Does anyone have their child on Zoloft and Guanfacine? My 9 year old has been on Zoloft since January and it has helped him tremendously with anxiety, but his adhd is largely untreated. He still struggles with emotional regulation, impulse control, and outbursts occasionally at school. His pediatrician is recommending guanfacine, but I’m nervous because I, a) am not finding anyone with experience giving their child this combination of meds and b) parents of the internet seem to have polar opposite experiences with their children on guanfacine. Either it’s like, “guanfacine was a God send for my child.” OR it’s like “my child passed out on guanfacine,”/“my child couldn’t sleep on guanfacine,”/“my child had horrible nightmares and hallucinations and peed his pants all the time on guanfacine.” It’s all making me very nervous.
Zoloft + Guanfacine anyone? - CHADD's ADHD Pare...
Zoloft + Guanfacine anyone?
We have recently tried guanfacine for a 2nd time & we use Zoloft & stimulant. If you search my prev. replies to posts, I hated it the first time. 1st time we weren’t on Zoloft though.
Our 2nd try was really different with different combinations. But behaviour was definitely worse in first couple of weeks (I assume because fatigue). Now we have a huge improvement with impulse control.
Thanks so much for your reply. I will search your previous posts.
No problem. Hope that initial reply made sense. So I just checked my notes and today is 4 weeks since starting our 2nd time trying guanfacine. He is so much calmer. However my boy is struggling a bit with late afternoon sport since starting though, as he is just too fatigued. But I haven’t spoken to our psychiatrist yet.
So for the first 2 weeks the day time fatigue & night time bed wetting was huge - but these have subsided.
So we haven’t done that exact combination you mention, because we started with a stimulant & it has remained throughout any other medication trials.
I wondered if you had tried a stimulant, or paediatrician had a reason for not trialing it?
We had really great results from stimulant plus Zoloft, once we got the dosages sorted. But that was only 8 hours of the day. Because of pretty extreme impulsivity outside the 8 hours, we decided to trial guanfacine again in addition.
But at least with a stimulant, you very quickly see the results that day & it’s in & out of the body quickly. None of the waiting weeks to know.
We started with a stimulant and he was able to focus while it was in his system but we got about 7 hours of the day out of the stimulant (whether extended release or immediate release), leaving 5-6 hours of crankiness and anger during the afternoon and evening. We continued in this way for 4 months and finally decided that he was just too miserable. Plus, at that time he wasn’t on Zoloft yet, which meant he was cranky, angry, and anxious all the time.
We may start back on the stimulant, but I’m a little reluctant to go that route because it seemed hard on his body.
I hope your son is able to adjust well to the guanfacine and can continue playing his afternoon sports!
We have 9 year old twins with ADHD and we started guanfacine 2mg per day 2 years ago with their methylphenidate. There is no problem and guanfacine has calmed their nervousness and aggression enormously, especially at school.
Helpful info. Much obliged.
yes my 12 year old is on this combo. It has helped him a lot. He's adhd with level one autism. It's not 100%. We've done a lot of OT, ABA and pragmatic speech therapy with him which is the other part that helps. Pills and skills they say. But in terms of the combo it's been good for my son- work closely with your child's doc to find the right dosage. That's important. Every individual is different. Good luck!
My son was about your child's age when he started on that combination. First the Zoloft and then a few months later we added guanfacine. He is now 12. Stimulants made him too irritable. That combination worked very well for him. The guanfacine helped slow him down. We did have to watch his BP, he was only able to mangage 1mg for about a year or 2 because his BP would get too low. He finally got to 2mg about 2 years ago.
Unfortunately every child reacts differently to meds. You really have to try it out to know what will happen. The only negative we had with guanfacine was he would complain of his stomach bothering him but it would always pass. He always took it at night.
Now at 12yo his main issues are focusing, and organization with schoolwork so our child psych has us transitioning to Qelbree. I've gotten so comfortable with guanfacine that it's a little scary/sad to let it go.
Well my son is 13 y o he has been on zoloft 100mg and 3mg of gafacine for about 2 years. He was having troubles with it not kicking in the a.m. so we are giving it at night an hour before bedtime. This seems to work but afternoons in school concentration is difficult for him. All in all I would say that combo is doing well for him. Again like everyone else it takes multiple trials to figure what works for him. It took us like 2 years to figure out which meds work and stick with it. Good luck!
