Tenex and weight gain~when to d/c med cause of weight gain?

jcox · #1 11-08-2009, 07:52 AM

E had his Tenex increased in September. He has gained 6 lbs this past month, which I believe is more than a coincidence. This saddens me because he had previously gained 65 lbs on Risperdal going from 35 lbs at age 4 to 99 lbs at age 6. Then when he went to the phosp they changed his meds around and since his release in March he lost 14 lbs and went down to 83. Recently he was put on Tenex in August, which started at 1 mg. In September they increased it to 2 mg. Now he is back up to weighing 89 lbs in just the past month or so. Reminder: He is only seven years old. I have a couple questions:

Has anyone else's child experienced weight gain on Tenex?

How do you know when to discontinue a med that seems to be working because of the side effects such as weight gain it causes?

I really don't want to see Elijah get back to the weight he was. He was so unhealthy, had no energy and it was so sad to see him that way. I am thinking of asking the pdoc to discontinue the Tenex, but he has shown improvements on it with his attention span increasing, decreased distractability/hyperactivity, really decreased anxiety level, etc. The school has been very happy with these improvements, but I wonder is it worth risking his health from all his weight gain?

All he wants to do is eat and when I don't let him he gets aggressive. He has been waking up in the middle of the night to eat. At that time he usually has me make him some oatmeal or hotdogs, which I know is not the best thing to eat at 2:30 in the morning, but being so tired and still half asleep I really don't want to deal with his mess that time of night, nor have him wake up everyone else in the house by having a temper. So I give in and make it for him. Almost all his tempers are about eating what he wants when he wants and if I don't let him it seems like the end of the world to him. Unfortunetly that is all too familiar from the days when he was on Risperdal. I really don't want him to get that unhealthy and sick again.

DDD · #2 11-08-2009, 02:16 PM

We were very happy with Tenex over a number of years. It was used as a supplement to the Ritalin (or alternative...I can't remember) to lessen the chances of tics. There was no increase in appetite or weight gain.
Risperdal, otoh, as caused GFG to NEED food in the middle of the night.

I'd discuss it with the MD and see what he says. Perhaps you can check out Tenex on the internet and see if increased appetite is shown as a common side effect. It could be another med. Good luck. DDD

lmf64 · #3 11-08-2009, 03:46 PM

I'm going another way here. When was the Abilify added? Was there a recent increase in dosage? My son has been on Abilify two seperate times. The first time he was on it he gained 80 pounds in 9 months and then stabalized at that weight (minor year to year increase, but nothing unusual because he was also getting taller at the same time) for the next 3 years. He was then taken off of it because we didn't think he needed it any longer and were trying to get the number of meds he was taking down. One year later (almost to the day) he was back on it and gained 80 pounds in 5 months at which point we said it had to go, we didn't have time to wait to see if he leveled out because he was showing the early signs of developing diabetes from it. The literature with Abilify used to say it wouldn't cause weight gain or didn't say anything about weight gain as a possible side effect, but gfg's pdoc said that every child she had used it with wound up with massive weight gain as a direct cause and effect basis. I loved the Abilify for what it helped my son to do, but will never again allow it to be prescribed because it was killing my son slowly. We switched to Geodon and although the literature says weight gain is a possible side effect gfg has lost weight since he began taking it and my grocery bill has gone down too.

smallworld · #4 11-08-2009, 05:18 PM

I did a quick internet search and did not turn up weight gain as a side effect of Tenex. I agree that Abilify is the more likely culprit. I also agree with checking in with the prescribing doctor to see what he thinks before you consider discontinuing a med that is working.

pepperidge · #5 11-08-2009, 06:05 PM

He is on a pretty hefty dose of abilify--15 mg--based on my experience of 2.5 mg which did increase appetite that could definitely increase weight. Tenex we didn't experience weight gain with.

I know stimulants are dicey with kids with mood problems, but if he is pretty well stabilized on mood stabilizers, might it be worth considering a low dose trial? My son does well with w/ Adderal and Risperdal combo (not large doses of either) and has been at a pretty stable weight.

