Adding Intuniv to stimulants | ADHD Information

Do any of you use both Intuniv and a stimulant? DS is 10 1/2 and weighs 68
pounds. He has been on all the ritalin stimulants for about 5 years. He
recently was switched off of Concerta 54mg because it stopped lasting all
day. His doctor put him on Ritalin (short acting) 15 mg 3-4 times per day
just so we could get through the rest of the school year (3 weeks and
counting!) The doctor talked about other options to try this summer. I was
wondering if Intuniv could be added to his ritalin? Also, when you add
Intuniv, do you find that your child will require a small dose of stimulants?
DS main problem is hyperactivity and anxiety.

The only stimulants we had problems with were the adderall line. Vyvanse
was tried a couple of years ago and he had extreme sleepiness.

My child takes both Intuniv and a stimulant (Metadate CD).  He started guanfacine drugs when he was taking Focalin XR, and yes, we found his regular stimulant dose was too high when combined with the other medication.  This was a few years ago, so at that time, he took short-acting guanfacine, but then he switched to Intuniv when it came out (long-acting guanfacine).  With that switch, we still found the same stimulant dose to be effective.

I'm curious why you decided to do short-acting Ritalin all day instead of Ritalin LA and then a short-acting booster dose?  Yours is an interesting approach that I haven't seen beforehand.

Ritalin LA only lasted a few hours and it lasted the same as short acting
Ritalin. We actually now have to give ds the max dose of 60 mg per day
which is 3 doses of 20mg. so he can get thru the school day. DS
metabolizes his meds sooo fast.   It is all so confusing and I know that ds
hates taking so many meds during the school day. We are struggling right
now.Has he tried Daytrana?  Maybe taking a medicine that doesn't enter his gut would be better for him since he metabolizes things so quickly?  Also, does he take the medicine soon after eating a meal?  I heard that can make medicine last longer.We've been using Intuniv and a stimulant for the past year now.

Pros: let us drop the stim dose, works great for sleep, helped even out rebound, got him on the honor roll for grades three times in a row.

Cons: he worked up a resistance quickly, now at 7mg which is well above the "approved" dose

All in all, I love it... but I'm not sure how much higher his doc will be comfortable going.

Audrey

He has tried Daytrana and it worked for a while. The problem was that I
would have to put it on him around 4:45am for it to get working for
school. It took close to 4 hours to start working and it stopped lasting
the entire day. We would have to give a ritalin booster in the morning.
Maybe we can try it again as it has been a few years and he is a bit
bigger now. I feel like since he is now close to 11 years old, thing are
changing.Trying Intuniv tomorrow. I believe that my son has GAD as well as ADHD.
In fact, I know he does. We usually have to go to the max dose of
stimulant with him as well as he has been taking Zoloft 50mg. for several
years for anxiety. I am really hoping that the Intuniv works to help us
reduce the stimulant. Going back to Concerta 54mg. The short acting
ritalin we tried gave him panic attacks. The rebound was awful. Hard to
watch. He was so nervous and agitated at the same time. We need to
reevaluate the meds here. Thank the Lord that school is almost over!!!

aesposito, our kids sound alike. Thanks for your input. Is your doctor
cool with going up on Intuniv dose? I was told that we can go as high as
3mg. Starting with 1mg the first week. We are using clonidine for sleep,
but will have to stop tomorrow when we start Intuniv. Does melatonin
work well with intuniv? DS used to take it before clonodine.can you use melatonin with Intuniv? Second day on 1mg. OK so far. [QUOTE=babygonz]aesposito, our kids sound alike. Thanks for your input. Is your doctor
cool with going up on Intuniv dose? I was told that we can go as high as
3mg. Starting with 1mg the first week. We are using clonidine for sleep,
but will have to stop tomorrow when we start Intuniv. Does melatonin
work well with intuniv? DS used to take it before clonodine.[/QUOTE]

Our pediatrician would only go up to 4mg (the FDA approved max).  But four was doing nothing for him eventually.  Our shrink said as long as we are monitoring bp he has some kids on as high as 8-10mg without a problem... so over time he has moved him up, now he's at 7mg.  All is well thus far, and his average blood pressure is 100/60 every day.

And yes, melatonin works well with intuniv for us, when we have to use it (which isn't as often as we used too... the intuniv helps sleep a lot too... and we've had a lot of luck with L-theanine and sleep).

Audrey