change to guanfacine er very emotional

[Alt49]

we just switched from 2x per day regular guanfacine to 1x per day extended release (both 1mg total) It’s been about a week. My son is 6.5 and also on a stimulant. The 2x per day guanfacine did a great job evening him out after stimulants wore out for the first few months but then became less effective so dr is having us try this. She said we could up the dose after a week if it wasn’t working. However what we are seeing is different - now he is very emotional (often tearful) and having a hyper fixation even when the stimulants are in his system which we haven’t seen in a long time. Anyone have issues like this switching to ER guanfacine from regular? Meeting w psychiatrist next week to discuss as well.

[SecretAgentIEP]

This happened in our family and we ended up stopping the Guanfacine and just use Vyvanse chewables, 2 x a day for longer coverage and less crash, now.

[Alt49 in reply to SecretAgentIEP]

Good to know. Thanks. Although I’m sorry you experienced it too.

[Mamamichl in reply to SecretAgentIEP]

What are Vyvanse chewables like? Are they gummies, hard chewables like Flintstone vitamins, or something else? My youngest may be getting on ADHD meds soon, but she hates pill swallowing. I want to know what options along this line are out there for ADHD meds.

[SecretAgentIEP in reply to Mamamichl]

Yes, they are like a powder, more like Flinstones and even the capsule version of the pill can be opened and sprinkled

[Mamamichl in reply to SecretAgentIEP]

Any idea if other ADHD medications are like that? I know I can’t do vyvanse with insurance, but my partner can.

[Alt49 in reply to Mamamichl]

My son takes chewable methylphenidate. It doesn’t taste like anything

[Mamamichl in reply to Alt49]

Thanks for the feedback! I had my daughter and me doing methilphenidate and dexmethilphenidate regular pills. I didn’t feel anything, and my kid started getting tics. I just got a gene sight test and will be discussing the results with her doctor in a week. I want to try her on a new ADHD med that doesn’t have adverse effects and an anxiety med that will help her with stress. She has outbursts like I do when I am not on a good med regimen.

[Onthemove1971 in reply to Mamamichl]

Please consider Wellbutrin ( his child psycharitrist made the recommendation).. we have had great success with it. It takes a few weeks to work, but it has replaced the need for stimulants. He also takes Gufancine 1x daily.

Best of luck!

[Mamamichl in reply to Onthemove1971]

I will see what the gene sight test says. My ex didn’t do well with it, but my gene sight test says only mild adverse effects.

[DataDiva]

I am not sure what you mean by just changed, but you will not hit a steady state of the guanfacine in his system for at least a week. If it has been less than this, what you are seeing is the ADHD without the peak levels of guanfacine you get with immediate release meds. Most psychiatrists would advise giving the guanfacine ER 2-4 weeks to observe maximal effect, as that is what the studies have suggested.

[Alt49 in reply to DataDiva]

He has been on the ER for a week and was on regular guanfacine for a few months.

[DataDiva in reply to Alt49]

It took us 3 weeks to see the level effect of the ER in our 7 yo.

The duration of IR only potentially contributes to worse withdrawal sx as the alpha2 receptors will have adjusted to having a certain supply of guanfacine around. Transitions from IR to ER meds are often bumpy.

[Alt49 in reply to DataDiva]

Interesting

[STARTwHello]

If you read about it, it’s first and foremost a blood pressure med. Our son now 7.5 just started on Clonidine after switching from guanfacine. We started the immediate release guanfacine in Kinder because he couldn’t take a pill and they could compound the immediate release to a liquid. He was on it for almost two years and in that time we tried twice to switch to extended release but the behaviors we saw were so goofy! With the immediate release they are going from getting a much higher dose more quickly to ER which is the same dose but way spread out so it feels like much less. It does some weird things to their blood pressure initially and we just didn’t want to wait through it. We never new if it was going to get better and with a sibling it was tough. It could be weeks before you know for sure. We feel that way about Clonidine now, we have to give it time to even out. What you see now most likely will not be what you see in two weeks is my guess but he’s feeling the effects of a much lower dose feeling of the ER. The Clonidine we just started is 12 hours ER so he takes it twice a day vs once. I do think that’s better for him. It’s not perfect right now though and I do think we’ll need to increase the dose during the day. We honestly saw some weird things with food on the immediate release guanfacine so I really wanted to switch off of it. Any time he ate peanut butter or cheesy pizza it impacted the med. Good luck and post an update! We’re on a similar journey but stimulants have not worked for our son. Lots of big side effects.

[Alt49 in reply to STARTwHello]

Thanks for sharing

[Jgirlie123]

not exactly like that. We did have hypotension and bradycardia. We stopped after two days.

[DoodleDoo2023]

This happened with our son too when he first started guanf and when we’ve increased his doses. Each time was hard for the first 5 days or so but then it evened out and it got better. This is just to reassure you that you are not alone! At first, I would want to stop the med completely, but I learned that for us it was better to stick it out through the weeklong rough patch and wait for things to even out.

[Alt49 in reply to DoodleDoo2023]

good to know. I may not have waited long enough but the fast acting didn’t have the emotional side effects (just didn’t seem to do much at first). Maybe need to wait a bit longer

[Mamamichl]

We didn’t have that kind of effect ion my family. When most of my family tried Guanfacine, they got light headed and it confused and concerned them. My stepkid even feinted. This is when I researched the medication, and realized Guanfacine is a blood pressure medication that lowers blood pressure. I would presume it works for ADHD by keeping people from being excitable or super energetic, but doesn’t do much for mood.