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[QUOTE=airey]I always thought it was the imbalance that causes the most frustrations. It's that you have part of the skills or IQ to do things but the other part keeps dragging you back. [/QUOTE]

Yes! Very well put, airey!

Cindy, if your son does well in the mornings on the Ritalin dose, I wouldn't increase *that*. No matter how much short-acting Ritalin you give him, it is still going to wear off in a few hours.

And about your comment that he is irritable when it wears off, I have to say I'm not surprised. I took a short-acting Ritalin exactly 1 (one) time - coming down off of it was [I]horrible[/I]. I was so irritable and short-tempered with my family, I said "never again". Coming down off of Concerta is soooo much easier.

Okay, as far as medication ideas, here are my thoughts. You could try to add a very small dose (start with 5mg) of Ritalin when his first dose is wearing off. Start very small. Perhaps he will be able to tolerate it if you start small enough.

OR, I would try the longer acting forms again. Concerta, as you know, has 18mg as the lowest dose to play with. Metadate, which is exactly the same medication - methylphenidate - just with a different delivery system, comes in 10mg doses which makes it easier to play with. Talk to your doc about trying that.

The other possibility to discuss with your doctor is *adding* Strattera to the Ritalin (or methylphenidate product). For my son, what worked best was a combination of Metadate and Strattera. Yes, they can be prescribed together and for some odd reason, taking them together seems to decrease the side effects of taking one alone. For instance, on Strattera alone, my son had serious problems with appetite suppression. Add the Metadate, and all the sudden, he was eating better. Go figure.

Those are my thoughts on medication.

Now about school - is he getting any accomodations?

Oh, one more thing about medication. Is your son seeing a psychiatrist or is his pediatrician trying to manage his meds?

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