So far I remain very happy with this medication. I do not see any of the rebound I have seen with the other medications. I think it is more smooothly given since it is a transdermal patch. I am not sure if we need to up the dose or not, we see psychiatrist tommorrow. I think I may want to wait untill school starts to see if we need to up the dose. It has certainly helped with direction following and some stuff like that. I will talk with psychiatrist tommorrow and see what he wants to do. The lamictal has been a lifesaver when it comes to smashing the irritability. We still have a loud home, but it has a better undercurrent. Now easy child has more preteen emotional stuff, and is harder to deal with than difficult child. go figure. So it can get better. It has been a long road, but there is hope.. 2 yrs ago difficult child was kicked out of boys and girl's club, suspended from school, and kicked off the bus. The last 1/4 of the year was way better than anything in the last 2 yrs.