Concerta/Clonidine | ADHD Information

[QUOTE=lisadc3]

Heres the story in a nutshell....My son is 9, diagonesed at 5 1/2. We started him on Concerta 18..did nothing . Went up to 36..still nothing..went to 54..What a wonderful kid we had. Quiet, calm, non violent...though he never shut his eyes , never ate. Doc said lets add Clonidine at night. Helped him sleep, but the mornings were BRUTAL...the anger was horrible.Suddenly he was off the wall again.Spoke with doc..Up to 72 milg of concerta (they dont even make that much) still no change. Maybe concerta is not working.. I think it is she said but Lets add Ritalin so we added 25 mlg each morning. Calm but miserable. Talked to doc again..She said he was depressed, lets add Abilify. First week wonderful..by week two 20 pound weight gain and was miserable, couldn't get him to stop eating and he cryed all the time. Went back to docs again. Said he was anxious.Lets add Tripodel,,More crying, more anger. Said that he needed Trazadone, this went on for a while. I had a quiet, crying, miserable, hated everything in life, angry child. I had it. I called a new doctor who said..HE has ADHD thats it. Lets stop everything, try the Adderal xr 40mlg in the A.M. and one 50 mlg Trazadone to help him sleep. It has been almost 3 weeks, usually by this point if its not working we can tell...BINGO he is a happy, rambunctious, playful, laughing, 9 year old. Do we have our moments of course we do..He is a 9 year old boy. I am not expecting perfection. The D's and F's are all A's and B's. Teacher has said he is wonderful, particiapets in class and gets along great with his peers. Now I am no expert, but my advice to you is THIS IS YOUR CHILD..... If you are not happy with what he is on find someone new. I am in the process of filing a medical charge against his physciatrist, She made him a walking zombie. My pharmacist said he was on more drugs than a person in a mental hospital. Like you I listened to the doc and thought SHE knew better. YOU know best he is your child, if your not happy with how he is. CHANGE IT. We are the only ones who have to deal with them daily. Keep insisting on what you want until you see him happy. I have had great success these past 3 weeks from him. I am hoping it lasts, but for now I finally after 3 1/2 years have a happy kid.

Hope I helped you some..

[/QUOTE]

My 8yr old son is on concerta and clonidine. Lately we have been having problems w/him saying that he is going to kill himself. Is there anyone else who has gone through this, I need help. I do not want to place him in a hospital like the doctors are suggesting, I fear that will only add to the problem. We have recently added risperdal and have seen a slight chane but we are still scared for our son.

kelly

k pons38282.2194328704My son was very angry all the time on concerta and clonadine, he never spoke of killing himself but he hated everything and everyone. We recently stopped the clonadine and concerta and are are using adderal xr and trazadone, it calms him down and helps him sleep and he is a much happier child. He is actually begininng to like me.Hope it helps

lisadc3

Thank you for that bit of advise. I know that he did not do well on regular adderall but maybe we can start w/taking away the coladine and adding trazadone. Since he is OK in the am maybe giving him trazadone pm might help. He only really acts up at night. I will definantley speak w/his doctor. Do you mind if I ask, how old is your son?

k pons38282.2382175926

Hope I helped you some..

Been in and seen in others similar situation. guanfacine is much nicer and more effective and fewer side effects than clonidine. helps sleep, can be dosed twice a day and sometimes you dont even need the concerta or other stimulant once they are doing ok on guanfacine. It improves mental acuity whereas clonidine actually worsens it - gee, just what you wanted for your academically stressed child! I have never heard of guanfacine, did you get it from ythe doctor or is it a over the counter med.

Guanfacine is otherwise known as Tenex, it is an alpha 2 adrenergic blocker just like clonidine, except side effects are a lot better than clonidine, and good effects are a lot more significant. It is used in Tourettes syndrome sometimes and in kids who have tics and you dont want to use stimulants. It is prescription. It used to be used for blood pressure control, but it does not control blood pressure very well, which is why it is ok to use in kids and adults with adhd and other problems as above. There are not a lot of studies with it, but some of the ones that have been done are very interesting and show it to be far better than clonidine.

IF you look on the tourettes web sites you can see some info about it, there just is not much out there, but it has certainly been a great thing for my son and also for some of my patients, as I am a Pediatrician and see alot of this.

