non stimulant trial with guanfacine - CHADD's ADHD Pare...

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non stimulant trial with guanfacine

Vintagecollector profile image

hello all!

Tired mom over here… after about 6 months of trying 5 different stimulants we recognized that they aren’t doing the job for our 8 year old son. Some behavior improved. Focus did not. Then behavior became aggressive and he just didn’t seem himself.

I read good things about guanfacine and our pediatrician recommended trying this as a change to the stimulants. It’s only been 1 week: first gave him in the AM but he was out of it and tired, so we switched to PM. He is still out of it and tired. I worry because he didn’t even want to go to the playground after school and he always does. He didn’t want to draw in bed which he always does and just feel straight to sleep. Is there an adjustment period for this? If anyone has used this medication and has some input we would be grateful. I don’t want to drag it on if it’s not the right fit yet again!

Thanks in advance :)

12 Replies
Booksmart profile image

the medication has to help, not hinder the child. He should be himself. Yes, there is an adjustment period. Have you talked to Dr about cutting pills in 1/2, less strength? How long has he been on med? Is it extended release or short acting?

Imakecutebabies profile image

Yes, there is an adjustment period. For our son it was a few days, maybe a week. The first day he took the pill, he took a NAP for the first time in 4 years. The first several days he was somewhat lethargic and subdued and didn't seem himself. When we upped his dose from 1mg to 2mg, he went through the adjustment period all over again.

Eventually we landed on the opposite side and he was staying up too late at night. Our psychiatrist advised us to start giving it after school because it takes 6-8 hours to make him sleepy. This has been working for us. He still has occasional bedtime meltdowns but now goes to sleep around 8:30 instead of 10.

Smfdaisy profile image

There was definitely an adjustment period for my daughter. She’s ten and she was never a napper, but she took at nap in the first few days she was taking Guanfacine. It definitely dulled her for about a week, and then she adjusted and she’s back on a totally normal sleep schedule. She takes it at night, which probably helps.

ADHDmetoo profile image

Yes, there is an adjustment period. We're on guanfacine and welbutrin.

Lesmills profile image

I’m an adult on guanfacine, with every increase, My blood pressure dropped a few points and my body had to adjust. I was dizzy, tired, and didn’t feel like doing things. It took a few days to get through the side effects. building up towards 4mg was an awful experience, and I understand why many adults will quit before making it to the designated 4-7mg.

But for me, it works! I can focus, sit in one place for hours. My mind is at peace, I can sleep and it decreased my emotional deregulations.

It also reminds me to take a lunch break, if I forget to eat, my head feels heavy, tired, can’t focus.. so I also gained 10 pounds while on the Intuniv.

stimulants made me cross my borders, I didn’t feel tired, did way too many things and eventually I was burned out! Intuniv slows me down, but I also realize that a feeling of tiredness is essential, now I have to listen to my body, focus on my feelings and emotions.

A few months ago my psych added vyvanse and the effect is subtle, but it lifted my mood and improved my functionality even more. My appetite hasn’t changed and I still need to eat, otherwise my body will remind me!

Pattimum profile image

Ask your child’s doctor how long it is recommended to trial Guanfacine until it starts showing therapeutic effect and if this is just adjustment period where body gets used to the medicine. I don’t know about Guanfacine but I know that other non stimulant Atomoxetine has sometimes such effect initially on children- sedation. Both my son and his class mate are on Atomoxetine and my son didn’t have any adjustment period- it was fine straight away for him and within 2-6 weeks it also started showing positive effect on his mood, behaviour and better focus. I’d say for my son it took about 6 months to fully kick in with the therapeutic effect- now he’s not oppositional at home, he can carry on clubs and activities until 6pm and then still come home and be well behaved and comply with 8pm bedtime.

On the other hand his class mate at first was extremely sedated on Atomoxetine (to the point that his mum was saying he would sit at lunch time and drop his head on the table and fall asleep so he needed mid day naps for the first 6 weeks ). She persevered because doctor then told her to try it for 6 weeks and give body time to get used to it. She was doing it over the summer holidays so there was not so much pressure to get it right quickly. Her son is fine now- happy, active and focused, not sedated at all however still even though my son and her son are the same weight and hight, her son only tolerates 25mg whereas my son needed 40mg to have a therapeutic effect.

Sorry that I write in such a detail about a different non stimulant. I hope this comparison will help you to understand that non stimulants sometimes do need adjustment period. Also some children will already respond very well at much lower doses and some like my son need a much higher dose to have a therapeutic effect.

