Tenex or Trileptol for Anger? | ADHD Information

My son takes half a tenex around 5:00 p.m. to help with the agression when concerta starts to wear off and supposedly to help with sleep.  Since we increased his concerta to 27 mg he has terrible problems falling asleep.  Now the doctor is suggesting taking him off tenex but she says it has to be done very gradually.  We get a different doctor every 6 months because we go to UCLA ADHD Clinic and they revolve the doctors.  I really hate it because one doctor will have a different opinion and they never really read through what all has happened in the previous doctors notes.  Now I'm not sure if we should take him off it or not.

My youngest is on concerta and guanfacine (tenex). She takes 2mg am and 2mg at bedtime. It helps with the anger and aggression. There was a difficult time last year when her stress over teasing at school and a bad teacher was too much and the aggression started coming back, so risperdal was added. The risperdal helped her a lot to get the aggression under control. This school year with a great teacher we tried without the risperdal and she has been fine for several months. I am prepared to go back on it if needed.

Basically, I would try the tenex first and move to the more aggressive treatment if the tenex does not do the trick.

Thanks for your response Vickie.

This week we took our son off Strattera, and lo and behold, much of the anger has dissipated. We're thinking that on vacations and weekends we'll keep him off meds, but find something else for his attention at school.  The stimulants don't work, so that leaves us with either a lower dose of Strattera (he's currently on 40mg) or I don't know what. 

We've been fiddling with meds and dosages for over a year now.  We had no idea it would be this difficult!  I wonder if others have had a similar experience?
Some find this easy and some have a tough time getting the right med. Have you looked at Tenex alone. Find the long Tenex threads for great info about this med for ADHD. It helped some for my youngest (when used alone) but not quite enough. We find that when her stress is under control, she can compensate for the ADHD but school and social interactions are stressfull any way you look at them.Hi, our psychiatrist has recommended that our 8.5 y.o. son take Tenex or Trileptol to calm his extreme angry ranges, in addition to his medication (40 mg Strattera) for ADHD.

Has any parent had experience with this?  We'd like to hear your views.  Thanks so much in advance.

I would like to know too. My son's psychiatrist wants to prescribe tenex for him because of his anger issues and because he cannot get to sleep at night. He is 9.5 and has ADHD and SPD. He is on the daytrana patch and taking focalin in the evenings when the patch wears off. I have also been giving him melatonin to help him get to sleep. The doctor wants an ekg before he will prescribe the tenex, so we haven't started it yet. My daughter takes Tenex in conjunction with her Concerta.    We added the tenex to help with tics and some sleep issues.   Tenex is also supposed to help with hyperactivity, implusiveness, anxiety, sometimes sleep and I believe aggression.

I don't know how well it works for aggression as most of our anger issues aren't around when her stimulants are at the right level.  She is considerably less wound up at bed time but it doesn't knock her out.  She does sleep more soundly and we are no longer using melatonin in the evenings.   I also think she is a little less anxious on it as well.

I have tried a couple of times to just use the tenex without her Concerta and it isn't enough on it's own.  I don't know if increasing the dosage would help, but for now, I am very happy with the combination of the two.

The other option is Clonidine.  It is much more sedating than Tenex.  This is what our prescriber was initially going to add, but I opted for Tenex instead.  I was worried it would be too sedating if we needed to add a day time dosage. My son Wyatt is on 54mg Concerta in the am and 1mg tenex in the evening.  The tenex helps him with the anger and agitation he gets in the evening when he's coming down off the Concerta and it helps him sleep at night which also helps on the aggresion end of things.  Jigsaw, I'm surprised that the patch has been a godsend for you.  Our psychiatrist didn't think we had a chance using the patch on our son.  We also figured our son would put up too much of a fuss, and there's the part about other kids potentially seeing it.  We've also started behavior therapy, which seems to work, sometimes. 

This week, we've taken our son off Strattera, and we are noticing a decrease in his hair-trigger temper.  It makes us think that the Strattera might be playing a role in the anger.  Although we tried this several months ago, we noticed no difference at the time, perhaps because he hadn't been on Strattera for as long as he has now.
In any event, we might have to change drugs, but to what I don't know.  Our son has been on various Ritalin-type meds, but they made his anger even worse than the Strattera.

Thanks HorseMom for your reply.  Jigsaw, our son had the ekg, and it's no big deal.  The big deal for us is that Tenex has to be taken more than once a day, and it's hard enough getting our son to take his 1 pill of Strattera, let alone fighting to get him to take more pills, and more than once a day.

So again, anyone out there w/ experience in any meds, particularly Tenex or Trileptol, for anger, please share with us.

Many thanks in advance. 


Henny, I understand the difficulty with getting your child to take meds. My son is the same way. For whatever reason, he doesn't give me much trouble taking the evening dose of focalin. I think it is because it is a small tablet. Before we started the patch it sometimes took 2 hrs to get my son to take his meds in the morning (Focalin LA they were capsules). The patch has been a godsend. I put it on while he is still sleeping at about 6 AM that way it has started to work at 8 AM for school. The patch isn't perfect, so my ped wanted to try another med. I said no way. I'll work with this. We don't need the aggravation in the mornings trying to get him to take the meds. He had about 40 latenesses last year at school because I couldn't get him to takes his meds. I hope they put some other ADHD meds into patch form. I'm hoping if we start the tenex that he doesn't give me a problem. I would discontinue the melatonin so, he wouldn't have to take that in the evening. I just really need something to help with his anger, aggression and frustration. We will be starting behavior therapy soon too. Wyatt's Mom, thanks for your response.  Does your son have any anger in the morning, or is it just evening? I am new to this, my son is 9, almost 10.  Has been on concerta 54mg. over several years predonimantly for aggressive, social behavior and impulsivity.  Have had our problems over the years and seems like the angry agression has skyrocketted.  Psy. has suggested tenex 2x daily, 1/2 mg. in the am , same at pm.  We are starting  in a couple of days.  Anyone with this type of experience????

Hi Henry, Sorry I never answered your question I actually didn't realize you had directed it at me until just now.  Wyatt was havign anger mostly in the evenings coming down off of the med but I did notice soem throughout the day when he was tired.  The tenex also helps him get a better nights sleep.  His attitude is better all around.  How are things lately?

Hi Wyatt's Mom,

Thanks for asking, things have been pretty good lately.  As I indicated in my prior post, we took my son off of Strattera because he was incredibly angry all the time
(except at school, interestingly enough).  Although we had done this sort of test once before and saw no difference in his anger, this time we saw (and continue to see) a marked difference:  no angry rages lasting for long periods of time, less quick to anger, and significantly less moody.  It feels like our good-natured son is back to himself.  Perhaps it was because he was on Strattera longer this time than the first time?  Who knows.

We will continue to monitor the situation.  We will also keep our son's weekly individual sessions with the psychiatrist.  Thankfully, summer is around the corner and we'll have a break from school!