Doctor won’t prescribe Tenex | ADHD Information
Small follow-up to my original post...I'm still looking for a new doctor. The neurologist told me I should see a neuropharmacologist, I called my HMO, they told me there were no neuropharmacologists covered by them in my area. I asked them for the numbers of any psychiatric nurse practitioners... they seemed unsure about what they were doing but gave me the numbers of about 4 nurses in the area. I tried them all but was told they're either not accepting new patients or that my primary care needed to be with them.
I tried turning to the internet for relevant listings in my area but apparently there are none. Not to mention it would need to be covered by my insurance too, which seems like a whole nother hoop to jump through.
Does anyone have any advice? I didnt know it would be so hard to find a new doctor.
I'M NOT SURE WHAT YOU ARE LOOKING FOR IN THE NEURO. IF YOU ARE LOOKING FOR AN EVALUATION OR FOR A DIAGNOSIS A CHILD OR PEDIATRIC PSYCHOLOGIST CAN DO THAT. IT SHOULD TAKE AT LEAST 6-8 HOURS TO DO THE TESTING AND OBSERVATIONS AND THEN THEY GIVE YOU A REPORT WITH A DIAGNOSIS AND RECCOMENDATIONS OF WHAT TO DO COME WITH THAT THEN IF YOU SO CHOOSE THEY CAN SEND YOU TO A CHILD PSYCHIATRIST FOR MEDS IF YOU WANT THEM. THIS IS ACCEPTPABLE AND WHAT WE DID BECAUSE THERE WERE NO NEUROS ON OUR PLAN. WE ENDED UP PAYING 00.00 FOR THE TESTING AND REPORT BUT IT WAS WELL WORTH IT. IT GAVE US SOME GREAT RECOMMENDATIONS AS WELL AS FINDING OUT ALOT ABOUT MY SON. ANYWAY I HOPE THAT HELPS .FEEL FREE TO PM ME ANYTIMEtry a large hospital. Many will have big psych clinics and the larger hospitals tend to take all kinds of insurance.Sounds like you are dealing with idiots at the insurance company. Call them back. Ask for the names of "psychiatrists" in your area. Don't tell them why. Then call the psychiatrists and ask if they manage ADHD meds and if they are accepting new patients. If that does not work, widen the area to the distance that you are willing to travel, and do it again. "neuropharmacologist" is just too complicated for someone answering the phone at an insurance company; you need to do their job for them (oh, BTW your neurologist should have referred you to someone in your network ---that's what my doctor does!).If this dr. doesn't know about using tenex/ guanfacine to control ADHD, he doesn't know much about drugs for ADHD. I'd definitely seek out a more knowledgeable dr. In the meantime, a few people have posted about approaching dr.s unfamiliar with using guanfacine for ADHD and that they went to an appointment armed with studies they'd printed. I know at least a couple of people said that their dr.s read the material and then were willing to prescribe it.
We have a child who took Addreral. He expereinced changes in personality and overall seemed tense(irritable) and negative. We tried different medications and found he didn't do well in the 'family' of medications which Addrerall falls in. His pediatrician recommended we work with a psychiatrist since it appeared he needed someone who really understands the medications available along with the expertise on how different medications can work with different people. That was great advice because his psychiatrist really works with him as an indivivdual and adjusts medication as necessary. Also, his psychiatrist respects our desire to minimize medication. Currently, he takes Metadate CD to help him focus. A few months ago, he started experieincing irritablity again. That's when Tenix entered his world. We were skeptic at first because their are side effects that had to be considered. He is taking an extremely low dosage. It really made a difference for him. I'll be honest we "interviewed" psychiatrists before selecting one. We met with each psychiatrist to determine whether the psychiatrist aligned with our objectives in treating our son as an individual with individual symptoms along with asking them for their initial recommendation. Also, we meet with him regluarly to ensure the medications are working as expected. Always remember you are in charge of taking care of you by finding the right support. There's no way unless you are a doctor that we would know all the possibilities and options available that match up with each person, Good luck in finding what works for you!
If you do consider changing doctors try looking for a nurse practitioner that specializes in psychiatric medicine. Can't gaurantee it would work out as well for you as it has for me but it's worth a shot if you are making a switch anyway.
After going to three psychiatrists in the about the same number of years I ended up having to change again because of a change in insurance. This woman has been much more helpful than any of the three doctors I had seen and she gives me much more time as well. The others ended up giving me less than 15 minutes per visit once the initial intro/diagnosis phase. She also seems to be more up to date on the medications than any of the others were as well. One of the doctors I was seeing even told me that there was no name brand equivalant for dextroamphetamine, when in fact dexidrine is the name brand and dextroamphetamine is the genaric.
It's worth taking the time to find a doctor that is both knowledgable on ADHD and treatment options as well as compatible with your personality type.
