How do you know its time to switch??? | ADHD Information

On another note, it must be the day for early morning risers.. I found Will up at 4:30 this morning, eating Oreos, watching TV, and playing in the basement. He even woke up his little brother to join him... But I learned something new.. Never give him 3 brownies at 9:00 at night, and expect it all to go well....

Too funny! I am becoming dissappointed with my pediatricians office....when I asked about Tenex they got all uncomfortable and wanted to refer me to a psychiatrist. I don't have a problem with see one, but we already go to a psychologist and out co-pay is a visit! I'm glad to hear that yours is working with you.

Yup....those eeeaaarly morning surprises keep you on your toes!

Must be going around because my eyeballs popped open at 6am--and THAT's unheard of.

And no--I didn't eat any brownies last night HONEST
It does get to be a lot with all the copays..........beileive me I understand, but I think you'll be happy seeing a psychiatrist, they really are the best to manage ADHD meds, unless you are lucky enough to have a developmental ped or a ped specialist. Our ped is not and wouldnt prescribe anything after two or three 1st line med attempts. I was ok with that and glad she knew when it was more than her expertise could manage. Our psych doesnt take any insurance so we have to pay him cash. It's killer! But he is good and only charges for office visits not phone conversations. We only go in the office once or twice a year usually.

Hi, I'm new to all of this and my 8 year old son started focalin xr about 1 1/2 months ago. I was SOOO afraid to start him on anything. He's incredibly bright and ahead of the curve in school, finished 2nd grade with all A's. But he is so distractible, impulsive and absolutely could not sit still in class.... to make a long story short we moved him to a more structured traditional style school which helped some, not as many distractions, but we finally gave in an gave meds a try. Focalin xr has been awesome for him. He's on 10mg at this point and the first day we started it, he came home all excited and told me that for the first time in his life, and I quote, "the noise was turned off in his head"! His teacher has been amazed, she's a 20 year experienced teacher and said he is doing tremendously well. Before he had a hard time interacting with his fellow students because he was so hyper and crossed boundaries with them, he would tell us they thought he was "weird" broke our hearts. He now has made so many friends, kids he's been in school with but didn't play with. He used to tell us he thought he was "stupid", (not, 139 IQ reading on a 9th grade level) because he couldn't finish his classwork like everyone else, now he's done at the same time as the rest of the students. I'm very thankful. I can really see how this disorder can affect them for life. I am also on focalin xr and have had the same kind of "ah, ha" experience that Carlton has had. I guess what I'm trying to say is, we haven't had any problems with appetite or sleep issues on focalin xr, if anything we both sleep much more soundly and get up much easier, no tremendous rebounds, it does seem to wear off around 6-8 hours. I'm not speaking from a world of experience considering that this is the only med that we have tried, but for those who have not tried it, it has truly been a God send for us. As I like to say about Carlton, "it hasn't taken the bounce out of Tigger's tail", just helped him be less hyper and much more focused.

Hope this helps.

It helps to know that other people are bringing their kids to a psychiatrist. It just seemed so.....scary, you know like he's REALLY in need of psychiatric help. But if that is the best way to go to find the healthiest balance for meds than that's what we'll do.

Elanabug, I'm so sorry that your boy has had to go through rejection like that. It sucks.....It sounds like he is doing really well now, and that's great. I wish the stigma of ADHD wasn't so awful, and there was more education about it. Our kids are just EXTRA special and that needs special considerations. I am not sure if focalin is an option b/c he is 5yo. I've read good things about it too, so who knows. Definately worth exploring.

Guanfacine is like clonidine but less sedating and longer lasting. Shire should be marketing a long version of this med for ADHD later this year. They submitted thier clinical trial data late last year,

The guanfacine was only a suggestion for symptom control when the stimulant is not in the system. Guanfacine does not just counteract side effects of stims, it augments the stims for more effective symptom control, and can provide symptom control by itself. There are studies showing that it is effective for impulsivity, defiance, hyperactivity, weight and sleep issues, and that guanfacine and stim combo is more effective than either alone.

