DOUBT ABOUT MEDICATION

[Chispi]

Please, I would like to ask if anyone in the group has taken Guanfacine? It has been prescribed for my son and I am afraid to give it to him because of the side effects.

Many thanks to all of you for your support.

[Hidden]

Are the side effects a certainty? The answer is no. Will he experience some side effects? Maybe, maybe not. Will being treated for the condition improve his quality of life? The answer is yes. Having anxiety is normal but you have to manage it with reasonable expectations. If you could know the unknown then you’d know but you can’t know the unknown because you don’t know what the unknown is.

[Chispi in reply to Hidden]

You are very right.

Thank you very much for your advice and for making me think positively.

[BlessedLady]

All medications have possible negative side effects, especially ADHD medications. The benefits need to outweigh the risks.

[Gettingittogether]

The FDA and the other regulators require drug companies to list all possible side effects. Doesn't have to be a frequent side effect. Lots of these side effects occur in 5 percent of people.

My father worked in drug research. His claim: all medications have side effects. All. The body is a whole. I have to tell you: all the OTC meds you take have side effects too, including Tylenol, Alleve, Ibuprofen, allergy medicine, cough medication--all of them have side effects meaning negative side effects for a few people.

It's great that you are being careful as a parent. But you can ease up. You can safety start the medication. You'll know if the side effects are bad. Then you report those to the doctor. The doctor will adjust and advise you or what to do. Lots of meds have side effects that disappear in a few weeks. Your son is not going to get hurt by some side effects. You report them. The doctor reduces the dose or tells you to hang in there a few more weeks (which YOU have power to veto if they do so) or changes meds. And you will also monitor the good effects.

Half of medicine is balancing the good effects with the negative side effects. I've taken ADHD meds that interfered some with my sleep. But that declined over time, and I paid attention. And I began to reduce my coffee and to exercise. When I exercised and reduced my coffee intake, my sleeping side effects disappeared. Actually what I did was cut my coffee intake later in the day. I now do not drink coffee past 12 noon. And I drink less.

But ironically, the same meds helped me with sleep because I was conscious enough, my brain focused enough, to realize that I needed to improve my sleep hygiene, my before-bed routines. I can't be on a bright computer screen with bright lights in a room and then close the computer and expect to be asleep in 15 minutes. I now gradually turn down the lights in the room, and I darken the computer screen and I avoid any analytical work before bed. I watch a light tv show.

GREAT concern. You're a great parent. But you're safe to proceed. Just remember, all meds have side effects. Some of my allergy meds make me drowsy. Well I tried different meds to find the one that made me the least drowsy. My favorite allergy med (Allegra-D) seemed to increase my blood pressure and my heart rate, so I backed off. Actually I made this decision with my ADHD psychiatrist! So now I do the regular Allegra, not as good as Allegra-D but good enough with none of the side effects. And someone else, including a family member with similar conditions to me, could have NONE of those side effects I have.

There are lots of ADHD medications. If one doesn't work, you try another. Getting the right treatment requires time. And part of that time is trying out various medications and noticing the good effects and the side effects.

Oh, and of course, untreated ADHD has tons of horrible effects and side effects: increased accidents, falls, car accidents, addictions, school struggle, dumb decisions, depression, demoralization, frustration, difficulty listening to people and having good conversation and relationships.

You're just taking a step. You can and will adjust if there is a problem.

[BlessedLady]

It would be a good idea to give your son his first dose of medications on a weekend or school holiday. I always did this with my kids. No matter what the medication were. One time my sons dosage of Ritalin SR was increased. I waited to give him the increased dose on a weekend. It made him sleepy. We were glad we waited to try it on a weekend.

[Tim_Othy]

I used to be a pharm rep. Often there is a list of frequent side effects and percentages of the tested effected and a separate list of rare side effects. Most often if the drug is discontinued, the side effects stop. Weigh out the risk and benefits, but most here on this site seem to get help from the prescriptions. All the best to you and your son

[STEM_Dad]

Well I have not tried Guanfacine, I have been on other ADHD medications.

I did develop the concerning side effect of tachycardia when on a higher dose of Adderall XR, but I didn't have the side effect at lower doses.

I am now on atomoxetine (known by the brand name Strattera). After several weeks on it, I developed a mild side effect which I experienced a few times over a few weeks, but then stopped. That same side effect has not reoccurred over the last several months, and no other side effects have presented themselves.