Sorry to be pain, but can you tell me some of the side effects, I looked it up and all I saw was stuff for high blood pressure. My sons physc. had him on 72mlg of concerta,,25 of ritalin..in the a.m. Everytime I would try and tell her something she told me there was something else wrong. anxiety, depression, aggresion. Of the course of 3 years since he has been diagonosed he has been on (and at one point all together) Concerta, Ritalin, Trazadone, Clonadine, Abilify, Tripedol, all making him much worse then when they first said he had ADHD, Now I have stopped this doctor, (Pharmacist said people in mental hospitals dont take this much meds) and he is on Adderal 20 release and 10 reg in the morning..and 50 mlg of trazadone to help him sleep, but he doesn't. All he does is eat and eat and eat, since starting this he gained almost 20 pounds, he crys at the drop of a hat and is pretty angry all the time. I am just with the peditricain right now, Waiting for an appt at Mass General Hospital for him. I am pulling at strings right now trying to find what is right for him. Do you think that med would help him. I know the adderal is working with him controling himself and his grades went from D''s and F's to all A's and B's report cards were yesterday. So that is a plus,,, but at what expense?

Guanfacine is originally a blood pressure med. As a result it does slightly decrease blood pressure, sometimes causing a little increase or decrease in pulse, but these seem to be temporary and tolerable side effects in most kids I've seen on it. Not all kids respond the same way, but it appears to me that kids who are very hyperactive and also very impulsive do very well, as it really decreases both of these, without the excessive eating side effects of the trazodone and company, and also without the appetite suppression of the stimulants. It may slightly increase appetite, but I have seen only one little boy (3yo) who got severe weight gain with it, every one else remained normal. If your kid is bipolar and not adhd, it potentially can precipitate mania, but usually you already know this because the typical bipolar kids get very agressive or bizarre on stimulants also.

Other common side effects early on are sedation, potentially nausea or vomiting. It is best to try it alone, not mixed with other meds, esp not the antipsychotics like trazodone/risperdal, as the 2 together can cause alot of hypotension and vomiting in some cases(my kid did that! -that's how I learned). The sedation, etc, is usually not a big problem. The trick is to start with 1/2 of a 1mg pill at bedtime and keep it up for up to a week, or until the child has gotten used to that dose and is no longer really sleepy the next am. Then add 1/2 a pill in the am, and then each week increase by only 1/2 pill, first pm , then am, and watch for effects and side effects. When it works, it is miraculous, and without the lousy side effects of stimulants and antipsychotics. I think it is just not prescribed much because it is cheap and there are no drug reps out there hounding the docs into using it, in contrast to the amount of pushing we get to try all the new long acting stims, strattera and the new antipsychotics.

Some kids need it twice a day , others every 8 hours if it wears off sooner, but either way, the child sleeps and eats normally and is much less overactive and much less impulsive, and therefore sometimes does not even need another med to help them as they now can concentrate. Others still need a stimulant low dose for school or strattera for the concentration part, though the guanfacine itself does help with "executive function"or organizational ability in the brain.

I have started using it as a first line in multiple patients of mine, with often very good results, sometimes some kids find it too sedating. I think those are the kids who are daydreamers but really not so hyperactive and impulsive, but it is not entirely clear to me. I had a really interesting experience this week. I had a family referred to me with 2 sibs, a girl and boy, about 8 and 10, both with severe school troubles due to apparent adhd. The boy was the classic hyperactive impulsive but very bright kid, and his sister more of a chatterbox in class, fidgety, out of seat sometimes but just not getting work done, less hyperactive, certainly impulsive and inattentive. I put the boy on guanfacine and the girl on strattera, as mom did not want anything to do with stimulants and I am very sensitive to this as my own son was a disaster on stimulants, so I try to work with the families individually. WEll, I saw them back last week, one month after starting the meds. The boy is up to 1mg guanfacine twice a day, and mom says he is a totally different child, responsible and attentive and appropriate at home and at school and getting great grades and getting better at the sports that he already enjoyed but was not really attending to. She did not want to change a thing. The girl, on the other hand, reported that she was able to pay attention better in school and take in and hear what the teacher said, but still was not completing work and still was out of seat and impulsive and chattering to classmates. Mom requested that the young lady be put also on guanfacine, so I'll see them back next month and let you know!

I must say I am very excited, both for my own son and my patients, that the guanfacine is so helpful and so benign.

Especially if you are getting jerked around and using multiple meds, as we were at one time, I highly recommend that you give it a try. It sounds like a lot of the docs treating folks in this message stream are still using clonidine, which is not a nice drug, but is similar in some effects to guanfacine, just nowhere near as good and much worse side effects.

Good luck.

I am going to ask to try that when I take him back on Monday. My son has severe ADHD and we are more concerned with the impulsiveness than anything else right now, his grades in school on the adderal have gone way up from C.D anf F's to all A'and B's this quarter. We are just trying to figure out why he is always so angry. When he was on the concerta and ritalin, the anger was not there, but it is in full force now. Maybe this will help if we added one in the morning and one at night, I am going to talk to the pedi on Monday were he doesnt have a phychatrist right now and is still on a waiting list for Mass General Hospital, Thanks for your help. You were describing my son when you spoke of the siblings. Anything that is not going to give me a lethargic miserable child will be a bonus....