Joseph is 9yo and has ADHD. He's on 50mg vyvanse in the morning and .2mg clonidine at night. His teacher called me this morning to set up a meeting between us, the school counselor, and who knows who else. She is very concerned over his behavior. He has been hitting his head on things when he is upset/angry. He has been doing some Obsessive Compulsive Disorder (OCD) things in class like repeatedly getting up to write more things on papers he has already turned in. He is withdrawing and not talking to anyone. He is not getting any work done. He has had two head injuries at school in the past week - one from falling in the bathroom and one from falling into the fence outside. She is not sure the stories he is telling are true and thinks he might have hurt himself because he was angry. Joseph has always been calm at school but very hyper, aggressive, and destructive at home. His teachers usually don't believe me that he is hyperactive unless they see him without medications. I have been asked in the past to up his medication dosage because he is inattentive, and later asked to lower it because he isn't interacting. So far we haven't been able to find a good balance. He's tried ritalin, concerta, focalin, daytrana, and adderall. He was on daytrana at the end of last year but it was giving him tics and he was having wild aggressive mood swings so he was switched to adderall. In november his teacher said she was concerned because he wasn't talking at all at school and was very withdrawn. His doctor switched him to 30mg vyvanse. I tried that for two weeks and his teacher said he was talking more. However, I noticed it was wearing off by 4pm. He couldn't do his homework or eat dinner and was constantly in trouble. So we raised the dosage and it does last longer. He's been at this dosage for six weeks now. I just refilled his medications yesterday, too, so I don't think insurance will cover it if he needs to switch medications this month. I don't really know what else they would try with him. I don't notice him being a zombie on weekends. He does tend to play by himself and gets very wrapped up in what he's doing. He never gets quiet with me like he does at school. I have noticed he has more of an attitude lately, like he really just doesn't like me. I thought that was probably a preteen thing? I'm partially afraid this is my fault - I just had a baby four weeks ago so his schedule has been disrupted. I've been having the usual postpartum mood swings and I've lost it with him a few times when he was out of control. Does anyone have any ideas or know what I should say at the meeting tomorrow? I know they'll want me to decrease or change his medications but honestly he's had this problem with every medicine he's been on. Either it makes him a zombie at school or a monster at home.