Chicago,
My son (who's 11) takes 40 mg Strattera and 36 mg Concerta--Concerta is a time release form of Ritalin. Over the past 3 years he has taken Ritalin, Concerta, Strattera, Strattera AND Ritalin, and now Strattera AND Concerta. For him, the Strattera/Concerta combination seems to work the best. Both Ritalin and Concerta helped all of his ADHD symptoms, of which he has many. The Concerta (54 mg) gave him the benefits of fewer ups and downs throughout the day, lasting for him a full 12 hours, and only having to take it once in the morning. However, he had SEVERE insomnia and loss of appetite. So, we tried him on Strattera alone shortly after it came out. Strattera immediately improved his eating and sleeping, generally reduced his activity level, slightly reduced his impulsivity, and it virtually eliminated some anxiety issues he had (nighttime fears about someone breaking in, obtrusive thoughts about dying, and panic attacks after medical procedures). However, it did very little for his focusing and attention. So, the doctor added Ritalin (15mg in the morning, 10 mg midday, and 5 mg after school) but kept him on the Strattera too. He would sometimes forget to take at least one of the doses of Ritalin during the day, so we switched to Concerta (Since he was also taking Strattera, the doctor reduced his Concerta dose from 54 mg to 36 mg). The Strattera seems to counteract the side effects of the Concerta that he exibited when he was on it alone. As long as he also takes Strattera, he eats much better and sleeps great (He goes to bed most nights between 9:30-10:00; when he was only taking Concerta he rarely fell asleep before midnight and usually it was closer to 1:00-1:30 am). In addition, there is no noticeable stimulant "let down" when the Concerta wears off. And, for my son, he has the added benefit of the Strattera controlling his anxiety. He has been very fortunate that after the first several weeks or so he had no side effects to speak of from the Strattera. Insofar as his mood swings are concerned: I would say that about every 5 weeks, he goes through 2-4 days of being extremely moody--easily angered, easily frustrated--not normal behaviors for him. But, the rest of the time he's fine. I have a highly focused, academically inclined, honor student, teenage daughter who acts the same way

for about a week, EVERY month...so what's a couple of days???!!! I wish you the best finding what works for you.