Its tough but with such a huge weight gain I would be looking at other meds too.

crazymama30 · #6 11-08-2009, 06:21 PM

I agree that the abilify could be the culprit, but I think Lithium causes weight gain also.

My gfg is on 7mg of abilify, and has gained a few pounds. I really don't know how much as he looks ok, actually is on the small side, but he has already outgrown his 10slims for 10 reg jeans.

It can be so hard to balance the side effect of the meds with the positive they give our kiddos. From what I have seen with dh it is just as hard with adults.

smallworld · #7 11-08-2009, 06:43 PM

CM is right -- Lithium can cause weight as well as Abilify. But I think the APs like Abilify are notorious for the non-stop eating that you're describing.

DDD · #8 11-09-2009, 06:16 AM

Geez........I can't believe I forget to add this warning to the post yesterday. Do NOT stop the Tenex. GFG ended up in the hospital because his biomom took him to a "new" Dr. who "wasn't familiar with Tenex" and changed him to something else. You must ease into the doses of Tenex and you must ease off them too. It can cause a spike in BP. DDD

pepperidge · #9 11-09-2009, 08:51 AM

Is he on both clonidine and tenex? Don't they do much the same thing?

jcox · #10 11-10-2009, 05:45 AM

Going to try to answer everyone's questions and respond to some comments as well:

Why Clonidine AND Tenex? He was on Clonidine since he was 4. He can not tollerate Clonidine in the daytime. When he was in the phosp back in Feb-March they decreased his dosage from 4x day to only a night dose. In the summer his school kept telling me that they were concerned with his "ADHD symptoms". I discussed this with his pdoc and she said the only 2 ADHD meds she would even consider for him would be either Tenex or Straterra because of his mix of diagnoses. She decided that Tenex was a better choice for him. She started him on one dose of Tenex in the morning. They have tried to get rid of the night dose of Clonidine, but with every decrease in dosage at night he can not sleep. Even at .1 mg at night he was having trouble sleeping through the night so that is why they added the night dose of Tenex.

Abilify and Lithium causing his weight gain:
I really don't think so in his case. He has been on both since his phosp stay in Feb-March and actually lost 15 lbs from February through August after that med change (As well as going off Risperdal). The Tenex is the only recent change, with it being added in August and increased in September. The Abilify was added in February and has not been raised up since.

Trying Stims:
The pdoc did not think that would be a good idea when I questioned her about ADHD meds, because she said my son is "Complex, Complicated, and a Tough Cookie to figure out". He has so many diagnoses in his mix. Ritalin at age 3 made him have a 5 hour nonstop rage.

Nobody seems to ever have heard of a connection between Tenex and weight gain. I have read about it online and can not seem to find a connection, so maybe this is a coincidence. I am going to try to change his diet for a couple months before I ask to get rid of the Tenex.

smallworld · #11 11-10-2009, 06:16 AM

Just a thought: There's brand-new med out called Intuniv, which is basically long-acting Tenex. Perhaps it won't have the same side-effect profile as regular Tenex. You might want to ask your pdoc about it.

tfratis · #12 12-29-2009, 11:46 AM

I think your son's weight gain is being caused by the abilify not the tenex. i am not sure what you could try in place of the abilify but I bet if you took him off of the abilify he would not be waking up in the middle of the night needing to eat.

jal · #13 12-29-2009, 01:19 PM

My gfg also did not have weight gain w/Tenex.

judela60 · #14 01-28-2010, 02:42 PM

Wow - sounds like my son, Jackson, who is now 9. He has steadily gained weight since he has been on Abilify, and at this point, the eating has become so much of a battle, that I doubt if the medication has anything to do with it anymore. While he had been up to 15 mg a day, he is now only on 2.5 mg of Abilify, but his hunger has not decreased. He is also on Tenex, (the Guanfacine generic), but I do not think that has had an impact on his weight.
In any case, I have let him eat as much as he wants until he gets sick, and that still does not stop his hunger. Like everything else, he cannot delay gratification, so he has to eat as much as he can, as fast as he can. I guess I just have to hope that he will have a lifestyle change which will impact the availability to eat on impulse.
Let me know if anything works! - Judy