My son has been on Focalin XR 5 mg for about 2 years now. It has been up and down but mostly has really helped. It seems like the Focalin gets him right to the end of the school day. Unfortunately, homework can be a struggle but he is only in 4th grade and doesn’t have to do more than one page per night usually. The amount he is on does not make him “perfect” by any means. He is still very high energy and the class clown. But the out of control behaviors have toned down considerably and his teachers say that once he decides to get started on his work, he focuses very well. We also walk the half mile to school and back every day (even in cold temps) and he spends 30 minutes on the playground before school. I also have him doing some sort of physical activity after school 2-3 times during the week and both days on the weekend, which I am absolutely convinced helps. He also sees a therapist 1x per month and a developmental pediatrician (who also treats my son with autism) once every three months. His 504(a) plan provides for some accomodations as well as social work every week.
At first he had some difficulty with sleeping, mood swings, etc. Also at first, we were giving him “breaks” on the weekends, which I have stopped because I was noticing it was making Mondays more difficult. Now things are pretty smooth and he sleeps pretty well. I tell everyone that the number 1 reason I am in favor of medication is because it helped him stop getting in trouble all the time at school; that was taking a toll on his self-esteem, which to me is the most important thing to protect, way more important to me than grades. But the grades have improved as well.
We are still taking breaks in the summer and on vacations because the silly behavior and lack of focus is easier to deal with for everyone then.
Anyway, it is a multidisciplinary plan that we use, including medication and while of course far from perfect, we are seeing lots of improvements. And he is not a zombie. Side note, my stepson was diagnosed with adhd when he was about 12 and was on an extended form of ritalin and adderall for several years. He was kind of a bad student but got to high school and excelled in school and extracurriculars. Now he is a senior in college (with a really cool job already lined up) and told me that since he has been in college he only takes medicine during finals and expects to fully stop after graduation. So, I am hopeful that my 4th grader will also be able to wean from the medicine eventually.