Med change timing, from stim to tenex? | ADHD Information

Ds is 10 years old. He was diagnosed with adhd and has been on ritalin la
since he was 5. He is currently very wild in the morning takes a ritalin la
30 mg in the am approx 6 am. By 2:20pm when I pick him up from
school he is out of control.

Psychiatrist today suggested we try Tenex 1 mg on the morning. If that
does nothing she suggested 1 mg in the evening then his 30 mg ritlain la
in the am. I am worried about trying only the Tenex 1mg for school
tomorrow.   He has a hard time at school as it is and I don't want to set
him up for failure. So I have been reading all your post about Tenex
seems as if most take it with a stimulant.

Should I wait till Friday to start the new meds when he has off from school
for 2 weeks? Is it better the add the Tenex and then wean off the
stimulant? Any advice is greatly appreciated we need to do something
but are frozen in fear of making it worse. Kohlsmom40162.8263310185

Tenex made my son tired at first when taking it without a stimulant.  If you are like me you hate to wait for results, but waiting until he is home may be the best time to try for the first time. 

Good Luck!

I reread your post and noticed that your son was only prescribed Tenex in the am.  One dose will not last all day (or at least it does not with my son).She is very cautious and said to try 1x am to start and then we could add
the pm dosage if needed.   As good as she is I am not sure she knows
what my son is like all day when he is on nothing or something that does
not work. Or at least what it is like for me with 3 other active children
that look up to my 10 year old and copy his bad behaviors it gets insane.
So of course I am hesitant to try anything new but also know the current
med dosage is not working as it only is helpful for school hours and he is
having trouble functioning at all other times.

I go back to see her on Fri and I am contemplating just waiting until then
and really coming up with a plan to try this. I think she is ultimately
thinking the new long acting tenex, name escapes me, that I was reading
about could really help him but wasn't sure my insurance wld cover it as I
have an HMO and they are sticklers wldn't let us try Vyanese (sp) etc.Have you tired Concerta?   We switched to that after we found that Ritilan LA wasn't giving us the coverage we needed.   We also do Tenex with her Concerta.  We started with an evening dose (.5 mg) for a week,  then added .5 mg in the am.   We then went to 1 in the evenings and then to 1 mg in the am.  Ever change we've made has been slow and in .5 mg increments.

My DS is 9 with severve ADHD and Asperger's.  He is currently taking Tenex for the ADHD after years of stimulants.  The stimulants began to give awful side effects; anger, irritablity, agitation.  We started on .5mg of Tenex in the AM and PM about 3 weeks ago. The first week was Thanksgiving and he was home and was amazing.  When he went back to school they complained he was lathargic, tired, sleepy and complaining he was cold all the time.  We lowered the AM dose to .25mg but lost the effect on the ADHD symptoms.  We don't see the sleepiness or coldness at home at all.  Because the behaviors haven't gotten to a desirable place we've increased the Tenex to .5mg in the AM, .5mg mid afternoon, and .5mg at bed.  They school is still saying he's tired but not signifgantly more as we increased the dose.  As far as it goes for controlling the ADHD, well I'm still on the fence with that.  He's much calmer physically but not nearly as compliant as he was when he was on stimulants and they were working for him.  The dev. ped. (who is perscribing this) thinks we will need to go up to 1mg three times a day but wants to move slowly.

This has been a nightmare for us.  He had to be pulled from his regular placement in the typical classroom and put into a small classroom with a one on one aide to work with him.  He is doing small amounts of classwork followed by periods of perfered activities.  I feel as though we are back in preschool again.

I will say there are some great advanatages to Tenex for us.  My son was very underweight due to years of stimulant use.  He now eats a ton and has gained almost 8 pounds since August.  I also don't see the ups and downs of behavior I would see on stimulants.  He also sleeps very well (almost too well because he's wetting the bed 3 or 4 days a week!)  They say that it can take up to 4 weeks to see the full effects of Tenex and as long for the side effects to work themselves out.  So I'm really hoping to have this all straightend out by January.

Sorry this is so long but it has been a struggle for us, an ongoing struggle.  I hope your experience with Tenex is positive and things work out quickly!

My DS tried Ritalin LA and metabolized it very quickly.  His wore off by about 1:30 in the afternoon.  He then went on Daytrana 15mg patch, and it worked much better for him.  DS started Tenex for tics in August, and it worked great.  He did 1mg in the morning, and .5mg afterschool.

We are trying Intuniv with Daytrana right now, and hope to try Intuniv alone in January.  Honestly, DS could not have only been on Tenex without his stimulant, it just doesn't work as his main med.  I am not sure that the Intuniv will work, either, but we can give that to him on the weekend without the patch for some ADHD management.  We have had to work up to 3mg Intuniv, it took about three weeks.  It made DS very tired, but it seems that is getting a little better.

I would just wait until Christmas break to switch, then by January you will know if he is still needing a stimulant.

Good luck!

We have had our 12 yr old son on both concerta and tenex since we began meds for him 5 yrs ago. I only can say positive things.

Our son is very adHHHHd and has sensory integration along with a speech delay. I also thought for awhile that he had aspberger's but no longer do. He had social troubles that made him very shy and inward, but it may just be his personality. He is doing quite well since beginning middle school two years ago. Elementary school was horrible for our son.

bkruse, How is social for your son? It sounds like the school is being very accommodating to him in the classroom. You are very lucky. I have a young man I am friends with who has both adhd and aspb. and he is brilliant, extremely brilliant.