Also you could ask your doctor about tests to determine genetically which medication and at what dose would be good for your child? I know these rare advances tests and only available in the US (it’s not available in the UK where we are so here it’s all about the trial and error and trying something else).

I’d say once non stimulants start working - they work well and I never looked back since I switched my son to non stimulants.

Shortcake0681 profile image

My 6 year old son takes a 1/2 tablet of guanfacine when he wakes up and then the other 1/2 at dinnertime. It is fast acting. It really helped his aggressive behavior. He takes this in combination with Focalin XR (stimulant). He has a good balance right now. Some days are harder than others, but that's with any medication.

I would definitely ask about taking the 1/2 tablet (fast acting) twice a day. Maybe the whole dosage is too much at once?

Ma_ma_mommy profile image

From experience with my own son who has been taking it for a bit over a year now(he is 12) this doesn't usually make you sleepy. We started out by giving him 1/2 tablet(half mg) twice a day to calm his blood pressure and soothe his anxiety discomfort/ relieve his tics. After a few months we switched to 1 full tablet (1 mg) twice a day. The only negative side effect that he mentions are loss of appetite. It's meant to lower blood pressure, not knock you out. I should mention that this medication takes a few weeks to take on full affect and build in the system. He always takes it right at breakfast and then 5pm. He rarely stays up past 8pm. Growing bodies need tons of sleep.

Roxinette profile image

good morning, after 2 years of tries and errors, my 10 year old has been taking guanfacin in the morning and clonidine at bed time. We tested a lot of stimulant and non stimulant medication with lots of side effects. Guanfacin does not have a drowsy effect on him, unlike clonidine. We actually replaced successfully the morning clonidine pill with guanfacin because of the drowsy effect Clonidine had on him. Our psychiatrist told us that guanfacin can have a drowsy effect on some, clonidine can have a drowsy effect on others. Both are non stimulants medicine. You may want to discuss with your doctor switching for clonidine if that s a possibility. Good luck

joshnyc profile image
joshnyc in reply to Roxinette

Our story is almost identical to Roxinette for our 9 y.o. We use Guanfacine a.m. and Clonidine before bed, supplemented with magnesium and vit B6. In case it helps, we learned that melatonin actually disrupted sleep and removed it completely.

MomBaller22 profile image

We had a similar experience! We tried two different stimulants for my 8YO son first, but he became very agitated as he came down from them (worse than the ADHD itself), so we tried Guanfacine. Our pedi had him take 1/2 pill at bedtime for the first two weeks, 1/2 in the morning for two weeks after, and we started a full pill in the mornings about a week ago.

A friend of mine's daughter also had taken it. They were not guided to start theirs in the evening, and my friend said her daughter was absolute toast for at least three days. Like, completely exhausted... so what you are writing doesn't sound out of the norm from her experience. I was braced for that, but because my son took his at night to start—while his body acclimated to it—we didn't experience that lethargy. When he moved to a full pill in the morning, he was definitely more tired and randomly fell asleep in the afternoons a few times, but that only lasted about 4-5 days.

All of that being said, we have had some positives with the medicine. He is more amenable and less resistant to normal, everyday expectations (morning routine, household contributions, etc.). He is FAR less fidgety and hyperactive. (That's probably the most noticable difference.) The teacher said he has been more participant in classroom activities and able to better-focus on his classroom assignments. Our biggest fear when starting him on medicine was that his "vibrant" personality would change (the parts that make him unique and special) and we didn't want him to be a "slug," but honestly, I have to say, the medicine has only brought his personality out more! He is in a better space to be himself, without all of the external stimulants agitating him and getting in his way. He has been kind and thoughtful and fun to be around! (None of this was coming forth before Gaunfacine.) A week and a half in, I can now tell when it wears off at the end of the day, but we mostly want to help him get through the school day, so overall, it has been great for him/us.

I hope once your son gets past the sleepy stage, he has a similar and positive experience. I'd be curious to hear how it goes for you in the future, as we are still a bit in the trial phase with it ourselves.

Wishing you all the best!

FrankenMummy profile image

My kiddo had an adjustment period to the guanfacine when he started, I think it was about a week before he got back to normal. When we increased from 1 to 2 mg, we had to change to the ER because the fast acting was making the poor boy fall asleep everywhere. It did definitely show an improvement in his impulsivity and his behaviors. Hopefully your son adjusts and it helps him....mine tried 2 stimulant trials and both were an absolute mess. His emotions and aggression were unmanageable. Hopefully he gets some peace soon.

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