Some side effects are short-lived, many side effects are minor. If any side effects occur which are concerning, contact the doctor right away.

[Chispi in reply to STEM_Dad]

Thank you very much everyone for the responses.

My son was also taking Strattera, but he had some pretty bad side effects and the doctor stopped him. That's why I'm so scared to try the new medicine. In addition, it is a tablet that has to be swallowed, it cannot be dissolved, and my son is still not able to swallow it at 7 years old.

Thanks for everything.

[STEM_Dad in reply to Chispi]

I'm relatively new to learning about ADHD. (I was diagnosed at 45, started taking the generic of Strattera, atomoxetine, at 46 after a bad side effect from Adderall XR. I'm now 47.)

From what I've read, at such a young age the stimulant medications usually work best (methylphenidate, or amphetamine salts). They're a lot harder to deal with, especially in schools, because they are controlled substances. But by the research data, they have a good track record.

Strattera is a SSNRI medication, so it's similar enough in function to SSRI antidepressants that I would be hesitant to try it with such a young person. (I'm certainly not a medical expert. My hesitation is mostly about not understanding what effect Strattera might have on a developing brain. There's just so much more research about the stimulants, and at clinical dosages, I understand the risks are very low.)

[STEM_Dad in reply to STEM_Dad]

Due to my own ADHD diagnosis, and all I've learned in the last couple of years, I'm noticing the ADHD-like traits in my own kids (ages 28, 20, 9 and 7).

The oldest (my stepdaughter) and her doctor agree that she should be tested... she seems more likely Predominantly Hyperactive-Impulsive.

My older son, the 20 year old, is very similar to me... And I clearly have the Predominantly Inattentive presentation.

My younger son, age 9, seems like he may be the Combined presentation. The youngest, my 7 year old daughter, seems noticeably Inattentive.

The 20 year old seems most strongly ADHD of the bunch. The others might be sub-clinical (which means "having traits, but not enough to meet the diagnostic criteria"). I think that if my younger son was in a regular school, a teacher would insist he be assessed for ADHD, because he would be that kid who can't sit still in a student desk...but he's been homeschooled all along. (He can stay in one spot on the floor to do his schoolwork, but will change positions 12 times in half an hour!)

[Chispi in reply to STEM_Dad]

In the case of my son, hyperactivity with impulsiveness and Asperger traits are clear. My son does need to get up several times, he cannot stand, much less his brain, it does not stop creating and being in continuous activity. I hope when he is able to swallow the tablet, that it works well for him, because everything he has taken so far (methylphenidate, atomoxecine, risperidone...) has made him feel terrible, he only has to try guanfacine.

Thank you very much for your help and that of the whole group.

[StZelie]

My son is 5 and started taking half a dosage over a week ago. He started taking a full dosage yesterday. I monitor for symptoms of low blood pressure as recommended by his practitioner. So far he has been fine but takes more naps. Unlike the stimulant ADHD meds he first tried, he has not had any irritability or aggressive behavior side effects with Guanfacine.

[Chispi in reply to StZelie]

Hello. Thank you very much for answering my question.

How many mg is the half dose? The doctor told me that the tablet cannot be dissolved, that it has to be swallowed. I had thought to start with a lower dose, to see how my son feels, because the other medications he has taken have made him feel very bad, but when he told me that it cannot be dissolved because it is prolonged release, I have to give him the whole thing. The tablet is 1 gr. The half dose that you give your child of how many mg is it?

Thank you very much for your support and that of the whole group.

[StZelie in reply to Chispi]

1/2 mg. He swallows it with water.

[Chispi in reply to StZelie]

That's ideal, start with 0.5 mg. But here in Alicante (Spain) it only gives you the option to start with 1 gr and also it has to be swallowed, it cannot be dissolved, because it is extended release...and that complicates it a lot, because my son still doesn't swallow it. I am in the dilemma. Thank you very much for answering. A greeting.

[StZelie in reply to Chispi]

It's actually a 1 mg pill that I split in half. But, yes, either way he swallows it.

[Hominid711]

Interesting. To the mum with the son who has been experiencing side effects with several different medications as in feeling bad. Is there any way of giving him the meds so he doesn't notice? Pulverised or otherwise and mixed with food or drink? Like adults kids can be affected by placebo effects - or placebo side effects. Just a thought. No disrespect.