I wish all well with the meds and tenex!!

Kohlsmom,

I would start it asap. That is my opinion. It has always relaxed my son and helped with his impulsiveness. He takes along with concert.

DS is 12 and has been on it since shy of 7.

We have only positive things to say about it. It has actually helped him instead of of adding a booster for the PM. We give another 1 mg of tenex instead. Then it doesn't get in the way of sleep and eating.

Have you ever tried concerta? It is a time released form of ritalin. My son makes it through school and homework AND it works like a charm with the tenex.

Is he having a hard time socially or academically in school? Hope it helps your son.

Bethann - The school is being very accomidating but it's getting frustrating for everyone.  My DS school has a program with self contained classrooms for Asperger's kids.  As they progress they are mainstreamed into the regular classrooms with an aide for support.  Last year my son was mainstreamed full time and required very little support from the aide.  We were considering bringing him back to his home school this year so he could make friends with neighborhood kids before going to middle school.  It's very hard to see him back slide so severly.  He can't even function in the regular classroom any more and requires constant support from the aide in a one on one situation.   He's doing very little school work with lots and lots of breaks.  It's heartbreaking and frustrating.  I'm hoping that once we get the Tenex where it needs to be he'll get back on track.  My son is very bright, has a high IQ, does well on standardized tests but just can't focus, sit still, and comply.  He is doing better socially on the Tenex than he was doing on the stimulants.  We had years of success with stimulants and it's very frustrating that they have failed him.

I am so sorry. It really does sound like the adhd is getting in his way. I honestly can't say if JUST the tenex will help. OUr son is very adhhhhhhd and could never make it through a day at school without the concerta. He really needs his meds.

Is he able to stay at this school for middle school?

Do the doctors have any idea why?

As a mother, the only thing that comes to mind is puberty. That is the one thing that changes the meds effect. We so far have only had to increase his dosage but I am keeping my eye on things.

I know you mentioned 9 years old. I do not know if he is still too young for that. I just can't think of anything else.

What about re-evaluating him?

there are so many meds out there to help and that can be taken in addition to another to help that person in need.

Have you ever brought him to a psychopharmacologist? OUr son sees on and he treats A LOT of adhd'ers who also have aspbergers. I can't say enough about our doctor. He knows these meds like the back of his hand!!

Please keep posting so I can follow how your son and you are doing!

I just now logged on and saw your post about the length of time for the Tenex to kick in.  I would say it took an hour or so before my son started getting tired.

I am sorry to hear that you had such a horrible appt today.  We had a former pediatrician that was like that.  I am really blessed with our current pychiatrist as she happens to be a part of our "mom's group" at church.  She also has two boys with ADHD so she knows what she is talking about, but also knows every child is totally different on how the meds work for them.

Hang in there and keep posting.  Let us know how the weekend goes.

 

 

Well we waited a few hours this morning and though a little edge was taken
off of his wild antics this morning, nothing that gave me reason to believe
that 1 mg of the tenex at pm wld be enough med to get anything
accomplished for the day. So we gave him his reg ritalin la to go along with
it. He had football equipment turn in and then basketball practice should be
back in a little while so hopefully dh will have an update on how he was.

Now I am debating wether to add another dose of the tenex or just keep
giving him the 1mg pm and then his ritalin la during the day. We also have
daytrana patched left so I guess I cld try the tenex with the daytrana if we
felt so inclined. We go back to the psych on Mon. I decided to wait. And I had an appointment today with the psychiatrist-
it turned into a mess. She says I don't follow through on directions. I do
but I have adhd and a ton of anxiety about medicating my kids when he is
mine and just a patient to them. I didn't think waiting 3 days was a huge
deal but she felt very frustrated by my actions which led to me feeling
attacked as if I don't feel bad enough about the whole situation.

I did get some clarification though on how we can go about adding the
Tenex. I thought she wanted one whole day without the ritalin la. She
said to give it to him at night and see how he does. If he is not doing well
she said we could give him the ritalin la even the same day.

So we started tonight. Gave him 1mg of the Tenex. So far it has not
kicked in how long until he should feel tired? Also can I give him his
normal melatonin with the tenex I forgot to ask as I was rather upset at
the appointment today.

Thanks for any insight. I appreciate it. Forgot to answer we did try Concerta at one point years ago and it was
like giving a sugar pill to him no effect whatsoever. But the current
psychiatrist thinks it is b/c they did not convert the dosage from the
ritalin la to the concerta properly b/c of how they are broken down and
released.

He is having a hard time in school lately. He went from a great teahcer
his 1st really good teacher who got him last year o a teacher who is
overwhelmed and having class management issues her self. His special
ed teacher is terrible no help at all she doesn't get it at all.

Not only is he severely adhd but he has sensory issues, dyslexia , the
worst dysgraphia a specialist said she had ever seen the laundry list of
strikes against him go on and on. We recently had an independent
evaluation done at Big Springs in Riverside at the cost of 00 out of
pocket and are waiting on a final report. We also recently hired a n
educational advocate who is going at the next IEP to push for the district
to pay for a NPS for him to attend. He is a bright kid but very complex
and I am going broke and having a nervous break down trying to get him
the help he needs.

Just though some insight might be helpful. I probably should go
introduce myself and Kohl's story on the general board but being adhd
myself I deal with the crisis and then slack . I do appreciate any
responses, experiences and opinions. ;o)