Pediatrician wants to add focalin to my 4.5 yr olds regimen

Brooke - posted on 11/22/2015 ( 4 moms have responded )

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Moms, i need advice! My 4.5 yrs old pediatrician wants to start him on focalin 5mg because of his substantial weight gain while on tenex. Im so nervous about the transition!! Also.... He has been having horrible nightmares on the tenex in addition to the weight gain. We have lowered his dose of tenex to 1/2 mg at morning and night and will add in the focalin in a few days. Any advice or experience with either of these meds, especially the combination of the two?

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Brooke - posted on 11/23/2015

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Thanks sarah. I really appreciate your input. I will try to locate the article i read before. It does list weightgain as a side effect on webmd though, ive seen a few other concerns about it on posts such as this.

Sarah - posted on 11/23/2015

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Well I hope you get the answers you need, I would seriously consider seeing a pediatric neuro-psychiatrist to make sure this is the right treatment plan for your child. I am not saying that meds were not an option for your family at the time, but maybe with a bit of maturity and some good behavioral therapy, he could go med free? Have you done a med wash out?
I think you will find families that have experience with both meds, as I have students on both meds, but not at 4 years old. I mean no judgement when I ask what options have been tried and failed before meds were started? I am a school nurse and I have never seen such a young child on these meds.

ETA: Can you refer me to your info linking tenex to weight gain? For my own understanding, as the research I have done does include nightmares as an adverse affect but not weight gain.

Brooke - posted on 11/22/2015

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Hi sarah, thanks for responding. His pediatrician is who prescribes his meds but we are currently working all together with his ped, a behavioral therapist, as well as occupational therapist.
We initially started with the tenex bc of his hyperactivity and aggressive tendancies. Ped did not want to put him on a stimulant before the age of 5. The meds seemed to help at first but as of lately (even with dose increase) his moods have gotten worse and his aggression more severe.
We collectively decided last week to change him to the focalin since we werent getting the desired results with the tenex.
He has gained 8lbs in 3.5 months. His quality of food has not changed but his appetite has increased significantly. The nightmares have gotten so severe here recently. I have read many things that link the tenex and nightmares as well as weight gain.
My question is really if anyone had experience with either med or with them being used together. While weening off of the tenex we will start the focalin. His ped said that it will not hurt to take both. The transition just makes me nervous.

Sarah - posted on 11/22/2015

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Is this your regular pediatrician or dose your child see a pediatric psychiatrist? I presume you child has been diagnosed ADHD or ASD? Neither tenex nor Focalin have been approved by the FDA for kids so young? I do see older kids on these meds at the schools I work at, but weight gain has not been an issue for the kids on tenex. How much weight did your child gain? I wish I had more information for you, but your post just raises so many questions in my mind. I have read one article about a psychiatrist using tenex on kids as young as 4 to control the hair trigger tantrums that tend to occur with ADHD. The main complaint associated with the tenex is it makes the kids' mood flat. Did you see good response to the medication? Is he still controlled at the lowered dose? Has the doctor ruled out other causes for the weight gain? Hypothyroidism, poor diet, low activity or binge eating?

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