We worked up to the dose for my daughter slowly watching sypmtoms and hoping it would help with weight gain. It stopped the weight loss due to concerta but added no gain.
Guanfacine has some of its own effects for ADHD and was originally given to my daughter because the doc did not want to further increase the stimulant (concerta at the time) for full effectiveness because of the weight loss. The combo is wonderfull for her. We recently started focalin because there is a chance it is not so hard on the weight. She has been steadily gaining weight, so maybe we have found the magic combo for her. She is on 15mg focalin, and I do not know how that compares to dex. It is twice as strong as regular methylphenidate (you use 1/2 as much).
The trials that shire did for thier long acting guanfacine used doses of 2-4mg per day. Just a little tidbit on dose info.
My son takes 1mg guanfacine (generic for tenex) in the morning with his ritalin LA, and 2mg at night before bed.
I know that before the guanfacine, Chase was constantly getting into recess brawls, and could not handle the noise and teasing that went on on the afternoon bus ride home. He just could not stop and assess what his best action should be, he came out swinging or yelling, landing him on trouble quite often at school. After the guanfacine, he can calmly tell children to stop doing _________. And if they continue, he finds an adult to help. Or he walks away....
And he is doing amazingly well at school academically as well, so the good things that the stim does have not been affected.......
That seems a big dosage of melatonin....have you tried the lower doses of that and they didn't work? I have read that it is much more effective at lower (1mg....2mg) doses, but I am sure that it is individual.
My son takes 1mg of guanfacine in the morning, and 2mg at night. I don't see why you could not give the afternoon dose in the evening, but you would need to okay it with the doctor first......
The dex may have a calming effect that gets him to sleep. My daughter sleeps better with her stim. If weight/appetite is not an issue, you might need to keep up with the 4pm dex. If weight/appetite is an issue you might discuss with the doc about a larger night dose of guanfacine. My daughter takes between 4 and 4.5mg a day, Chase takes 3mg a day, the Shire study worked with between 2 and 4mg a day...for reference.
You might also keep a diary of meds and behavior/sleep patterns to help sort it all out.
Struggling to find the right guanfacine dosage for my son. He currently takes 5 mg. of Dexedrine 4x per day. His last dose is usually at 4 p.m. He also takes 1 mg. of Guanfacine in the morning and has been taking .5 mg. of the Guanfacine around 3 p.m. when he gets home from school. The last two days I have not given him his 4 p.m. dose of Dexedrine because it seemed after taking the afternoon dose of Guanfacine, it wasn't needed. But he has been up all night the last two nights. Is it the missed dose of the Dexedrine or should I be giving the afternoon guanfacine dose in the evening? He also takes 4 mg. of Melatonin at night before bed.
Sorry if this is confusing, but I,m baffled.
You should always ask the doc about these things, and I know it is hard to get all the info at each visit. Do you mean .5mg rather than .05mg of guanfacine?
My daughter takes 2mg guanfacine in the AM with her focalin, 1/2mg after school as needed and 2mg before bed. We slowly ramped up to the dose and really like this med. We even tried it without a stimulant (for weight issues) and it worked pretty well but just not as good as with the stim (for school focus).
I would try the guanfacine without the melatonin to see if the melatonin is still needed. Guanfacine is calming and slightly sedating when first started. My youngest never slept until starting meds. They calm her busy mind.
There is a long thread called "Tenex", which is a brand of guanfacine. You should look at it for all kinds of info and link on this med.
I am taking a 1mg. tab and cutting it in half, so it would be .5mg. I have an appt. with the doc in a week. I'm going to ask him about the guanfacine dose that you give your daughter and see what he says. What dosage of the stimulant does your daughter take? My son has been on 20 mg. a day for about one year, and sometimes I wonder if he needs a higher dose of the dexedrine.Just joined the forum and can't believe how informative it is - glad to know I am not alone.
My son is 10 and is taking 5 mg. of Dexedrine 4x per day for ADHD. The doc has started him on Guanfacine for aggressive and disruptive behavior. I have started giving him .05 mg 3x per day and would like to know if you give him the dose of Guanfacine along with the Dexedrine at the same time. It just seems like giving him a stimulant and something that lowers blood pressure at the same time defeats the purpose. Also, before being prescribed the Guanfacine, he had been taking Melatonin at night to sleep. Is it OK to give him the evening dose of Guanfacine along with the Melatonin?