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Forum -> Parenting our children -> Our Challenging Children (gifted, ADHD, sensitive, defiant)
ADHD Medication help
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amother
OP


 

Post Mon, Jul 05 2021, 4:48 pm
Hi,

I can use some guidance from experienced moms out there…

My 8yo son has been on Adderall for about 2-3 years. It’s really helped him during the daytime hours, especially at school. But we’re really struggling a lot in the morning and especially with bedtime. I can’t give him an afternoon XR dose because it prevents him from falling asleep, and the immediate release dose gives him a crash worse than not taking anything at all. Right now we’re trying Guanfacine 1.5 for the evening, and though I’d like to assume it’s helping, he still needs help.

I discussed this with the psychiatrist and pediatrician (they work together) and I’ve been given these options. I’m wondering if anyone can weigh in.

1) Switch from Adderall to Vyvanse. Tends to have a smoother on-off transition and may last longer than the Adderall

2) Increase the Intuniv to 2mg or 3mg (with current Adderall)

4) Try the Catapres Patch (clonodine) for a 24-hr option. This is more sedating, and may help with behavioral problems.

Now in the summer is the perfect time to sort this out so that we can have this sorted out for the new school year. I’d greatly appreciate your input.
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amother
Strawberry


 

Post Mon, Jul 05 2021, 5:05 pm
My 10 year old son takes his (8:00-9:00am) morning medication (Focalin 30mg) in addition to Guanfacine 4 mg.
I add a booster medication at 1:00 (to last till rest of day). He takes: Guanfacine 1mg and Focalin 10 mg.
It does wonders bh. He is able to go to sleep on time.
I would suggest Adderall in morning and add a booster midday.
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amother
Snowflake


 

Post Mon, Jul 05 2021, 5:38 pm
We have found Vyvanse plus guafacine to be best combo. Definitely agree raising to 3mg.
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amother
Butterscotch


 

Post Mon, Jul 05 2021, 6:20 pm
amother [ Snowflake ] wrote:
We have found Vyvanse plus guafacine to be best combo. Definitely agree raising to 3mg.


Curious - is 3mg of guanfacime a normal amount for a 12 yer old?
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gootlfriends




 
 
    
 

Post Mon, Jul 05 2021, 6:35 pm
amother [ Butterscotch ] wrote:
Curious - is 3mg of guanfacime a normal amount for a 12 yer old?

Well my 10 year old is on 2 mg. So probably if doctor is prescribing. Weight is taken into account.
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mha3484




 
 
    
 

Post Mon, Jul 05 2021, 6:42 pm
My 10 year old has been on 3mg of intuniv for many years.
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amother
OP


 

Post Mon, Jul 05 2021, 7:21 pm
amother [ Snowflake ] wrote:
We have found Vyvanse plus guafacine to be best combo. Definitely agree raising to 3mg.


Have you tried Adderall? Wondering if his current Adderall plus guanfacine is the same.

And what is your schedule with the medication? When do you take what?
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amother
Copper


 

Post Mon, Jul 05 2021, 7:43 pm
2 of my children were on Concerta, and when it didn't last long enough, the Dr. switched them both to Adhansia XR. It lasts a very long time- really through the whole day. It's a fairly new medication (in the Ritalin family) but my kids have been on it for over a year and are both doing so well.
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amother
OP


 

Post Mon, Jul 05 2021, 8:46 pm
amother [ Copper ] wrote:
2 of my children were on Concerta, and when it didn't last long enough, the Dr. switched them both to Adhansia XR. It lasts a very long time- really through the whole day. It's a fairly new medication (in the Ritalin family) but my kids have been on it for over a year and are both doing so well.


I wasn’t given this option for whatever reason. So I guess we’ll try sticking to one of the three options I explained in my OP.
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amother
Forsythia


 

Post Mon, Jul 05 2021, 9:04 pm
So here's an out of the box idea that worked for us.

My son needed his meds to last for longer than they did, but he also crashed when given anything that wasn't XR. He was on Concerta (methylphenidate) and really needed something that would last from the early morning through homework time.

My doctor suggested trying a low dose of the non-XR medication (in our case, Ritalin, which is also mehtyphenidate) in the morning right when he gets up, and then taking the XR medication a few hours later before the Ritalin was due to wear off. This stopped him from crashing, and provided that extra boost to get him through the rest of the day. It might mean taking meds in school. For us, he was getting up so early (like 6 or 6:30 am), and he didn't leave for school until at least two hours later, which the doctor said was enough time between the two doses.

