Good morning, my 6 year old son has been in Guanfacine for about 3 weeks now. He was diagnosed with ADHD and ASD. He takes 1mg once a day in the mornings. Initially it seemed to work great, especially during school hours. Now he seems to be more active and little aggressive. It’s supposed to be a non-stimulant so I am not sure what’s causing this. He throws everything in sight and has loud outbursts. He also doesn’t sleep well at night. It takes forever for him to fall asleep and it wakes up at 2am every morning making loud sounds and cutting on all the lights. He is unable to swallow the tablet so I have to crush it and sprinkle it in his milk. Not sure if this is diluting the effects of the medicine. I am not sure what to do. He has been on a few stimulants and that was a horrible experience. Any suggestions? I’m thinking about stopping meds and trying micronutrients instead. I feel like the meds are having a negative affect on his brain due to the new behaviors he is exhibiting.
Guanfacine: Good morning, my 6 year old... - CHADD's ADHD Pare...
Guanfacine
my son is 12 years old he’s been taking Guanfacine for six years, it’s the only thing that helps him sleep
Oh wow! What’s the dosage amount? Does he take it at night or morning?
Our son (6yo) takes guanfacine ER in the evening. Our Rx bottle has a sticker on it that says, “Do not chew or crush, swallow whole.” This was also reiterated by his psychiatrist because, as I understood it, it can affect how the body metabolizes the drug. We practiced swallowing mini m&ms whole first and made it a game before moving to the guanfacine tablet.
Thanks so much for your response! He takes the immediate release so I’m guessing that one is fine to crush. His psych is the one that suggested crushing it and adding it to food. I would rather he swallow it whole so I will definitely try practicing with small m&ms.
When my 6 year old son takes his, we place it in a spoonful of applesauce and he can swallow it without it being crushed.
Hi there. My son started on Guanfacine at 6 years old as well. He is diagnosed with ADHD (with ODD) and I also suspect ASD (not diagnosed).
It's not the first pill that he has had to learn to swallow whole: that was Ritalin. Though small, the Ritalin had a strong flavor. I would cut a gummy into a small cube, cut a slit into the cube and insert the Ritalin. This coated the pill and prevented my son from tasting it. Because he didn't have to taste it, he was enabled to hold it in his mouth long enough to prepare for swallowing it. After a few months, he learned how to swallow whole pills without needing the gummy. The Guanfacine we administer is a tablet; usually, it's thin and flat. I think you might be able to coat it like I did with the Ritalin if yours is a similar shape and size. While this might delay digestion of the pill slightly, it's better than crushing the pill and making it dissolve more quickly.
Because my son had learned on Ritalin, he swallows Guanfacine without issue. Guanfacine can be sedating so we give it half an hour before bed. He sleeps very well much of the time, but it's not perfect. He does have ADHD after all. When does your son take his Guanfacine? If it's during the day, perhaps he's feeling frustrated at the sedative effects. I recommend giving it at night. When we forget my son's Guanfacine, it's harder for him to get to sleep. Here a side effect is actually a good thing for us!
Guanfacine can also cause irritability. We switched to Guanfacine because Ritalin's side effects were unsatisfactory. The Guanfacine wasn't as effective as the Ritalin had been, so we tried him at 2mg/day for a while. His irritability increased so we lowered him back down to 1mg/day and are now experimenting supplementing with Strattera.
Hope this helps, but I'll try to answer if you have other questions for me.
Interesting, I wonder why his psych recommended giving it to him in the morning. I wouldn’t mind switching to giving it to him at nights but I feel like the effects of the medicine will wear off during school hours. I do have a question regarding the gummy trick. How did you determine that he was swallowing the pill and not chewing it along with the gummy?
Our sons Guanfacine is a 24 hour dose. We started in rhe night time and then needed to add an additional dose in the am.
We must observe him taking his medicine, or he'll legitimately put it down and forget every single time. He likes to be observed anyway as it means we can encourage him to try again if swallowing it fails, or praise his success. Then he shows off his empty mouth, so we can tell whether it's been chewed or cheeked. I don't think he's ever thought about cheeking his meds. I'm crossing my fingers he never adds that brand of defiance to his repertoire.
Our guanfacine is not the Extended Release kind, but since we give it at night and his irritability was evident in the afternoons I presume it was still active then at least partially.
