Tenex/Guanfacine and night-waking?

[crescentcitygal]

Last week, we took our 6-yo (almost 7) DS off Strattera in order to start a Focalin XR/Tenex combination. We have been giving him the Tenex (no Focalin yet so that we could see how the Tenex affects him) for 6 days: 1/2 mg in the morning and 1/2 mg at night. It does seem to have a mild calming effect on him during the day, and seems to help a little with impulsivity. However, he has been waking up at night 1-3 times every single night since starting the Tenex. I thought Tenex was supposed to be sedating? How can this be?

There is not much information to be found online about the use of Tenex for ADHD in children, and any side-effects, since it is mainly used as an anti-hypertensive. I did a search on this forum and one other, and read a few posts from parents stating that their children also experienced night-waking from Tenex. Is this common? Is this a side-effect that is expected to subside over time? I'm just wondering if it is worth sticking with it for a little longer to see if the sleep improves, or if this is what I can expect from now on with this medication (which would be unacceptable).

The Tenex was prescribed to help with tics and evening rebound/insomnia caused by stimulants (which we know about from previous experience on stims). So far, it does NOT seem like it will work as expected for him!

[Mayleng]

Tenex is supposed to have a sedating effect. It is better that you discuss the nite wakenings with the doctor. Do not stop Tenex cold turkey as it might affect your son's blood pressure. You should ramp down if you are stopping.

It might be that your son needs a higher dose, a change in timing or it might not be the right medication. But only your doctor can help you figure it out.

Hopefully, some of the members who have tried Tenex will be able to give you some input.

[chaknine]

B was on Tennex for awhile to help with sleep, but it did not work as well as the Clonidine and she started having anxiety attacks on it. We switched back and for the b/t clonidine and Tennex for awhile. The Tennex and Clonindine at lower doses would stop working for sleep after awhile. Once they got her up to 0.4 mg of Clonidine (she is 11) it has worked the best for us.

[crescentcitygal]

I called the dr. yesterday and asked if it would be okay to discontinue the evening dose of Tenex (while continuing the morning dose) until our next visit. He said that would be fine. I did not give him his evening dose last night, and it was the first time he slept through the night since starting the Tenex a week ago!

I will continue the morning dose for a while because the original idea was to add the Focalin back in to see if the Tenex helps him better tolerate the stimulant.

[VaMom]

Hi crescentcitygal,

Have you seen this article about Tenex, from a psychiatrist?

www.askdrjones.com/2006/11/07/tenex/

He really likes the med, but does not seem to feel it is very sedating, he says Clonidine is the med if you want sedation. Perhaps you are on the right track with only dosing in the a.m.

[crescentcitygal]

Thanks, VaMom. Yes, I did stumble across that article a couple of days ago. In fact, one of the reasons our dr. prescribed Tenex instead of Clonidine is because when we tried Clonidine before for a brief trial, it was way too sedating for him during the day. I wish we could find the happy medium. Still working on that.

[zachsmom]

My son was on Tenex/Stimulant combo for a long time (recently switched to Clonidine as we were not getting tic control on Tenex. When we raised Tenex dose the tics increased). His doctor wanted him to take the 2nd dose after school because there was not as much benefit from giving it at bedtime. My ds slept very soundly. You might try moving the dose earlier in the day to see if this helps.

[kc4braves]

We tried Tenex with Concerta and saw great results initially but had to back down several times becasue of night waking and panic attacks at night. We tried lowering then going back up and never saw teh great results again but managed to get his sleep pattern all messed up to the point we were all exhausted and he was scared to go to sleep. So now we have weaned off Tenex completely and quit Melatonin. We are trying a fresh start, so to speak, with only the Concerta. He has been off the evening meds for about a month and now mostly sleeps all night once asleep. He takes a while to get to sleep but I have decided that is easier to deal with than finally getting to sleep and waking up totally anxious and freaked out several times a night. I have been told that Tenex should not do that but I believe it was teh casue for my son. We would love to find something that would help with getting to sleep but I'm afraid to give him anything again for a while.

Kathy