Holy rages and temper tantrums

I had called last week for a refill on Josiah's Risperdal (mood stabilizer) as he was running low. I thought I had given them ample time with the holidays being around to get it refilled. However, they didn't get the refill called in. Christmas came and he ran out of meds. He was doing ok on Christmas, the day after he was still doing ok. Today, he has been so agressive, full of rage and super hyper. The occupational therapist came and he decided that would be a good time to test me. He wanted to do puzzles at the table and so I went and got their new ones for him to do. He started throwing his puzzle pieces on the floor and at Emily. I told him not to mix up the pieces and he started flicking them all over all the more. I sat him in time out and he started pinching me, kicking me, screaming that I was hurting him. He finished his time out and I let him go back to the puzzles and he just continued with the bad behavior and saying inappropriate stuff. The more I warned him and asked him to behave, the more he was acting up. I told him to put the puzzle up and that he was done as he wasn't obviously wanting to do the puzzle very badly. He swiped all the pieces onto the floor and started kicking and screaming "I don't want to, I don't want to." I told him to pick the pieces up and he just lost it. Ran into the living room and when I went to go get him, he went around the side of the recliner and literally tried flinging the recliner into me. I finally got ahold of him and telling him to go to his room. He wouldn't. I wound up carrying him up to his room and he was scratching me and kicking me the whole way up the stairs. The minute I sat him down on the floor, he came at me full force. I managed to get out of the door and get the door closed and I had to hold it shut. He flung himself at his wall and his bed and I went to come downstairs and the next thing I know is he had come running out of his room and flung himself at the carpet at the top of the stairs. Melina is screaming downstairs and Emma is telling me "the baby is crying, the baby is crying." The therpist was still working with Tracie in the playroom. I had to go put Josiah back in his room and no sooner would I get to the stairs and he was right back out flinging himself on the carpet at the top of the stairs. I'd pick him up and tell him that when he could calm himself down that he could come out and he'd scratch me some more. Finally, after I don't know how many times of repeating that scenario, he finally listened and calmed himself down in his room. He came down and started testing the therapist as she was getting ready to leave. She told him that he was making some horribly bad choices and I told her that he'd been off his meds for 2 days and she said that he'd probably get worse before he got better and to just keep putting him in his room when he behaved that way. Something happened right after she left and he lost it again and he started pulling the girls hair and trying to step on them when they wouldn't let him play with a toy that they were playing with. Had to separate him from the girls and he once again threw a major fit. I finally wound up calling Andy at work and asking him to call the hospital as I couldn't do it myself with all the commotion going on. He could hardly hear me to figure out what was going on between Josiah screaming and throwing fits and the baby all upset. He called and the lady said that they jsut got back into the office and they weren't all aware of what all was pending to know if I had called in a refill or not and that she couldn't guarantee that they could get to it that day. A couple of hours later, after a few more rages, I called Andy and told him "I just don't know if I can do this all day. I am so burned out." He told me to hang in there and if I needed him to he'd come home. I didn't want him to miss more time at work as he was out of personal time and vacation time to take and so I told him that I'd just have to hang in there. Thankfully just after lunch, the hospital called him and told him that they had gotten one of the doctors to write his prescription and Andy went to pick it up. I wound up driving up to his work to get it from him so that we could get him back on his meds. Lesson learned, I will start giving them more than 5 business days to get a refill. I will start giving them at least 10 so that we don't have med withdrawals again. I get scared sometimes about what the future holds with him if he can be this hard to handle at 4 1/2. However, I do my best to try to just take it one day at a time.