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cindyk,

I really hope index.html chimes in. I'm out on a limb. Index, where are you?

It is impossible for your son to focus later in the day. Accept it. If you ask me, the work around is don't bother trying, that is, don't bother with academia when he is incapable of focus. Help him do something else constructive and by all means, help him find something he is good at and encourage it even if it is not something considered prestigious in our warped society. For example, my hobby is carpentry. My wife and I are building a cabin in the woods. I do not need drugs to stay focused on our cabin. I love every minute of it.

Not entirely practical? I agree. Society has become too complex for little or no formal education. Your only other option is meds.

You might try a longer acting methylphenidate like Concerta. It can be effective at an overall lower dose than multiple doses of Ritalin. I doubt if your son will ever be able to focus in the afternoon without med assistance. I can't. I can run a difficult task started in the AM into the PM, but not start one.

I feel normal on stimulant meds. That is, I have no trouble with concentration and swapping between tasks. The catch is, the med is not entirely responsible. I had to learn good organization skills after beginning the meds. Since you are providing structure for your son, it is very possible that a longer acting med may be all that is needed to manage.

Two weeks ago I switched to Adderral XR 20mg - 1 a day in the AM. Please, keep in mind that I am not advocating Adderal simply reporting the effects on a 53 year old man. The Adderral is replacing 3 doses of 20mg Ritalin spread over the day. I would have switched much sooner but for one my HMO will not pay for it and the other I feared dexamphetamine because it can be very addictive. The ironical thing is I am having much less urge to take a little extra because Adderral is truly efficacious for 12 hours. I was cycling with Ritalin and that was wearing on me. The results are the same when either Ritalin or Adderral wears off. I get very tired and lose the ability to focus.

I am going to hold my breath with the next statement. Hopefully others will throw in their two cents to balance my opinion. I think therapeutic doses of amphetamines are very safe. All the horror stories you hear (and I can attest to) are of abuse, NOT therapeutic use. There are numerous reports of people using amphetamines for ADHD control for decades with no apparent harm. Additionally, I am convinced that low self-esteem is the root cause of addiction. Therefore, if a therapeutic dose of amphetamine helps a young ADHD sufferer master basic skills, it tends to prevent addiction not cause it. The big difference between me now and me 35 years ago is now I use amphetamines to function not get high. The difference in motive makes an enormous difference in how I behave toward the drug. For example, I know for a fact that if I get blasted on it, Iíll stop functioning. Oh, Iíll feel good all right, but wonít be able to get anything done. That is not what I want.

This is a very serious conversation with enormous ramifications. The decision you make can mean either a happy well-adjusted life for your son or one of misery. Think it through carefully and get plenty of info. You are the one that will live with it one way or the other.

Your efforts show you are a good mom. Keep it up.

Bob





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