We also use a psychiatric nurse practitioner. She knows her stuff and has been doing it for years. Our appointments with her are scheduled for an hours, so we have lots of time to talk about issues and just chat. She is also very accessible and returns her own calls in a timely fashion.
BTW - She just prescribed Tenex for my daughter for tic management. She is also on Concerta.
HorseMom39457.9258101852Dont get too hung up on trying to get Tenex. Seeing a psychopharmocologist is the BEST way to go! He/She should be willing to discuss all options with you. See what they have to suggest and offer your suggestions also. They may prefer to just try a different med altogether to try to keep you on one medication rather than mixing meds and prescribing off label. Tenex for ADHD is only prescribed off label, it is not FDA approved for ADHD. Most of us have used it at some point however.
Good luck, try to keep an open mind.
I've read good things online about guanfacine or Tenex being used for ADHD. Specifically I thought it might help me have less impulsive thoughts and maybe reduce the slight social anxiety I feel is a symptom of my ADHD.When I raised these ideas with my neurologist today he was less than helpful. I asked him if he had ever heard of Tenex being prescribed for ADHD and he said no and tried to make me feel dumb. When I told him about specific studies that show it is in fact helpful, he changed his story and pretended he had heard of studies but that they showed the opposite and thats why it's not FDA approved.
I was so frustrated with this doctor I don't think I'll be seeing him again in any case. He tried to diagnose me as depressed, having an anxiety disorder, and having OCD. I think he was lashing out at me for questioning his authority (he is an older gentleman) and suggesting a treatment he has never prescribed(Tenex).
I was very much looking forward to the possibility of having so many frustrating symptoms relieved by this potential medicine, in combination with the Adderall I'm already taking, but now I am dejected and pessimistic.
My question is, should I give up on out right asking for Tenex? It sounds like a panacea for the symptoms Adderall doesnt treat for me, but now I am afraid to even bring it up with another doctor. He did refer me to a psychopharmacologist, would they be more likely to listen to me and treat me? Is there a way I can find out if a doctor is open to Tenex before I visit? Am I approaching this the wrong way?
Any help or stories would be appreciated. Thank you!
This doctor is not a good fit for you. I suggest that you find a psychiatrist to manage meds rather than a neurologist. A psychiatrist would probably have more experience with the myriad of meds available to alleviate ADHD symptoms. This doc won't listen to you, and you don't agree with his diagnosis. Also, it sounds like he is talking down to you. Personally, I'd bail.
You are correct. Tenex/guanfacine can decrease the symptoms of hyperactivity, impulsivity, anxiety... it decreases the level of excitement in part of the brain. It's used in combo with stims often. You should be able to get it from a psychiatrist with relative ease.
[QUOTE=jt203]I've read good things online about guanfacine or Tenex being used for ADHD. Specifically I thought it might help me have less impulsive thoughts and maybe reduce the slight social anxiety I feel is a symptom of my ADHD.
When I raised these ideas with my neurologist today he was less than helpful. I asked him if he had ever heard of Tenex being prescribed for ADHD and he said no and tried to make me feel dumb. When I told him about specific studies that show it is in fact helpful, he changed his story and pretended he had heard of studies but that they showed the opposite and thats why it's not FDA approved.
I was so frustrated with this doctor I don't think I'll be seeing him again in any case. He tried to diagnose me as depressed, having an anxiety disorder, and having OCD. I think he was lashing out at me for questioning his authority (he is an older gentleman) and suggesting a treatment he has never prescribed(Tenex).
I was very much looking forward to the possibility of having so many frustrating symptoms relieved by this potential medicine, in combination with the Adderall I'm already taking, but now I am dejected and pessimistic. 
My question is, should I give up on out right asking for Tenex? It sounds like a panacea for the symptoms Adderall doesnt treat for me, but now I am afraid to even bring it up with another doctor. He did refer me to a psychopharmacologist, would they be more likely to listen to me and treat me? Is there a way I can find out if a doctor is open to Tenex before I visit? Am I approaching this the wrong way?
Any help or stories would be appreciated. Thank you!
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Like Diane said, don't get too hung up on Tenex. I asked DD's dr about it a while back, he prescribed it, and DD ended up in the ICU with a dangerously low blood pressure, she only took 1/4 of 1 mg , she took it once a day for 3 days, then her BP dropped. It is not the med for everyone, and our Psych refuses to Rx it now.
I say go with the psychopharm, probably your best bet.
You might print out the articles on guanfacine for the psychopharmacologist that the neuro referred you to. There are links in the long thread for the uses of this med and for FDA approval for the long acting for by Shire for ADHD (though they are not marketing it yet). However, if the psychopharmacologist has no experience with this med, they may be reluctant to prescribe it because they will not be able to manage it effectively for you.see the pharmocologist it is your best bet. Hopefully he won't be so full of himself. I have had 2 pdocs poo poo tenex for any reason and made me look stupid. Alot of people here use it so I don't know