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I don't think it sounds like it's working for him. If I were you, I'd try another drug. My daughter was diagnosed with ADD in 3rd grade and she started out with Concerta. She felt a difference the first day. Over a few months we felt like it stopped working as well as it did at first. Her Dr. suggested trying Adderall instead and she felt that worked even better. She has now been on Adderall around 6 years and it has been working well for her up until Jan 2010 when we switched to generic and she noticed that it wasn't as effective. In the last few days she's been taking Adderall XR made by Shire (brand name) and she thinks things are markedly better.

Side story (please ignore if this isn't helpful to you):
My daughter was initially diagnosed in 3rd grade by a pediatrician who is a specialist in learning issues. But later in 6th grade I took her to a physician who specializes in neurofeedback (a type of biofeedback). This neurofeedback is a practice (kind of like Yoga, but with EEG feedback) that kids and adults can do to "calm down" their brain waves over time with practice. I have ADD also (not nearly as bad as my daughter), I tried it and it works. Long story, short, my daughter made progress one summer, but I could never get her to keep going with it because she felt overloaded just getting through the school day and homework. The last thing she wanted is another thing she had to get done. HOWEVER, I'm still glad I took her to this physician because we learned some information from the Dr. about what ADD looks like, from a brain perspective. Most importantly, the Dr. performed a qEEG on my daughter (electrodes all over her head taking measurements while my daughter performed math problems, read, or just stared straight ahead. The results of the qEEG were interpreted and written down by a pediatric neurologist. It was helpful for us to see in black and white that her brain waves were not "normal" and that there was a physical reason for her difficulties. In addition, the physician was able to see which kind of "boost" her brain would need in order to function better, so she was able to tell us which drug would work best for her. It turns out that the drug we found by trial and error was indeed the drug that the physician recommended (Adderall).

For anyone that can afford the time and expense, I recommend seeing a neurofeedback physician and getting hooked up to a couple of electrodes and getting an easy quick peek on the monitor or getting a full qEEG done (1-2 hours) for their child. It gives peace of mind.

In the meantime (and ultimately), 'guess and check' is a perfectly good way of finding the right medication.

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