Wednesday, August 25, 2010
A Reader Question About Intuniv
Someone just asked me if Intuniv is still working for our ADHD daughter. I can't find their post, but I wanted to reply and say that 4mg was too much, and 2mg was too little. 3mg seems to be the right dose, but we felt that while it helped with her outbursts it didn't do as much for the focusing part, so we did add Vyvanse to the mix, at a very low dose. I am told by our psychiatrist that this has been a common finding among parents, that Intuniv doesn't help with the inattention as much as the explosivity.
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8 comments:
Thanks for the information on Intuniv. My son will start it Friday. He was diagnosed ADHD three years ago, Bipolar in March, and ODD today. The psychiatrist doesn't know if the Intuniv will help at all, but I'm willing to try just about anything at this point. He's already on Lithium and we haven't been treating the ADHD for the last three months. We desperately need some peace around here. At least this evening has been calm. It seems that the psychiatrist scared him a little bit by supporting us.
My son just went to bed saying tomorrow will be better. I keep hoping it will.
Hi Sara, I hope your home will experience some peace soon too! I know that feeling when you are just desperate to help your child. Intuniv is probably a good med to try since stimulants would likely exacerbate his problems. The ODD is a part of bp disorder. When the bp disorder is treated with the right mix of meds, the ODD will definitely decrease. Hang in there!
Hi Megan. I know I'm asking about an old post - but do you recall how you knew that 2mg was too little and that 4mg was too much? Particularly since you later needed to add Vyvanse into the mix, how did you judge what the "sweet" spot was with Intuniv for your daughter? Thanks! Jackie
Well, there wasn't a big difference in her explosive behavior until we got up to 3mg. We did go up to 4mg for a while but when we added the Vyvanse to increase her focusing ability, the 4mg was too much, so 3mg was better. I think it comes down to behavior: if your child's irritability and intolerance to frustration is not significantly reduced by 3 or 4mg of Intuniv, it may not be a good monotherapy for him/her. Just my opinion! Hope this helps!
Megan, I'm sure my brain is foggy this morning and it's me, not you - so could you clarify one point for me? What specifically gave you the sense that the Intuniv was too high at 4mg? Thanks again for your wonderful blog!
Sorry J! I should have been clearer. At 4mg, she seemed too dopey in the daytime, and not necessarily more focused. The 3mg did the trick with curbing temper tantrums over everything, so we knew it was working, but she wasn't too groggy during the. The Vyvanse made her better focused.
Megan,
While my son was better focused on vyvanse with the intuniv and his grades did improve, so did his short temper return and his meltdowns. He is on 3 mg intuniv(4 mg made him sleep during school) and 30 mg vyvanse, 3 mg risperdal and 10 mg prozac. He is back to daily explosive behaviors and overreacting to people. This week he was kicked off the bus for striking the driver. Stimulants don't seem to work on him but he has bad adhd. Any suggestion?
Mich, has your son ever been evaluated for bipolar disorder? I ask because, as you might know, a child who is put on antidepressants and/or stimulants and has a bad reaction (irritability, outbursts, meltdowns, mania) can have latent or undiagnosed bipolar disorder, mistaken for bad adhd. The adhd would then be addressed medication wise after the child was stabilized with bipolar meds first. He may not have early onset bipolar disorder, but with his reaction to Vyvanse, it needs to be looked at. Vyvanse can produce bad reactions in kids who arent' bipolar too.
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