Janice,  I'm not sure how the dosage of Intuniv compares to Tenex.  I do know there have been several reports here of kids becoming agitated on Intuniv, but not all of them were previously on Tenex.  I found this info at the official intuniv website:

DOSAGE AND ADMINISTRATION - - - - - - - - - - - - - - - - - - - -
For all patients (2.1):
• Dose once daily.
• Tablets should not be crushed, chewed or broken before swallowing.
• Do not administer with high-fat meals, because of increased exposure.
• Do not substitute for immediate-release guanfacine tablets on a mg-per-mg basis,
because of differing pharmacokinetic profiles.
Dose Selection (2.2):
• If switching from immediate-release guanfacine, discontinue that treatment and
titrate with INTUNIV® as directed.
• Begin at a dose of 1 mg once daily and adjust in increments of no more than 1
mg/week.
• Maintain the dose within the range of 1 mg to 4 mg per day depending on clinical
response and tolerability.
• Consider dosing on a mg/kg basis. Improvements observed starting at doses of
0.05-0.08 mg/kg once daily. Doses up to 0.12 mg/kg once daily may provide
additional benefit.
• Doses above 4 mg/day have not been studied.

So it looks like you're supposed to stop the Tenex and then titrate up on Intuniv the same as someone who was never on Tenex.  I think it is also interesting that you are not supposed to give it with a high fat meal.

--

Brenda,51, CABF Parent to Parent Volunteer
Mom to A, 17, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel, Allegra
E, 15 1/2, BP,AS: Seroquel, Eskalith CR, inositol, Buspar
B, 14 & H, 11
Married 18 years to DH, 50

FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.

 We had great success on Intuniv, perhaps the most relief of ADHD symptoms to date on any medication.  We had to switch to Tenex because Intuniv was cost prohibitive for us, costing #200+ a month (in addition to three other meds). 

--

Mom to Nicolas (10) -- bipolar disorder (Lamictal, Lexapro, Risperdal, Tenex and Tanner, seemingly without any mental health issues:)

The pdoc put in two prior authorizations to try to get the insurance to cover the Intuniv.  No luck.  They denied both of them saying it was not medically necessary.  It does not look like E will be on that med anytime soon after all.  --

Janice from MA

I'm not surprised.  Insurance companies are getting very tight with money for prescriptions.  How is he doing on the Tenex?  If it's working, I guess that's the main thing.

--

Brenda,51, CABF Parent to Parent Volunteer
Mom to A, 17, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel, Allegra
E, 15 1/2, BP,AS: Seroquel, Eskalith CR, inositol, Buspar
B, 14 & H, 11
Married 18 years to DH, 50

FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.

We switched him back to the Rite Aid brand instead of the CVS brand.  That's going a bit better.  We used to go to Rite Aid but a few months ago they got a new Clonidine, which E did not do well with so we switched to CVS.  Rite Aid at that time told me they could not request a certain generic.  They just got what the manufacturers gave them.  So we switched.  Elijah did better on the CVS Clonidine then he did on the one that Rite Aid was giving us at the time, but worse on their Tenex.  We switched back to Rite Aid and this time a wonderful pharmacist put in a special request.  We waited a couple days and they got him the old Clonidine they had before the switch.  So he's doing better now for the most part I guess.  He just did not do well on the CVS Tenex for some reason. 

--

Janice from MA

Blog: Wonders in the Night which is about raising 2 boys with alphabet soup and having a BP DH. Private to protect my boys confidentiality, but will send invite if interested... just send me your email address. Facebook: find with email address.

"And when it rains on your parade, look up rather than down. Without the rain there would be no rainbow." Jerry Chin
"Sunshine is my quest". ~Winston Churchill

Hey Janice,

      It"s Angelique-----

               I am glad things got a bit straight. I know that just with myself, that when there was a diferent manufacturer for my lamictal I went very weird the first day and only day I took it. My pdoc said that could happen. I thought I was going crazy. Anyhow, I am glad the pharmisist is working with you. Our pharmisits at CVS orders the right brand of Lamictal for me. It is so important to have a pharmacy that really cares and is very helpful.  I am glad it worked out:)

--

(Me) Angelique 33- BP,Anxiety..Lamictal, Klonopin
(DH) Craig 40- Nothing???
(DD) Ariana 6yr old- BP,Tic Syndrome,Gad,Sensory processing Disorder, Adhd. Meds.... Lamictal, Intuniv,Serequel, Melatonin. Have tried many other meds...hoping this is the right mix!
(DS) Christopher 4yr old- No problems yet????

You mention both Tenex and Clonodine as if they are interchangeable. Theya re different but similiar medications. Tenex is related to Clonidine.  But Tenex is 10 times stronger in the prefrontal cortex than in lower brain centers where Clonidine has the same potency in all brain areas and is therefore much more sedating – If you are going backa nd forth between the 2 medications that could be causing some problems.

 You might consider writing an appeal to the "not medically necessary" determination, especially if both you and the pdoc can supply a well written letters.   Although in all honesty, we have not had good luck with insurance appeals.

On another note--- I would certainly support a consumer protection group pushing to stop big pharma from re-packaging an old drug (guanfacine) with a simplictic time-release formula, then getting a new patent, and then committing highway robery of the consumer. 

