New to board...desperate...need help! | ADHD Information

Hi.  I'm new to the board so I really haven't had a chance to look around yet, but I just need to get this out there and hope someone can give me some advice.

My son is 13 and in 8th grade.  He was diagnosed with ADD at the end of 5th year.  So far we've been able to somewhat keep his grades in check with medication, with the exception of one or two bumps in the road.  But now I think we're in a ditch.  And I'm definitely over my head.

We got his first report card back in November.  He failed one class and got C's & D's in the rest (he's always been a B & C range student).  Now we're at the end of the second quarter and he has 1 C and 4 F's.  There is no way he can bring them up by the end of quarter.  Unfortunately, we found out too late that his medication wasn't working as well as it should (he was on Vyvanse 40 mg) so the Dr. increased it to 50 mg and recommended that we take my son to see a psychiatrist, which we did.  The first visit, she determined that his medication was still not working - wearing off way too early in the day so he was not doing his homework, etc.  She also added the "impulsiveness" feature into his diagnosis, along with oppositional anger issues and depression.  AND possible learning disabilities (which I need to work with the school with in getting tested and diagnosed).

His PCP, based on the psychiatrist's diagnosis, changed my son's medicine to 20 mgs of Ritalin SR in the morning and 10 mgs Ritalin (quick release) at 3pm.  There has been some improvement, but not the improvement I've been looking for b/c honestly, I am so petrified that my son is going to be "penalized" for things that are out of his control by having to repeat 8th grade.  That is all of ours (including his) biggest fear.  I keep telling him that we're going to start off the new year right and we're going to focus on school and getting his grades up for the last two quarters but I am at a loss on how to go about doing that.  I'm also at a loss on how to be able to tell (or have him be able to tell me) when the medication doesn't seem to be working.  He is extremely bright.  Tests above average on everything on his standardized tests.  He comes off as being extremely popular but I can tell he's extremely insecure (which is not helping his depression).

I feel like he's just gotten diagnosed with this instead of it being diagnosed 3 years ago.  I guess it's because he can't "skate by" anymore and reality is setting in.

I need suggestions!  HELPS!!  And thanks in advance!

Puberty is definetely in the mix. It is probably changing his meds. He may need an entirely new med due to puberty.

I bet he has a lot of anxiety due to trying to hold it together for all these years.

Do you have a psychopharmacologist who can help you with his meds? Our pediatrician referred us and it has done wonders.

My son is 12 and has been on meds since 7, the same but many increases. He is on concerta and guanfacine.

Did the psychiatrist recommend the Ritalin or did the PCP?  I'm just wondering because the psychiatrist would (should) be much better at diagnosing and determing which meds are appropriate.  Ritalin is such a fast acting medication that if he/you aren't seeing results then it needs to be increased or the med changed altogether.  I think Bethann is probably right about puberty. His whole body is changing so the meds have to be adjusted.  Don't get discouraged!  If this current plan with the Ritalin doesn't work, keep trying!  If you have a good doc and can hang on, it will get worked out! Good luck and keep us posted!