New Member
We're off to see the pediatrician tomorrow for a medication check, and I'm going to lobby hard to try something other than Ritalin for my son. He basically can't stay on any task at all (particularly at school) without some kind of medications at this point, but he becomes a totally evil monster when he's coming off the ritalin almost every day. Screaming, crying, irrationality, occasional violent outbursts, etc. By the time he's settled down, I'm wishing for medication for myself! Anyway, we've tried regular ritalin, and the extended release type, both 10 and 20 mg, plus extended release followed by regular, and various other combos, and still have this problem to some degree on any dose. We've been trying this for more than six months now--I think that's probably long enough to declare that this is not really the right medication for him.

To make matters worse, my insurance won't cover some of the obvious alternatives, such as Strattera or Concerta.

Anybody have any ideas? I'm thinking maybe Adderall? Anybody used Tenex? (I've heard that doesn't really have any crash at all.)


Well-Known Member
We use Adderal. Does your ins. cover it?
We refused Ritalin flat-out b4 we were even given a list of drugs, and the dr. kind of chuckled, because the drug has gotten such bad press, he doesn't even prescribe it any more.
Good luck!


Well-Known Member
Alot of people have good results with Adderal. We did not.
The Concerta has worked best for our boys, Prior to Concerta,
we would use a 5 mg Ritalin to help with the daily transition
time. It's so hard to have to keep testing medications but hopefully
you will find the right combo soon. Hugs. DDD

PS: Tenex was used as a supplement with the Ritalin when the
boys took that medication. It was designed to prevent tics and worked
well UNTIL the younger difficult child was taken off Tenex cold turkey and
ended up in the hospital with blood pressure problems. You have
to be careful with it.


New Member
Seb takes Daytrana (transdermal patch) and has had very good results-- but it derives from Ritalin I think or at the very least is in the same class of medications. Seb does not have a rebound effect when the Daytrana wears off-- he did with Adderall XR. Seb had the same highly emotional outbursts whenever the Adderall would wear off.

With Daytrana Seb has been pretty much free of the emotional side effects. The bad side effect he does have is lack of appetite which is pretty much par for the course with all stimulants.

Other Ritalin type stimulants that friends have had success with are Focalin and Metadate. I believe they are stimulant type Ritalin based medications, but I can't say for certain.

Let us know what works for you!

Wiped Out

Well-Known Member
Staff member
My difficult child has tried most of the stimulants. Adderall and Metadate worked the best but none really worked for him because of his Bipolar. My easy child takes Adderall for ADD (no hyperactivity) and doesn't have any problems. I hope whichever one you try works well!


New Member
Tenex and Clonodine are antihypertensives, not stimulants. They are given to kids with ADHD, my easy child has ADHD, Combined Type, and neither did squat.

Adderall made him angry.

He's on a low dose of Concerta, and we've had great results. He actually got "Most Improved Behaviors" in school this year. Was great. We DO see when it wears off, usually around supper time. We give warm baths, reading time, quiet/down time to get him to settle. Write, reading in bed, stuff like that.

The thing about ADHD medications is, from what our psychiatrist said, the ADHD medications will help the child to calm down and pay attention, but it isn't a drug to make the child listen or change behaviors. With that being said, once you get your child to calm down on the medication, that is the time you want to work really hard with them to get the behaviors to change. It is not a quick fix and it won't happen overnight.


Well-Known Member
Just tell the doctor what your insurance does not cover and I am sure he will start with something other them Concerta or Straterra.

Tenex is pretty dangerous - has to be given at the same time everyday - usually at night due to it making them sleepy.
I swear that was the best drug for my difficult child, but I could not count on Dex giving it every night (he left it up to her) and could not risk the blood pressure issues.
It helped with her mood alot!


trying to survive....
My child took tenex for a few years. I gave it to him two to three times per day--I was never told to give it to him the same time every day. However, it really does very little for attention. It mostly helps with impulsivity, activity level and mild agression. Each child reacts differently to the medications.

For kids without mood issues, stimulants often work better than tenex.


New Member
My daughter has been on Focalin XR 10 mg for 7 months now and it is helping. She tried Adderall XR 1st and it made her cry all the time and get angry. She is a lot calmer now. Unfortunately there is not a medication for the bigger problem ... her ODD. She also takes Zoloft 50 mg for anxiety that started 3 months ago.


Sara PA

New Member
Methylphenidate is sold as Ritalin (Ritalina, Rilatine, Ritalin LA (Long Acting)), Attenta, Concerta (a sustained release capsule), Metadate, Methylin and Rubifen as well as the Daytrana patch. Focaline is just the d-isomer of methylphenidate or dexmethylphenidate.

Adderall is mixed amphetamine salts.

Strattera is an SNRI antidepressant.


New Member
My difficult child was on Straterra (extended release) and Concerta for two years. It definitely helped settle him down and he was able to focus. However we still had periods of the anger and aggression. He has recently been diagnosed with bipolar. The doctors told me that the depakote they were putting him on would help stablize his mood...and it seems to be working. He isn't having angry outbursts like he used to and getting pouty.

The Concerta is also helping his ADHD symptoms of hyperactivity and loud voice volume.

Unfortunately, when it comes to medications it is all trial and error.

Why won't your insurance cover Straterra or Concerta? I didn't realize that insurance companies would do that.


Well-Known Member
If the ritalin is working but the rebound is what is bad, you might want to consider trying the tenex to "catch" the rebound. That is often done. In fact, there was a year or so that we used it with my middle son when my youngest was going through some of his harder times and it was effecting the family badly. Middle son was stressed and rebounding at night and we used tenex at night for a short while and it worked very well.

The other possibility is to get your doctor to contact the insurance company and try to get them to cover the concerta. Maybe the doctor could give you some samples to try for a month to see if it works well and then lobby the insurance company...you can normally get things waived in even if they say they dont cover them if a doctor says its medically necessary.


New Member
Thanks, everyone. I just talked it all over with the doctor, and she wants to try a different form of time-release capsule (30%/70%), since it is actually working for the ADD despite the rebound. She said she has seen worse rebound effects from Adderall, and didn't think that would be a very good choice. She also said that she is getting a bit out of her depth here, and after this change, wants to transfer his medication management to a child psychiatric nurse practitioner. (Waiting list for child psychiatrist is long and we're nowhere near the top.) Anyway, I've got a call in to the nurse practitioner--maybe she will have some ideas. Thanks again!