HowlerKarma--thanks, I will take a look. As I said before, I'm not sure what I could do differently because she seems severely affected and non-functional in school when not on meds. But I still want to know what the risks are (as long as it is good solid research and doesn't just raise more questions than it answers). The "mania" when taken off is scary to me, although I think it only lasts a day or two. I thought Ritalin has been prescribed for years so why aren't there good studies of the long-term effects?