After about 5+ years of difficult childs Adderall working well, it stopped working. Weve been going through one medication adjustment after another. Upped to 30 mg, then back down to 25 mg but added Tenex, then increased Tenex. All to no avail. We went back to the doctor again yesterday afternoon. Apparently, puberty causes so many changes that it can adversely impact medications. Seems we have encountered a fairly common problem with puberty and medications. Dylanta (sp) declined (difficult child would pull the patch off). Ritalin declined because difficult child has taken it before and it doesnt work, difficult child gets the rebound, and he becomes aggressive. Strattera doctor says it wont help difficult child on its own (ADHD Combined diagnosis). Concerta is our next trial. (Not happy about it its a form of Ritalin, therefore, will not start administering until after school is out. Just not worth the risk that difficult child would knock somebody up side the head with little provocation.) If that doesnt do it, well add in the Strattera in about 6 weeks. Of course, it takes a couple of weeks for the Strattera to kick in. (Not happy about it.) Seems there may be a possibility that the Adderall will work again once difficult child gets through puberty. (Throwing mom a bone of hope.) Puberty is rapidly rising to the top of my things most hated list. Were also going through a dont need the medication, dont want to take the medication phase. Its not optional, so doctor proceeds to with some straight talk to difficult child. Among other things, in a nice way, he told difficult child to disregard information from friends (you dont have to take that), husband (you just want to be the class clown), etc., and listen to your mother. Shes researched and knows what she is talking about; she knows more about ADHD and medicines than most doctors I know. Then he looked at me and said, I mean that. A true compliment and I just said, I appreciate that. But somehow it didnt give me the warm fuzzies to learn in more concrete terms just how vulnerable the medical profession, and in turn our kids, can be.