Thank you for the replies.
SWOT, we have always felt the Asperger's diagnosed fit pretty well, although she does not have any gross or fine motor difficulties, she is a great writer, and has a great imagination. But the rest fit fairly well (especially the inflexibility!). It is the hatefulness that is disturbing now. She was not hateful like this before. She blames everyone for everything, she takes no responsibility. I think she is well aware of other people's feelings, she just doesn't care about them. She cannot deal with the slightest stress. Her moods change very quickly. She does get sort of silly/hyper with rapid speech. Other times she zones out into a game or TV and when we try to talk to her she tells us to shut up no matter what we say. She goes from being really nice to 8 year old sister but tries to control her. The minute sister doesn't do what she says she tells her she hates her and wishes she didn't exist. It is so not fair for an 8 year old to be on this roller coaster 
A low dose of Zoloft has been better than nothing, but other antidepressant, a stimulant, and non-stimulant ADHD medication have all been disasters. I know we are headed toward a mood stabilizer. A year ago or even 6 months ago it didn't even cross our minds. Now, something has got to change! We've done play therapy, CBT, she now sees a psychiatrist. I feel like we have tried so much and she has had several doctors eyes on her for years, but things just get worse.
