Guanfacine for 5.5 year old - shift from evening dose to morning ?

[missbonafide]

Hi Everyone.

My son is 5.5 years old in Kindergarten so he's definitely on the younger side but his impulsivity and hyperactiveness was affecting him too much at school. It was also a safety issue with a lot of running away/elopement.

He was prescribed guanfacine 1mg (extended release) by the pediatric neurologist. Because he is young we all agreed a stimulant would not be the best idea so non-stimulant was our first attempt at providing him some support. He's been on it about 6 weeks now and we have seen an improvement and the incidents at school although not 100% gone they have gone down which we are happy about. Still doesn't help w focus and/or memory but it has slightly slowed him down so that he can make better choices....

Ped Neurologist told us to give it to him at night 2-3 hours before bedtime. But I believe I've read a lot of posts of kids that take it in the morning. Pediatric Neurologist recommended taking it at night b/c it can make him sleepy but I wonder if we switch to giving it to him when he wakes up in the morning would it have a better effect w impulsiveness at school b/c my thought is he's taking it at 5pm every day so is the effect of the medication lasting throuhg entire day at school (8a to 2p)?

Anyone here that switched from evening to morning dose for Guanfacine specifically? And for situations where it's just the non-stimulant the child is on?

Or would it be better to try increasing dosage but keeping it same evening routine...curious to to hear your experiences. THANK YOU!

[Onthemove1971]

How about the best of both worlds.. Could you ask for a 24 hour dose? Our amazing Child Psychiatrist started us at night with a dose that last 24 hours. Our non-stimulant helps to decrease impulsive behavior which is the root of our issues, then the non stimulant helps with focus and mood.

We are so thankful for the medication intervention.

Hope this helps.

[missbonafide in reply to Onthemove1971]

is your child taking a non stimulant and a stimulant? The non stimulant my son is on is 24 hour dosage.... but was thinking that the effect of it is stronger first 12 hours but he's taking it at 5pm so 12 hours later is 5am and he's up by 7am so just wondering if we switch to morning dosage would have help him even more at school. I know a lot of students do that nonstimulant and a stimulant but since my son is so young (5 yrs old) we aren't ready for a stimulant yet and this is his first time taking any medication.... staying positive though....medicine intervention is helpful for sure

[Onthemove1971 in reply to missbonafide]

Yes, he takes a stimulant and non stimulant. Every parent worries about their child and medication. Studies about children with ADHD show the benefits of long term medications.

Just curious why his age worries you?

Stimulants only stay in their system as long as it is prescribed. So if it is dose is given for 4 hours, that means it is suppose to be their body and metabolised therefore uses and then it is no longing in their body until the next dose.

Our child psychartist recommend both a stimulant and non stimulant becuase each medication only has one "job". For our son he must have help decreasing his impulsive behavior and that is exactly what the stimulant does.

I understand your concern, but to me medication younger seem more beneficial. As our children with ADHD get older they gain maturity and this helps them know and understand how to control themselves. When they are younger they have no control.

I am not here to convince you of anything, just discussing the impact of not having the ability to control themselves and the benefits that medications provide.

With any medication you have the option of trying it and if it doesn't work you stop, without any "long" term consequence. The side effects are out of their system when the medication is gone. There is no " build up" in their system.

Hope this makes sense

Best of luck to you.

[missbonafide in reply to Onthemove1971]

Well be open to stimulant once our son is 6 or 7. We are just getting started w meds and wanted to start w non stimulant first. But also our son is very slim and a picky eater. Didn’t want to give him a medication that would suppress his appetite and cause other issues. Once he matures a bit I hope his eating improves. Nothing against stimulants just not the time for it yet for our son who’s only 5.

[MustangGma]

Hi. We started guanfacine ER in the evening. Changed to morning. Made OUR girl a little tired the first couple of weeks but that side effect went away. For a while we tried 1mg in evening and 1 mg in morning but that made her tired and she had alot of hands and feet falling asleep so we backed down to 1 mg in the AM again. Still needed some help for school so add 5 mg adderall XR in the AM. GETS her thru the school day. She just turned 7 and the adderall is a new med. Guanfacine just wasn't enough for her.

[Auggie123]

We have our 9 year old on a morning and evening dose of Guanfacine. He needs the support morning and evening. So far it's helping, mostly. We increased the dosage from 1 to 2mg yesterday because some behaviors were coming back. He was sleepy the first week hestarted at 1mg, then that wore off-- am noticing same sleepiness since we increased the dosage to 2mg yesterday. Am expecting that to wear off in a week, But hoping the benefits stay longer. We tried stimulants--was not a good fit for him. Those increased agitation and anger for him. Medication trial and error is very hard-- feels like he's a Guinea pig we're experimenting on. But the alternative was not manageable. I have to remind myself of that. Good luck, take care...

[missbonafide in reply to Auggie123]

Thank you for sharing!! Yeah I’m not ready for him to get stimulant at this age. But agree the alternative of no meds isn’t manageable but sucks the trial and error. Good luck w your son!!!

[Ksec329]

Hello! Our son is also 5yr (will be 6 in June) we also started him on non-stimulant Guanfacine for kindergarten this fall. Our behavioral development pediatrician has increased our dose steadily throughout the year he is now at 2mg. We give 1mg in morning 7:30 and 1mg at night 7:30. Since your son is taking 1mg ask your pediatrician if you can split the dose in half and give .5mg in morning and at night. That is how we started out in the fall/winter now we are up to the 2mg. I found it helped with my sons behavior getting ready and going to school and at school taking some in the morning. But also at night with nighttime routine. Once he is 6 we will talk to pediatrician about possibly a stimulant also for focus in school for next year. Goodluck!

[missbonafide in reply to Ksec329]

So helpful!!! Thank you ☺️☺️ Will try half in evening and half in morning. I do feel he needs more of effect of medication while at school.

[missbonafide in reply to Ksec329]

Hi! Just wanted to say thx for the suggestion of doing .5mg in evening and .5mg in morning … this really has made a big difference at school for my son. The incidents have gone away and my stress level has gone down. He still needs redirection but the impulsiveness has decreased so much. Thx for the tip!

[Ksec329 in reply to missbonafide]

Hello! I am so happy to hear the two dose morning and night is working better for him and making a difference. We have had to up the doses as our son has grown and gained weight ( so keep that in mind) if you notice after a few months his behavior start to become like before. For us it was about after 6 months. All the best reach out anytime! Enjoy your summer!

[IheartDisney]

My now 10yr old takes 2 mg in the morning. We tried taking it at night but it made it really hard for him to go to sleep. We give it to him right when he gets up at breakfast and it doesn't seem to make him tired at school.

[Nats2005]

I don't recall exactly when we made the switch, but we did go from giving our son (who'll turn 7 in July) Guanfacine in the evening (usually just after dinner) to the morning because of aggressive and impulsive behavior at school. At the time he was getting Adderall a couple times a day as well.

Currently he's on 15mg Adderall XR and 2 pills of 0.1mg Clonidine in the morning plus a booster dose of short-acting Adderall in the afternoon. That combination and timing does seem to have helped with school, though evenings and weekends at home can be interesting.

[Littleme2000]

we have our 8 year old on Intuiv, the XR formula, 1 mg and we give it to him in the morning. It works well for the impulsivity in class, as giving it to him at night made him too hard to wake. Working through supplements w a functional doc, which has really helped with his immune system and appetite, and improvements as a whole. He Can’t do stimulants, as he lost too much weight and has ASD characteristics, so some behaviors like tics and missing social cues became worse. Good luck, it’s a journey, but you will find the right path!