I feel your pain and can relate to much of what you have written. My daughter began guanfacine which is a 24/7 med rather than a 4, 6, or 8 hour stimulant. I'm not a prescribing physician, so obviously you can't take my work for any of this - but I agree with others - it could be a good time to try something else. Tough to hang in these when you're doing it all in the morning (I'm right there w/you). And the schools don't get it either (again, right there w/you). The right med could help get you relief and him (it's not easy for anyone, is it?)

Not sure where you live or how the school situation is working out for you, but have you heard of the The Newton School in Sterling? Most of the kids there have some form of ADHD. My son has been there for two years and the transformation has been amazing. Kids alternative between movement and classroom. The small class size (4-6 kids) has been huge.

Based on your description, it doesn't sound like the current meds are working at all. I would take a close look at the Straterra. It's been documented to cause irritability and angry outbursts. Find a doc who will work closely with you to figure out meds and dosages. You might need to do some more trial and error. We tried Vivanse (various dosages), Concdrta (various dosages) and finally settled on 25mg Focalin for my 11 year old with combined ADHD. Not a magic bullet, but definitely a big help. Every kid is different and you really need to try different meds and dosages until you figure out what's optimal for yours.

Agree with others that you should have the medication re-evaluated. Another thing, if the teacher is contacting you, it probably means that your son's performance has declined, not that the school doesn't understand ADHD. Last thing, if his medication is fine, my personal tactic was to isolate and be more hands on. During the difficult periods, my son wasn't allowed to be around other family and they could not be around him because my son couldn't handle it and he needed the space. Also, rather than nagging, I was far more hands on - I would help dress him rather than nag him to get dressed. We also did things weekly instead of daily (like choosing clothes) so that he didn't have so much on his plate each day.

My son is 13 years old and started out with Adderall at 9 and it was not good for him at all. He was flat and zoned out. The pediatrician switched him to Concerta and it has worked much better for him. I can even tell when it takes effect. He is more settled and can focus. It seems the medication your son is on is ineffective for him and he and your family are suffering. You need to make a change.

It does sound like you need to look closely at the medication. Why does he take the straterra so late? Does he need it? Why are you staying with adderall when the teacher has not seen an improvement in behavior? Finally, is he sleeping well? Our psych had my DS on 1mg of melatonin nightly and it made a world of difference. All of a sudden he was not rolling around everywhere and was able to get to sleep (and stay asleep) which led to much better behavior in the morning.

I know how overwhelming it all is. Good luck!

You need to talk the prescribing physician. The meds are not working well for him. I am with you, I have a 10 y.o. girl and we are having rebound issues on Focalin. We tried Adderall with her and it was a nightmare. We are still having figured out a perfect med, but we keep trying. But you at least should talk through options and changes with the physician, especially if he has been seen for a while.

Have you talked with your psychiatrist? He should not be having so many symptoms at school is he is taking medication. Perhaps he needs a different formulation (short acting vs. XR, which has greater rebound issues) or a different med altogether.

What kind of evaluation did he have? Could there be an additional diagnosis like anxiety?

My son is 10 and was diagnosed with ADHD combined type at age 6, although we had known for several years at that point that a diagnosis was inevitable.
We are having a terrible time currently and I do not know how to improve the current situation. My son wakes up either extremely argumentative where he picks a fight at any possible opportunity or perceived insult/threat/injustice when it is really nothing, ether with myself or my 5 year old child; or he wakes up extremely hyperactive, unfocused, and unable to follow directions i.e. screaming high pitched for no reason, exciting the dog, running for toys etc. I am having to supervise him intensely in order for him to get dressed, brush his teeth, and eat his breakfast. Mornings are horrendous and evenings about dinner time on are the same. Its obviously connected to the rebound when the meds wear off but not sure how to cope with this? I feel like we are constantly having to fuss at our son and often are short on patience because it feels like groundhog day, where its the same thing everyday and nothing ever changes. I don't give him the meds until after breakfast in the morning so as not to affect how much he eats and to not shortchange him through the school day with his meds and he takes the strattera at dinnertime. Clothes are laid out for him, breakfast is set out for him,... same routine every morning. I am often off my schedule just trying to get him out the door and sometimes giving him extra time because he is so out of sorts I don't want to drop him off and have him get himself in trouble. To top it off his teacher messages me saying that he has trouble focusing, following directions, and not getting involved with others... I mean really? Have you not heard of ADHD? This is typical no? There really needs to be continuing ed for teachers in ADHD, etc if classes are going to structured for immersion.

Any tips? Hints? Advice?