My youngest does not take a stim on weekends and will not for the summer so she can gain weight even better. For her, the guanfacine is great for everything except attention in school. She is no longer impulsively irritating her friends and is keeping friends much better, and she is not as defiant and having rages. She can better self reflect and makes better choices. We see the same results on stims but cannot keep her on stims 24/7 so augmenting with guanfacine has worked for us. It is not for everyone and should be managed by a doc that is experience managing this med.

vickie39236.9021527778We also added Guanfacine for to help supplement ny daughter while on Ritalin LA and I feel it is helping now that weve stopped stimulants and are trying to find another path. Diane V39237.2635185185Thank you all for your input. I put a call into the Pediatrician to discuss Guanfacine. I hate that this is part of his life, but I am willing to do ANYTHING to help him. I want him to be happy.

My 5yo son is on Adderall XL, and while it has helped with school time, morning and evening are getting worse. For example he almost started a fire in the microwave at 5am while we all slept. This morning he was practically attacking my youngest for no reason. There is the usual ADHD and SPD with the spinning, talk-talk-talking, impulse control etc, and the medication is great while its in the system. I feel like my son "visits" me for a few hours a day and he is courteous, polite, empathetic and reasonable. When the Adderall wears off, he changes completely. I'm thankful for the changes meds have brought ( I was super resistant before 6 months ago) but these off times are horrid, and not just for the rest of us, but for him too. All that hard work he does every day at school, with the Psychologist all the positivity gets trampled. I hate myself then and frankly have a hard time liking him too. The regular Adderall was a nightmare and the pediatrician doesn't want to try Strattera (I was thinking all day benefits) I don't know what to do, but something has to change. Would Concerata be good? Doesn't it last longer than Adderall XL? help!

twodoodles39236.8009259259

Does he sleep ok on meds (some people sleep better on meds than off)? If so, and there are no appitite issues, he would be a good candidate for a second dose of the med. Or you could use a boost of a short acting form of the same med. This would maintain the good effects you are seeing and adjust the med schedule to your son's needs.

Soon, shire will be selling vyvanase which is a longer acting med like adderall (I think it is 16 hours).

Beyond this, you might look at augmenting the "off" times with guanfacine. Especially if weight or sleep is an issue.

He does have sleep issue, and I give him melatonin every night. Is guanfacine like Clonodine? I don't want to sound reactionary, and in reading the boards I understand that is common practice, I just don't know how I feel about taking a medication to counteract another medication. Does that make sense? I'm still in the guilty feeling stage of giving him medication, and that's my own issue. What does guanfacine do? Is it another blood pressure medication that's found another use? **sigh** sorry for all the questions...as always I'll do my googling, but I've found reading personal experiences from the boards is as informative as what I can find out in cyberspace.

(and before I forget...thanks vickie )

The guanfacine is indeed a blood pressure med prescribed 'off label' for ADHD.

I so totally get not wanting to take another med to counteract the first med.....but the guanfacine has been a great addition to Chase's meds. It not only counteracted the unwanted side effects from the stimulant, but it also helped Chase in other areas as well. He has always (even before stims) had issues with anger and yelling, and the stimulant only worsened those. His focus and grades in school were helped so much though by the stim. Once the guanfacine got titrated up to the target dose, within weeks, I noticed a vast improvement in his ability to deal with his peers. He can understand that he has choices in his reactions....like if someone makes him mad, he can either scream at them, or he can brush it off, or just tell them "I don't like you stepping on the back of my shoe, stop it!" He now takes the time to reason through his actions and think of the consequences.

It also helped him gain weight and to sleep better, he has color in his cheeks. I have stopped his stimulant for the summer, and have only kept him on the guanfacine and the periactin for the summer. We are only one week in to our summer break, but it has been a busy one, with my adult daughter's dance studio having her recital, and we all are recruited to help out. Chase was in charge of the curtain, and did a fabulous job.

I have the same feelings about giving the meds.. At our dr's visit, I felt like I was at the end of our rope with Will's behavior. The metadate did well for him at school but the mornings and evenings were horrible..

I went into the dr's office fully intending on adding a new med to the mix just because he did so well with the Metadate at school, but his dr said let's give Focalin a try.. We did and so far, things are so much better.. mornings are still rough, just because he's SO loud and annoying, but the evenings are much better and he isn't SO defiant during the day. Maybe this isn't the right med for you..