My son was on just guafacine for a year and we recently took him off of it. We were concerned it was impacting his sleep and actually making his emotional dysregulation worse. He's been off it now for almost 2 months and is doing much better.
Our doctor thinks while he has a ADHD diagnosis, his issue may be more anxiety. She recently prescribed him Zoloft, but my wife and I are hesistant to start him on it due to the side effects it may have such as decreased appetite and potential sleep issues. He already is very thin and doesn't have a big appetite and finally seems to be sleeping better after having been off the guanfacine for almost 2 months. This is just our experience though and others in this group have had success with both RXs
I definitely appreciate your insights here. I’m in the rich meaty heart of perimenopause and the last thing I need right now is another reason to lose sleep.
Was your son on guanfacine ER or IR and at what times of day was he taking it?
I’ll offer this: I was *terrified* of giving my son Zoloft. It took me six months to decide to go forward with it for many of the reasons you’ve articulated. He was and still is very lean, and he was depressed, anxious, and dealing with OCD. The thought of giving him something that might make all of that worse was unthinkable to me for a long time. At some point, I decided that the chance of him being miserable in the absence of another intervention (we had worked with several therapists at that point) was 100%. The chance of him having a really bad reaction to Zoloft was much lower.
It’s such a personal decision, and I don’t envy anyone for being in the position of having to make it.
Ultimately, my son’s adhd has yet to be adequately addressed, hence my original post. However, I am so glad we opted to get him on the Zoloft. He took 12.5mg for two days and started feeling calmer and more able to focus. We kept that dose for about four months before increasing to 25mg. He’s still struggling with impulse control and emotional regulation at school, but at home, he’s happy as a clam, willing to try new things, and far more able to learn skills to cope with the adhd and any anxiety that arises.
Sending you my full sympathies and wishes for good luck whether or not you move forward with the Zoloft!
My son was on the IR release and took it in the morning before school and in the evening before bed. Appreciate sharing your experience with Zoloft. It's good to hear its worked well in you case. Our son has more Anxiety/OCD tendencies than ADHD and tends to show that more at home. I'll say his outbursts have been much less since stopping guanfacine. He does see a therapist but not that frequently right now. As others have said, having to experiment on your child is not easy but we all need to find what will work best for our own child.
My son is also 9 and has been taking guanfacine (ER, 2mg) for a year and a half. He also takes generic Concerta and Lexapro. The guanfacine feels critical to managing his behavior but also it’s more subtle than how the Concerta affects him. I would recommend trying it for a few months because you just won’t know if it’s your saving grace or not until you do. It’s not ideal that we have to go through this trial and error process with meds but it’s the only way to find that perfect fit. Good luck!
This is clarifying and helpful advice. I appreciate your support! I’m challenged by the feeling that I’m experimenting on my kid. Even if my intentions hold his absolute best interest in mind, it’s a painful process. He trusts me to keep him safe. He trusts that I’ll never put him in harm’s way. It’s challenging to feel like I’m deliberately putting him through so much discomfort (hopefully not harm) in the interest of finding a sustainable way for him to peacefully exist (and hopefully thrive) in the world. It’s helpful to hear stories like yours.
Our 11 year old has been on guanfacine for a while now and it works well as an afternoon adhd medication for emotional dysregulation after school. There was an adjustment period of about a week when we started on it. It made him more emotional (crying) and tired for about 5 days until he adjusted to it. He started at 1 mg. Later, he moved up to 2 mg and the same thing happened with the crying and being a bit more tired, but only for about a week again. So just know that there is an adjustment period and it might be rough but it doesn’t last forever. Therapeutic dose is actually 3 or 4 mg so it takes some time to get up to that level.
Our son also takes generic Adderall XR as his primary ADHD medication every morning. He also takes fluoxetine every morning for anxiety, which works well. The guanfacine is taken in the afternoon and it helps so much after the Adderall wears off, which can have a crash effect. It helps with that transition for the afternoon and evenings to go more smoothly for him.
We tried Zoloft and that was a very horrible experience. It caused anger and aggression so we had to go off of that after a month and transition back to fluoxetine. That works so much better.
Incontinence can be an issue for many ADHD kiddos at times with or without medication. But medication transitions can affect this more while their bodies adjust to the changes.
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