We use the Strattera in the morning, hoping it diminishes hyperactivity and compulsivity. The guanfacine was initially an attempt to reduce the defiance, which is also compulsive, but becomes aggression when combined with hyperactivity or desperate boredom.
Neither pill is quite allowing him to tolerate his own quiet company so he can do a puzzle or his homework for longer than ten minutes the way the Ritalin did, but we also needed to use 20mg of Ritalin to even touch the hyperactivity and then top it off in the afternoons with an additional 10mg, and that came with unsustainable side effects.
I would agree with people saying to give it at night. My son was on Guanfacine all the way up to a 4mg dose. He was a zombie but would have anger outbursts out of nowhere. Didn't work well for him.
My son is ASD and ADHD (both types). He was taking 2mg ER but felt very lightheaded whenever he stood up. So we are backing off to 1mg. I think it does help calm him. He takes it at night as instructed by the psychiatrist. I can't be sure if it's this or coincidence, but he's been sleeping better too.
Our son is 10, same diagnosis as your child. He does guanfacine and sertraline. Both have been life savers. But the pills don't take care of everything. The pills are there to help make it possible for our son to learn skills from speech therapist and social skills group. "Pills and skills". Also we were advised that it is completely fine to crush guanfacine if it's the certain kind that can be crushed. Your child's psych would absolutely be able to tell you if this is the kind he is on. We crush ours and mix it with a small bit of water and it's down the hatch twice a day 1mg. But your child's psych should also be able to tell you other options out there if he's not tolerating the guanfacine. Good luck.
My son (almost 7) took immediate release guanfacine (morning and bedtime) and atomoxetine in the morning from age 4-6. We tried three different stimulants, all of which yielded only negative effects.
Over time we found the immediate release guanfacine did not seem to help as much and he also had night terrors which we think may have been triggered by having immediate release right before bedtime.
Since then we switched to extended release guanfacine (the dosing is different and our psychiatrist worked with us on this) and atomoxetine in the morning and we've seen some improvement as well as a significant reduction in night terrors. Unfortunately both need to be swallowed.
We also used to give him melatonin gummies which helped him get to sleep a bit quicker. We also were able to gradually reduce and take him off the melatonin at bedtime. He still wakes up very early sometimes but has been able to find activities to keep him busy and we've made clear that our bedroom door remains locked until 7am and over time he has become accustomed to this.
He only has an ADHD diagnosis but has some spectrum-type behavior and can be very explosive at times, though it has improved recently. Overall I think he's doing very well relative to where we started.
My 16 year old grandson was put on it when he was young with the same aggression showing up. We changed meds. But when he was 12 and got unstable again it was added to his Straterra and really helped him. He is on extended release and takes it in the morning. He had lots of trouble when young swallowing pills and never do it unassisted. We used ice cream, pudding, whipped cream etc. Now he swallows three at once.
You never know what is going to work until try try it.
We started meds for my son around 7 and he is 13 now. We used to have him on stimulant meds in the morning and Guan at night to help with the comedown of the stimulants and to help him rest. It worked for a couple of years but the stimulants had too many negative side effects as we increased the dosage with his growth. We now have him on Straterra in the morning which is a non-stimulant ADHD med and no more Guan. It seems to be working well enough and definitely got rid of the bad side effects of the stimulants. Hope that helps!
Ask your psych about the timing of it. My son is on the extended release, but when we were giving it at bedtime he couldn't fall asleep. His psych mentioned that it takes 6-8 hours to cause sleepiness. We started giving it right after school instead and now he sleeps well.
We also had him practice swallowing mini M&Ms before starting him on it.
Hi Ya,
We have been on a long road with our son and meds. He is currently 9. Things got better when we found a prescribing dr willing to meet every month to discuss and change meds if needed. For my son replacing the Guanfacine with Clonidine was helpful. Does your son receive ABA? They might be able to help with some behaviors but they also might not. I found that it didn't seem to work as my son got older.
You might also look up your son's weight and the prescription dose recommended.
Best of luck!
We have a 12-y-o son who's been taking meds for ADHD since around age 5. He only takes guanfacine now but has been struggling lately in 6th grade. When he was your son's age we had him on Risperadone, too, which helped us a lot with the rages/tantrums and reactivity. Our psych also recommends magnesium to help calm as well.
Is Riperadone a stimulant?
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