I've charted all the stimulants my son has taken for nearly the past 3 years. Here is the pattern I am seeing: At the lowest doses, it is not effective. The next dose up curbs some of the annoying behaviors, but not totally effective in any way (although way better than when he is un-medicated). The next dose up causes extreme aggression. Here is what he has been on so far in this journey: Focalin XR 5mg 3 mos. Adderall XR 10mg 18 mos. Vyvanse 20mg 1 mo. Vyvanse 30mg 1 mo. Vyvanse 40mg 1 mo. Adderall XR 10mg 1 mo. Adderall XR 15mg 1 mo. BrightSpark (Naturopathic) 3 weeks Adderall 5mg in A.M. 5mg after school 1 week Concerta ER 18mg 1 mo. Concerta ER 27mg 7 mos.+ Intuniv 1mg+ Concerta ER 27mg 1 week so far From other's experience with ADHD/ODD and stimulant medications, do you think our pediatrician should be doing something different? It seems like we have just been barely getting by, not anywhere near an ideal situation - and it's been 3 years!! 3 very formidable years -from age 5 to 8. (Sigh) So far I don't see any improvement with the addition of Intuniv, but it has only been one week. Dr. wants him to take 1mg for 15 days, then up to 2mg for 15 days, then check back in. I know most docs titrate this medication by 1mg for one week, then 2mg for one week and so on until the desired result is achieved. Any advice? I feel like maybe we should have been doing something differently for the past 3 years. I feel like I am screwing up my kid's life even more. I just wish it didn't have to be like this. Here are the key things we need help with (when on medications): Verbal aggression Physical aggression Inward verbal aggression (I hate myself, etc.) Purposely annoying everyone Defiant Moody/negative disposition Forgets things (coat, lunch bag) Not organized Not responsible - we have to be on top of things all the time (when not on medications) It's all of those same things (except the aggression), just way more often/intense. If you made it all the way thru my lengthy post, thank you!