handle this.  I can see it now divorce maybe even a brief time in the hospital for me.  I am scared.


Thanks

Karen

[Kevin Kennedy, Ph.D.]

Dear Karen,

I really can't offer you guidance about the proposal to wean your son from his medications and start afresh. There are certainly times when such an option is sensible. It is not unusual, in fact it is pretty typical, for patients who have been diagnosed with Bipolar D/O to be on several medications.

However, relative to discharge planning, it sounds like you earlier received the opinion that your son might require residential treatment. Such twenty-four-hour-a-day care is, of course, a major intervention, and out-of-family care of any sort should only be entertained if all other options have been exhausted.

Depending on your location, public agencies sometimes collaborate to provide intensive services (including out-of-home care) to children who are being discharged from hospital-level care. Have you consulted with your state agencies that oversee the care and treatment of children? You might ask about this with hospital personnel. What you'll want to learn is the mechanism for referring children for residential placement.

[danielle]

I work with children who suffer from a wide range of mental health issues.  If you research the topic a bit I think you might find that lithium is not effective in children, you should seek alternate medications. Your proposal makes sense and has proven effective with kids like the ones I work with.