I haven't been on the boards in a very long time because of time constraints...and my attempt at not obsessing
...but I wanted to add my two cents. I don't have lots of time, so I didn't read this entire thread. I apologize if I'm repeating prior info.
We have done the whole medication roller coaster as well, and interestingly, we experienced the same side effects for each medication as your son. My son is 8.
The med that finally worked for us and has continued to work for quite a while is RITALIN IR (instant release) 10mg 4 times per day. Each tablet lasts a max of 3 hours, so we have to stretch it out. We usually give the doses 2.5 hours to 2.75 hours apart. So, our schedule during school goes like this: 7:15, 10:00, 12:30, 3:00. On weekends, he usually gets his initial dose later, so we can have a little more coverage in the evening. His doctor is ok with a 5th dose if needed on certain days for extracurricular activities. We have a prescription for 15 mg each dose, but ds usually only needs 10. So, we typically have some left over for those days when he needs one more dose to get him through afternoon/evening activities. At such a low dose, he is still able to eat without putting up a big fight, and he eats very well at breakfast and dinner. Extended release Ritalin and Concerta (both methylphenidate) had lots of ups and downs and major anxiety/irritability. We do not see this with the instant release ritalin.
Sometimes, if I do see any irritability (which is rare) I give ds a little caffeine (green tea, usually) and he's a new man. We never have any sleep problems.
Another thing that has worked well for ds (and me-anxiety, adhd) is NEUROFEEDBACK. I didn't expect to see (or feel) such great results, but we have been shocked. Family members and friends even comment on the improvement.
DS is on Zoloft for anxiety, so that is likely having some added benefit as well. He used Prozac first, which actually seemed better, but it quit working. When ds is anxious, adhd behaviors (impulsivity, distraction, hypersensitivity, emotional regulation difficulties) are more evident. So, if we keep the anxiety in check, focus and self control are much better.
Finally, we are also using the TOTAL TRANSFORMATION parenting program, and while much of it seems like common sense, I have to tell you it's made it a huge difference in our home. I had ds listen to the entire program with me, and he totally gets it. It has seriously been life changing.
Good luck. I know it's tough. We are living it along side of you.
