Reply to Please help me figure out my angry 9yo

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[quote=Anonymous]She's diagnosed with anxiety and has characteristics of adhd and autism per neuropsych but no diagnosis for those. She has dramatic rages that result in property destruction and make me worry for the safety of her siblings (since at least age 3). I could see an ODD diagnosis in her future. She's in therapy, and we've done several varieties of parent training. I think getting the meds right is the most critical issue right now. We're on our second psychiatrist -- and this one objected strongly to the medication the first had her on, saying it's not appropriate for children. Neither regime is working perfectly, though both options have worked better than nothing. Would another psychiatrist be willing to talk things through with me without her becoming a new patient?

I'll also crowd source in case any of you have thoughts. Here's what we've tried (over the course of 1.5 year):
1. very low dose Prozac -- made her extremely fidgety and unable to sleep
2. 12.5mg Zoloft -- also extremely fidgety and unable to sleep
3. low dose Remeron (mirtazapine) -- no side effects at all. symptoms improved but not resolved. 
--swapped psychiatrists because we moved, new psychiatrist was absolutely opposed to mirtazapine use in children--
4. guanfacine 1mg --&gt; 2mg --&gt;1mg ER --&gt;2mg ER over 2 months  -- absolutely no improvement in symptoms. psychiatrist was adamant it takes time
5. guanfacine 2mg ER + 12.5 Zoloft -- immediate improvement with the addition of Zoloft, but child complained of nausea and dizziness with sports (guanfacine lowers blood pressure)
6. guanfacine 1mg ER + 12.5mg Zoloft + 10mg Hydroxyzine  -- reduced guanfacine which resulted in a return of the Zoloft related fidgeting and insomnia. Added hydroxyzine to deal with insomnia.

So now we're at 3 medications, which child really resents and I don't love either, and while symptoms are better than before, they're not resolved and we can't increase the dosage. And I have to administer them at *exactly* the right time or sleep is impossible.

I'm looking for
-Do psychiatrist 2nd opinions exist?
-Any psychiatrist recommendations for this profile (for 2nd opinion or just general treatment)? Willing to go anywhere in the DMV area. 
-Other medications that have worked for your child with a similar profile?
-Any exceptional therapists for similar children? The one she goes to is convenient but doesn't seem very experienced with kids at this level. 
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