Increase in Tenex | ADHD Information

My daughter has been doing great on her new meds. I did notice however that her irritability was starting to return since we increased the Concerta from 18 to 27mg. I increased her Tenex today by half a mg. She was taking 1/2 a mg twice a day and the Dr. told me I could increase from 1mg a day to 2mg a day if needed. (no more than that so as not to cause BP changes) It seemed to work today. She was in a much better mood. I guess my question is...has anyone had to continually increase the Tenex to negate the side effects of the stims? I have read a lot of post about stim breaks, but I do not see that as an option for us because of my dd impulsivenesses and hyperactivity. Her impulsiveness has gotten her in dangerous situations and I am afraid to let her go without the stims. I know the stims are mostly for focus but I am still afraid. We haven't increased Tenex above 1 mg total for the day. She started out on .5 mg once a day. My 2cents is to watch out for signs of depression with Concerta. Our dd became depressed, withdrawn, and angry on Concerta. It works great for some people, and others have these side effects.My son just started Tenex last week.  We tried Adderall in the fall but it made him hace ticks so now we're trying Tenex.  By next week he will be on 1mg at night and 1 mg in the morning.I think we are doing good so far. I gave my dd 1mg in the morning and 1mg in the evening. The only thing I see as a small set back is that she seems sleepy around noon and wants to take anap. I am hoping her sleepiness will ease up as she adjusts to it. Thanks for the input. It really makes me feel better that my concerns are valid and that I have such wonderful people to rely on to help me through this trying time. Thanks everyone.  I think it is perfectly normal to have to increase the tenex a little until you find the dose that does the trick.  Chase increased in .5mg increments until he got to 1 mg in the AM and 2mg in the PM (bedtime).  I think that vickies daughter is on 2mg both am and pm....it is an individual thing, and since the stim was increased, it stands to reason that you may need to increase the tenex.  That is why the dr. left it up to you (within his limits), to try to fit it to your dd's needs.... chasesmom7939188.5536689815

I would suggest keeping a long for a few days and chart her day....perhaps on the weekend when you can observe her all day.  Jot down a couple words each hour or so....on mood, behavior, sleepiness....then call the doctor.  The log may help the doctor (and you) determine which med needs adjusting.  Do it for longer if you want....just chart the hours before and after school.

Good luck and just remember, when you finally get to the dose that is best for her, it will be all worth it.

I agree with keeping the log. I keep one when we are making changes and it really helps.

Anxiety can complecate things as you know.

My daughter takes 2mg AM and 2mg PM of the tenex. It took us a while to get to that dose.

What we found was that if the stim was not high enough she could seem to functuion OK (but now quite up to her best) at school and we thought things were fine. But with time (4-6 weeks), it took a toll on her and the anxiety increased with an increase in defiance. With the stim back in place, the defiance is settling down. We are watching things closely though in case the defiance (her expression of anxiety) comes back. We may have to add something for anxiety at some point.

You know what Chase did yesterday??? 

I have his meds in a pill case that is divided into compartments (AM/PM and Mon- Fri).  Then I pretty much just leave it to him in the morning to take his meds...though I watch to make sure he remembers to get the pill case and take them.  I saw him take meds, but did not pay attention beyond knowing he took them. He put the case back on the shelf and went on to finish getting ready for school.

When the bus came, I got the daycare children that come to my house off the bus, and asked the driver where Chase was.....she asked a boy at the back of the bus if Chase was back there....he had fallen asleep....hmmm odd I thought...then he tells me that he was so tired today, he fell asleep in Social Studies....very odd I thought...

Then when he goes to get ready for bed and take his evening meds, he says "Hey the compartment is empty...."  So I check the morning one, and HIS MORNING MEDS ARE STILL THERE!!!  He had taken his nighttime dose of guanfacine, and no stimulant AT ALL.  So it is no wonder that he fell asleep in school.....when I asked him he did admit he felt unfocused at school all day....

I was a little stressed about it, but he seemed fine.....and it had been 12 hours since he took the meds....

 

I am noticing the aggression starting to resurface. I have increased the Tenex to 1mg in the morning and 1mg at night. My dd seems sleepy during the day but okay. I am wondering which one of her meds may need to be altered. When we first started the Concerta was at 18mg, the Tenex was at 1/2 mg in the morning and 1/2mg at night, and the Lexapro was at 5mg a day. Her anxiety is starting to resurface also. I wonder if her Lexapro should be increased to 10mg a day. I don't know!!! AGH!!!! Her Concerta is at 27mg at the moment. The 18mg seemed okay to me but her school work seemed to suffer a bit. This is soooooo frustrating. i am so tired of changing meds, increasing meds, etc. I just wish she would wake up and be okay. I know in reality this will not happen but I am sooooooo tired. Really tired. I have been on vacation this week and I feel like I have worked more on my vacation than I do at work. I just feel like screaming. AGGGGGGGGGGGGHHHHHHH! Okay there, I screamed. What now??????????

chasesmom79 I love your stories!  He is one heck of a boy!!

I do hope he feels well.

He is also very mature for not only his age but for having adhd!

Enjoy your son!!

Beth

Thank you!  I think he is a great kid too!

Last night he almost went to bed without taking the meds....guess I have a while to go before he remembers on his own every time, huh?

Nothing like an accident to get you to try a day with out the stim to see if it is really needed.