Seriously I am, of course, against using medications with small children before they are needed BUT from experience I know that some children need stimulant help before they reach the "magic" age of six. Have you tried other medications to see if you have better results? In our family (spanning almost fifty years and four ADHDers) we have used multiple Rx's. None of the stimulant medications required titration as they were all quick in and quick out. Ritalin was the first and followed by extended release Ritalin, followed by great success with Concerta, Tenex (which is not a stimulant and does have to be carefully titrated in and OUT) and a combo. We had no appetite issues for breakfast or for dinner although lunch was often impacted.
in my humble opinion if a child is being singled out as a "trouble maker" at age four or five the residual effects often carry forward like a negative label can. As a result integration into the social events of the peer group get waylaid etc. In an ideal world none of our children would ever need medications but sadly many of ours do.
