question on recommended medications

[sjexpress]

Well we finally saw a psychiatrist with difficult child the other day ( we've always seen psychologists or counselors) since we now feel things are so bad with him that we have to try the medication route. After her evaluation she diagnosed difficult child with a mood disorder with some signs of adhd (said he does not fit all the classic signs but many others are there). I was not surprised at this diagnosis after all the years of reading about difficult child signs and symptoms but now a professional has confirmed my thoughts. I asked her about odd and how he fits all the signs of odd and she said that those are caused by underlying problems and is not an actual diagnosis she gives out ( just like many of you say here!). She feels with medications and behavior therapy we may find some success.
Anyway, the psychiatrist gave me the names of some medications we could try. She wants me to read up on them to see for myself and them we will meet with her again next week to make a decision on what to start and the treatment plan. Since difficult child has a history of getting aggressive, she said she would not like to place him on any stims. She suggested to look at these 3 medications and I was hoping some of you here with more experience could let me know what you think of them? I fully realize that each medication affects each person different so no 2 people will have the same response but I do appreciate any input. husband and I are scared to death to start medications but again, things are so awful for difficult child and us, we have to get more help for him. He is spiraling downward in every aspect of his life and making our home life **** !
The medications she would consider ( of course just one of them at a time to see what works) is Intuniv, or Wellbutrin, or Strattera. I believe she is leaning towards one of the last 2. Thanks for your help!

Jan

 

[BusynMember]

For a mood disorder? Looks like she is strictly sticking to ADHD medications. Straterra and Wellbutrin are antidepressants. Wellbutrin CAN (probably isn't always) stimulating. My husband, who has no mental illness at all, took it to quite smoking and it made him so nervous he quit the medication, not the cigarettes , however everyone is different. Straterra CAN (probably not always) cause more aggression after about 4-6 weeks when the level kicks up. I'm not sure about Intuitiv. If it's Tenex...no experience with it. Our psychiatrist didn't feel it was helpful so he didn't prescribe it (may have been the only medication he didn't prescribe...haha).

 

[InsaneCdn]

Here Strattera is used as an ADHD medication... for those who cannot tolerate stims, or for those who need a 24/7 baseline.
It has to build up in the system, and be ramped up slowly.
It does have side-effects. For us, the worst ones were during the ramp-up period, including nausea. That went away after about 6 weeks.

 

[TeDo]

difficult child 1 has tried Wellbutrin (some years ago) but he had a side effect he couldn't live with - maybe severe headaches or stomach pains, can't remember for sure. We stopped it after a week or so. He's been on Strattera for 9 years with great success. It is an antidepressant that helps tremendously with his ADHD as well. For difficult child 1, it does help with both. He's on the short acting version of Intuniv (Tenex) at bedtime to help with sleep and has no side effects. We do have to keep an eye on his blood pressure since that's what Tenex's main use is for. We tried a dose in the morning to help with the impulsivity but his blood pressure went down so we had to stop that.

I am glad she's on the same page but I agree with MWM. Intuniv is used strictly for ADD/ADHD, Wellbutrin is usually used as an antidepressant, and Strattera is used for both. As you said, no 2 people react the same but as long as you are able to pick up on subtle differences, you'll be able to see any negative effects coming before they get too bad.

Good luck on your new journey and the possibility of a quality life for difficult child ..... and you.

 

[confuzzled]

the protocol for treating mood disorders is to first stabilize the mood with before attempting stims or antidepressants (i'm not positive how that translates with non-traditional stims like intuniv--that might be different, but still)

i'd first ask *why* the psychiatrist is going those routes instead of a mood stabilizer (probably because many take an eternity to titrate, require monitoring, etc).

that all being said--i took wellbutrin for the same reasons as MWM's hub and *HOLY COW*....i was nuttier than a fruitcake. i sort of recall it to be so activiting that i couldnt function. and it could be argued that i probably have some form of underlying depression even though i'm actually ptsd/Generalized Anxiety Disorder (GAD). i dont remember, but if you chose to go with this one i'd ask how quickly can it be *STOPPED* if need be--i dont recall if you can just stop or if you have to titrate down, but also ask how long it takes to clear the system (half-life) in the event it causes issues.

and like MWMs hub....i still smoke.

in any event, everyone is different and you wont know til you try. but if she wont go with MS as a first line, i'd start cautiously with the fastest in/out just in case. for my daughter, she had terrible responses to a variety of classes of drugs *until* the mood was stable-then we were able to address things like adhd with stims (the depression fell away with stability, no need for an AD).

 

[buddy]

what kind of mood disorder?

 

[JJJ]

Intuniv would be the only one I would be willing to try. The other two have a huge risk of activating a mood swing. It would seriously worry me that those are even being suggested.

 

[DDD]

Somehow I missed how Tenex was introduced into this thread but I do have positive experience with Tenex and feel absolutely compelled to note that even though it was of wonderful help to difficult child#2 it must be carefully titrated both up and down. A Pediatrician told #2's bioMom that she should stop the Tenex and use another medication. She followed orders and two days later when he came home to me he was "off". He ended up in the hospital as his BiPolar (BP) had flown up. The Tenex was and is a great help to many but you have to keep in mind not to go off cold turkey. DDD

 

[TerryJ2]

I have no advice, just wanted to lend some support. Glad you are following through. This is a long journey and you are just beginning.
{{hugs}}

 

[justour2boys]

My difficult child#1 is using Straterra and has used Tenex as well as stims. My easy child/difficult child#2 is using a stimulant (Concerta) and Intuniv. I echo a lot of what TeDo said above and here is my experiences.

Straterra... we started using this medication because my oldest difficult child was not putting on weight when on stims. So we switched to Straterra. It did take some time to ramp up the dose and we did have side effects. But we changed the time of dosage, to the evening right after dinner (full stomach), and it has really worked well for my difficult child. We have since added a small stimulant dose in the AM to help with school.

Intuniv... both my boys used this medication, but used it differently. My oldest difficult child used only the generic twice-a-day (12 hr) dosage called Tenex. It was a drug originally developed for blood pressure management, so it has side effects... some "good", some "bad". My oldest used it to help with rebound from stims. It also helped with "winding down" in the evening. Sleepiness is one of the side effects! ;-) But he had to stop taking it due to it lowering his blood pressure to much.

Now, my youngest started with Tenex (generic is cheaper) and then moved on to Intuniv which is the once-a-day dosage. Now this child puts the H in ADHD so for him its a stimulant (Concerta) in the AM and Intuniv in the PM... and this combo works very well for him. We did try just Intuniv... and that lasted only 2 days!

So, having said all the above, here is my 2 cents. My experience with Tenex/Intuniv is that it works best when used injunction with a stimulant. But if you want to try this medication, I strongly recommend starting out with the generic Tenex... it is cheaper and easier to find and manage the right dose. Then if it works, you can always switch to the name brand Intuniv (its $$$).

In my experience Straterra works better for ADD, inattentive kids then for ADD, hyperactive or combined kids. It is also a name brand drug so it is expensive.

Also, I have no experience with Wellbutrin and/or mood disorders. But then I have a teenager so moody is his middle name!