It was a life-changer. Just wanted to put that out there to possibly discuss with your doctor if you think it would work for you...
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knish




 
 
    
 

Post Mon, Jul 05 2021, 10:32 pm
I have done all combinations of Vyvanse/ Intuniv (4mg) aderall/ intuniv and even Vyvanse with a boost of Aderall in the afternoon with Intuniv. The Intuniv can go up to 4 mg from a young age if needed and helps with the dips. For the early morning issues, wake up your child (just enough to swallow the meds) about 30 min before you would normally start the day- it does wonders!
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amother
OP


 

Post Mon, Jul 05 2021, 10:36 pm
amother [ Forsythia ] wrote:
So here's an out of the box idea that worked for us.

My son needed his meds to last for longer than they did, but he also crashed when given anything that wasn't XR. He was on Concerta (methylphenidate) and really needed something that would last from the early morning through homework time.

My doctor suggested trying a low dose of the non-XR medication (in our case, Ritalin, which is also mehtyphenidate) in the morning right when he gets up, and then taking the XR medication a few hours later before the Ritalin was due to wear off. This stopped him from crashing, and provided that extra boost to get him through the rest of the day. It might mean taking meds in school. For us, he was getting up so early (like 6 or 6:30 am), and he didn't leave for school until at least two hours later, which the doctor said was enough time between the two doses.

It was a life-changer. Just wanted to put that out there to possibly discuss with your doctor if you think it would work for you...


The problem is that we can’t rely on him taking meds in school. So we can only work with giving him meds in the morning and after camp/school.
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amother
OP


 

Post Mon, Jul 05 2021, 10:39 pm
knish wrote:
I have done all combinations of Vyvanse/ Intuniv (4mg) aderall/ intuniv and even Vyvanse with a boost of Aderall in the afternoon with Intuniv. The Intuniv can go up to 4 mg from a young age if needed and helps with the dips. For the early morning issues, wake up your child (just enough to swallow the meds) about 30 min before you would normally start the day- it does wonders!


Thank you. Of all the combos you mentioned, which one did you find to work best? I know each child is different, but I’d like to hear experiences.

Regarding waking him up to take his meds, he usually wakes up from early-riser siblings and jumps right out of bed, into chaos. There’s no “waking up for a minute and falling back asleep” thing. Or even remaining calm. For some reason his mornings and nights are the worst, even when he takes no medication during the day. His body is just so much more hyperactive in the mornings and nights.
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amother
OP


 

Post Mon, Jul 05 2021, 10:41 pm
Thanks all for your help. Some days I just feel like burying myself or running off and never coming back 😢

I know with Hashem’s help he’ll be fine one day. I know he can grow up to be a respectful, successful, responsible adult. My husband B”H is, without meds. But each moment, each day until we get there is just so hard.
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amother
Chocolate


 

Post Tue, Jul 06 2021, 5:49 am
My son switched now from Vyvanse to Adderall
and he is crashing midday

Thanks for this convo

I am with you on the 'one day...' but right now Punch
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amother
Orange


 

Post Tue, Jul 06 2021, 5:56 am
My daughter didn’t take catapres. She took intuniv + propranolol. She was never on ADHD meds, but the combo helped with her being explosive. She is off those meds now. My son has ADHD, on vyvanse, and he’s reaching puberty. He is newly angry all the time. I find myself yearning for intuniv.
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amother
OP


 

Post Tue, Jul 06 2021, 7:19 am
amother [ Chocolate ] wrote:
My son switched now from Vyvanse to Adderall
and he is crashing midday

Thanks for this convo

I am with you on the 'one day...' but right now Punch


So why did he switch?
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amother
OP


 

Post Tue, Jul 06 2021, 7:23 am
I’m especially trying to find the combo that will carry over for the mornings also, before his morning meds kick in. But I’m uncomfortable with the idea of a patch.
Any of the above mentioned combos can help ease the mornings if one of them is taken in the afternoon?
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mmesti




 
 
    
 

Post Tue, Jul 06 2021, 12:17 pm
How about concerta? My son had exactly that same problem when he was 8 yo and he got concerta. It has a slow release action. It help him a lot until he turned 12 when we started on Ritalin.
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amother
Snowflake


 

Post Tue, Jul 06 2021, 1:36 pm
amother [ OP ] wrote:
Have you tried Adderall? Wondering if his current Adderall plus guanfacine is the same.

And what is your schedule with the medication? When do you take what?


We tried Adderall it was awful for my child.
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