for years my difficult child took the same dosage of medications and they worked pretty good. A few months ago he was having real issues at school - nothing bad, just the same stuff over and over - not following directions, rushing through work (will get a 95 on one paper and a 42 on the next, even though the answers are there if he takes his time and looks), doing his own thing, NOT LISTENING! I upped his dosage from 40 mg ritalin la to 60 mg, and keeping the 5mg focalin 3x per day. This has not really helped at all, and now he can get very emotional, more argumentative, more defiant. He's not a real bad kid, he just requires CONSTANT supervision and direction, which the public schools don't give. And I have to sit with him the whole time he does his homework just to keep him on track so he can complete it and get it right. i think because i upped his dosage he's having more rebound effects, but i'm not sure. i called his psychiatrist but haven't heard back yet. any suggestions?