If this were my child, I'd see if the medications are dulling him first. If they are, punishing him will make him want to NOT take medications. I know my teenage daughter threw out her Depakote. She was in a two year college and, in her words "I can't think. THese medications make me stupid" and she refused to take them or ever medicate herself again. You can send him the wrong message--that if he does poorly because he can't think as sharply as he used to, maybe medications that help him aren't good. I would have him talk to psychiatrist, have psychiatrist ask him if he can think and remember like he used to. Sadly, you pick your poison. If you have bipolar, you give up something to remain stable. Everybody I know in my age bracket who has a mood disorder also has memory/cognitive issues. It's part of long term use of medications. Also, a new study just came out indicating that the brain of a person with bipolar is different and that memory problems are very common due to this (I checked it out, though, it's NOT Alzheimers). If it were me, I'd want some sort of reasonable accomodations for him so that he doesn't give up. I gave up when I tried and tried and couldn't concentrate and couldn't sit still to read or do my homework. I had racing thoughts and would get lost in daydreams even while I tried so hard to focus on what the teachers were saying. I'd realize I'd lost half of what she said before she/he started on another topic. I did really well when my mom hired a tutor. One on one, if I'd had an aide at school (which they didn't have at the time) I would have been a good student. I needed somebody to keep me from drifting thoughts, which are part of most people with mood disorders, especially bipolar. Since I've lived with it, all I can say is for me it was very frustrating. It killed my self-esteem to get such bad grades, but I finally decided it was better to be "Pam who is smart but doesn't try" other than "Pam who tries hard, but is just a dummy." In the eyes of my peers, Pam the rebel was cool. Pam the dummy would have been social suicide. This is a serious issue for all parents of kids on medication who has serious psychiatric problems. But, trust me, it's harder on the kids, who already feel "different." I would go easy until I found answers. This child is not your "typical" child. I was able to get decent grades until seventh grade, then it all fell apart--too much multi-tasking. If your child has ADHD too I'm guessing that perhaps he DOES have underlying Learning Disability (LD)'s, on top of the bipolar, making it hard for him to remember or multi-task. If not, it could just be the medications alone--they are powerful stuff. I've taken them for thirty years now and couldn't survive without them, but it's foolish to believe that there are no side effects. It's better to take the medications than not to, but they still take a toll. In my case, I always had a serious NonVerbal Learning Disorder (NVLD) too and that didn't help. You may want to do the neuropsychologist thang to see if anything was missed and I wouldn't feel bad about getting your child modifications so that he feels encouraged and doesn't give up. I barely graduated high school and it was such a sore spot for me that I refused to go to my graduation, thinking I didn't deserve to walk across the stage. And nothing my parents said could force me to take that walk. ANyways, just my usual rantings...lol.