stimulants vs. non-stimulants? | ADHD Information
My son has been on different stimulants for the past two years and none have worked well enough without side effects to keep him on them. We tried Metadate, Focalin, Vyvanse and then back to Focalin, and now he's been off medication since July 4th. However, now that school has begun, I can see he really does need something. I thought it didn't really help him in school, but I guess it was doing something because he hates school, hates his teacher, the kids, the hallway!, etc. I've had several phone calls already, and he even got into a "fight" with one boy (he's only in second grade!). His resource room teacher said he was never like this last year, and that's what made me realize the medication did help him.
So, his doctor had said the only other medicine to try is Strattera, but I don't like the black box warning. She thinks that because he has tried several stimulants and different dosages, that the only other thing to try is a non-stimulant and she said Strattera. I get nervous with the suicidal thoughts as a side effect, because he had those with Vyvanse.
We never tried Concerta. I'm hoping to try other stimulants before having to try Strattera. Has anyone had success with a stimulant after trying a bunch of other stimulants before that? I'm thinking of asking for Concerta, or how about even Daytrana. His side effects have been no appetite (which we can work with), extreme moodiness, crying spells, anger, and crankiness when it wears off. Also, I've seen some of them only seem to last a few hours.
Thanks for any input.
Kathy
Normally, I'd remind you that suicidal thoughts are an extremely rare side effect...but if your son experienced that side effect with one medication, it's very possible that he'll experience it with another.
Don't give up...it may take a while, but you'll find the right combination. There are TONS of medications out there for ADHD. While you go through that process, be sure to keep working with your son on the skills he needs to cope with his ADHD. There isn't a medication out there that can teach him organizational or social skills. Working with him on those things will also provide a more stable background as the meds are changed around.
Let us know how it goes!
My son hasn't been on a lot of different stimulants (just Adderall and Ritalin) but we tried every comination, timing, dosage etc with both of them. Stimulants seems to work wonders for his hyperactivity and impulse problems but they aggravated his emotions so he had a lot of the side effects that you described. His doc suggested going to Stratera but we decided to stick with Ritalin but add Tenex (he's actually on the generic called guanfacine). The Tenex calms his emotions and helps with his anxiety and moodiness that he gets from the Ritalin. Maybe it would do the trick for you too! You might want to ask the doc about it. Just FYI though...usually you have to go to a psychiatrist to get it. Pediatricians don't usually like messing with it. Good luck!Thank you for your idea. I never knew what Tenex or guanfacine were for even though I read about them on here. Maybe that would help. Do you give both medications in the morning at the same time, or separate times? Are there any side effects that your son has experienced with the guanfacine?
We see a developmental pediatrician, so I would assume she knows about this and can prescribe it if needed.
Kathy
He takes 1 mg a day total. We split a 1 mg pill to use 3 times during the day. He gets .5 mg first thing in the morning with his Ritalin. Then .25 later in the day along with his Ritalin and another .25 at bedtime (the theory on this dose is that it will help him in the moring before his Ritalin kicks in). I haven't noticed any side effects with the guanfacine. The only thing I noticed in the beginning was some drowsiness in the evening but that wasn't such a bad thing! 
It's actually a blood pressure medicine when used in adults. I'm not sure why exactly it works well for ADHD kids but it does. We had to get my son an EKG before we started it to make sure he didn't have any heart defects and the doc checks his blood pressure periodically. But other than that it's been really no different than what we do for the Ritalin. Definitely talk to the doc about it. It may be exactly what he needs! Good luck and keep us posted!
also, I forgot to mention that guanfacine is not "fast acting" like stimulants. It has to build up in the system to get the full effect. So it may take several weeks to see any benefit. Just fyiLogan'sMom,
My son just had his 8 year old physical and I mentioned the guanfacine to the doctor. She said it is something to consider and that it may also help him sleep at night. We have his appt. tomorrow with his developmental pediatrician and I will ask her about it. I'll let you know what happens.
Kathy
An update.....my son has been taking Concerta the past 4 days and I have heard better reports from his teacher and speech teacher at school. Today (Saturday) is the first day he has been home all day so that I could see how he is on it, and he still gets whiny and upset, but a little better than when he isn't taking anything. So, if all is well at school, we'll stick with this. He still needs some kind of behavior therapy though, so I'll be looking into that.
Kathy
Good luck with the Concerta! I hope it works for you!My DH just started taking strattera and has not had good luck.. He wakes up in the am ready to go but is very tired later. It has really messed up his sleep. He gets probably 2 hrs less of sleep anight with the strattera. It hasn't helped his focus either so he is about ready to call and try something different.
DS is 11 and takes adderall xr 15 mg in am with clonidine .1 mg in am and pm. This was to help with tics and it has helped with the things you are concerned about too. I'd say try some other stimulants too that you haven't. One may work wonders. The side effects will usually get better after he's been on it for a while.
Hope you find the right combo soon.