Tenex info needed | ADHD Information

We just started with a new child psychiatrist and feel pretty good about him.  He had a long talk with our son (8 years) and took a ton of information from us.  My son has been on Daytrana (15 mg) for for over a year.  I recently added 10 mg of Ritalin in the morning for the time before the patch kicks in.  He is very HHHHHH and impulsive.  He does have some anxiety -- I would call it panic attacks (just two topics that he occasionally obsesses about to the point of being unable to function normally) that usually occur in the afternoon, and I believe it's when his methylphenidate dose from the Daytrana is at its max.

Anyway, this doctor explained how Tenex works and how it affects the adrenaline and can really help kids who are hyperactive and impulsive.  He is on .5 mg once/day to start in will go to .5 mg twice/day on the 4th day.  He weighs 55 lbs.

Anyway, today he had a panic attack at school and I went to get him.  I could tell that he had too much stim in his body -- flat affect yet wild-eyed and worried.  He seems extremely sensitive to the methylphenidate.  Anyway, I told him to take his patch off right away.  This was 2 p.m.  By 4:30 he was crazy wild, impulsive, defiant -- his old self, in other words.  So I thought, let's try the Tenex. 

Long story short -- it had absolutely no effect whatsoever.  Is that normal for day 1?  I'd read here that some people saw an immediate effect.  Also, the pharmacy gave us the generic (guanfacine),  Is this as effective as Tenex?  I ask because I recently heard about a study on Wellbutrin that showed that the generic acts very differently than the brand name.  Has anyone had this experience with guanfacine?

Anyway, we will keep trying it to see if we can calm down the HHH.  I would love to be able to decrease the stim dose eventually if the Tenex works because the anxiety is pretty extreme.  Has anyone been able to do this?

Thanks everyone.

Joy2

It can take time to work or time to get to the right dose. My youngest takes 2mg AM, 2mg at night and a 1/2mg booster after school for challenging social activities. Here is a long thread on this med with articles and other good references:

http://www.adhdnews.com/forum/forum_posts.asp?TID=24770& KW=tenex

Thanks for your reply, Vickie.  I read all the way through that thread and a few others on Tenex.  It seems that almost everyone is having good luck with it except us.  I have had the most frustrating day in a long time.    We started the Tenex last weekend (.5 mg) and added .5 mg in the morning today.  I like to start new meds and dosages on the weekend, just in case, and in this case my caution was warranted.  We had a day of obsessive and aggressive behavior.  I hadn't seen any positive effects from the evening dose all week, although I was really looking for them to the point that I would have been happy with a placebo effect.  No sleepiness or calmness.  What I saw were outbursts that were like rebound from his Ritalin, but ongoing.  I really feel like crying, it was such a bad day, and I'm usually one who sees the glass as half full.   DS usually isn't aggressive unless he's rebounding.  I just can't figure this out.  He also reacted terribly (but differently) to Strattera and hallucinated after 6 weeks of Concerta.  He saw double/triple/quadruple (he couldn't really explain it) on Metadate.  He's done well on the patch but has these panic attacks, and I think that was part of what the psych was trying to address.  He wanted to take the edge off, as he put it.  We were also hoping to deal with the hyperactivity, but I'll take the H over the aggression any day.  Also, his heart has been racing lately.  I'm not sure if it's from the Tenex or the Daytrana.

I am just venting tonight.  This child worries and frustrates me to no end.  I really worry about why he reacts so sensitively to all of these medications.  I am so glad that this forum is here or I would feel crazy right now from this stress.  ADHD really makes life so chaotic, even if you aren't the one who has it.