For the first time in more than a month, we gave Ryan a small does of his medication this morning.

It is not a decision we take lightly, nor did we arrive at it easily, but in recent days it has become obvious to us it was the right decision to make. All the behaviors that caused us to consider medication in the first place are as obvious as ever — primarily impulsivity and hyperactivity. The negative side effects that we thought were caused or at least aggravated by the medication — primarily a facial tic — remain even without it.

On top of that, Ryan’s sleep, always a persistent problem, has deteriorated once again. He has been waking for good as early as 4 a.m. and unable to get back to sleep.

Watching him run around the house before school yesterday morning, doing everything at warp speed and at top volume, it was obvious that something had to be done. I recalled the words of Ryan’s psychiatrist, under whose direction we first placed him on medication.

“We can slow this child down a little bit.”

Yes, that sounds about right. Ryan does need help to slow down. Recent feedback from his teachers confirms it. He has been calling out more in class. His voice is louder. He rushes to complete assignments, making mistakes resulting in the need to repeat things.

I wish this was easier, that the right answer was clearer. We struggled to find a medication Ryan could tolerate, but even that one had side effects we didn’t like. The benefits weren’t always obvious, but have become more so after we took him off. Still, I have little doubt that we’ll face another crossroads before long.

For now, we’ll begin the process of ramping up Ryan’s dosage back to previous levels, in careful consultation with his doctor, while closely monitoring his behavior.

My son deals with so many challenges. He needs a full night’s sleep to do so, and all the tools we can arm him with to help. Today, we feel that medication needs to be a part of that tool kit.

Will we feel the same in six months?

Only time will tell.