Brian

--

BK Daughter 7 BP/violent rages. Unsuccessful with multiple meds. Now reasonably stable for last 2 Months on Intuniv + Restrictive diet + True Hope's EMPowerPlus & AminoPowerplus + low dose lithium. Still working towards getting endocrine and metabolic testing.

Brian,

"I would certainly support a consumer protection group pushing to stop big pharma from re-packaging an old drug (guanfacine) with a simplictic time-release formula, then getting a new patent, and then committing highway robery of the consumer. "

That is one of my biggest pet peeves!!  I have seen it happen so many times with psych meds.  You know they are just trying to make an easy buck.

--

Brenda,51, TCBM Parent to Parent Volunteer
Mom to A, 17, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel, Allegra
E, 15 1/2, BP,AS: Seroquel, Eskalith CR, inositol, Buspar
B, 14 & H, 11
Married 18 years to DH, 50

FROM TCBM: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.

Hi there! I'm new to the group, and found you guys during my research regarding Tenex & Intuniv.

My 6 year old daughter has an Autism Spectrum  Disorder (basically Pdd-nos), and moderate to severe ADHD. We have worked for 3 years since she was diagnosed with Pdd-nos to manage her behaviors (mostly occuring in groups, not so bad at home) with OT, speech therapy, floortime, play therapy, social skills group, etc. etc. etc...

Her ADHD has really gotten in the way at school, so I quit my full time job to be home with her. She was out of school for a year, then in a mainstream preschool with a shadow last year. And this year we have enrolled her in a special needs school, but it's WAY over board as far as what she needs, the small class size is great for her, but other than that, we feel like struck out, to top it off , it's extremenly expensive.

So - in preparation for trying to get her into a more main stream school environment, we started down the road we said we'd never tread - medication! We have tried two stimulants, Focalin XR and Vyvanse, both with disasterous side effects. Intuniv was our next hope, and we did manage to get her to take one last saturday, she chewed it a bit, which they say DO NOT do. However, she seemed find. Very tired in the afternoon, which I know is a side effect that wears off. But she slept great (she wakes in the night every night), and we were looking forward to the next day. However she absolutely wouldn't take it again. We were all so devestated, she was angry, and yelling at herself that she hated her body because it wouldn't "calm down" (we/teachers/therapists oftentell her to calm her body down) and that just felt awful to hear.

So, we will try again this weekend. However, a friends child takes the Tenex form of the med, and they crush it. I'm reading various accounts on the internet about whether or not you can crush the Tenex. But all i see about Inutniv is don't chew or crush...

Anybody have any experience with crushing either med?

Thanks so much.

Scottie

Hi, and welcome to TBMF.  Intuniv is an extended release forumulation, and those meds (ER) should never be crushed.  If ER meds are scored then they may be broken in half.  Tenex is the immediate release form and is probably okay to crush and mix with applesauce or other food.  My ds15 took Tenex when he was younger to calm his hyperness (not for ADHD).  We called it his "chill pill".  It worked well for that for 1 - 2 years, then it just didn't do anything anymore so we stopped it.

I just came across this info in the prescribing information for guanficine: 

Pediatric use

Safety and effectiveness in pediatric patients under 12 years of age have not been demonstrated. Therefore, the use of Guanfacine in this age is not recommended. There have been spontaneous postmarketing reports of mania and aggressive behavioral changes in pediatric patients with attention-deficit hyperactivity disorder (ADHD) receiving Guanfacine. The reported cases were from a single center. All patients have medical or family risk factors for bipolar disorder. All patients recovered upon discontinuation of Guanfacine HCl.

I have certainly heard several of those reports here, and more so it seems from Intuniv.  I just wanted to give you a heads up on that.

You say your dd had disastrous SE's from Focalin and Vyvanse--would you mind giving more details there?  Many kids with BP do not tolerate stims--they can destabilize and induce cycling.  If that is the case with your dd, then perhaps she indeed has an underlying mood disorder, and that might be better treated with MS's.  Of course I cannot diagnose your child here, but it is important for us as parents to be aware of all these possibilities.

Your dd sounds miserable with her body that won't calm down.  Is this how she feels normally?  Or was this a reaction to the Tenex?

--

Brenda,51, TBMF Parent to Parent Volunteer
Mom to A, 17 1/2, BP, Tourette's, OCD, ADHD: Eskalith CR, Lamictal, Cytomel, Allegra
E, 16, BP,AS: Seroquel, Eskalith CR, inositol, Buspar
B, 14 1/2 & H, 11 1/2
Married 18 years to DH, 51

FROM TBMF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.

My dd was exhausted on 2mg of Intuniv but she's very tiny.  She wasn't as sleepy when she was on the tenex, but she was still a little sleepy.

--

Jessica - BP2, Pristiq, Abilify, Lamictal, Xanax - Vegan diet
DD - Lilli ADHD w/ ODD (close to EOBP DX) (5) Abilify, Focalin XR
Delayed Development
Regular Kindergarten with IEP
Maryland

For those of you who see that Intuniv is working and it is NOT covered by your insurance try this...

http://www.shire.com/shireplc/en/contactus/patientassistance

My son has been on tenex, Intuniv, clonadine and meletonin (OTC for sleep) at some point in the past 12 months. Clonadine has worked best but it always  seems to stop working after 3 or 4 months.  We have a med review today.  ACE's teacher does not seem to think the new meds (2 mg Intuniv in am and .1 mg clonadine at bed) is working. She says that Aiden is very talkitive, interupts alot, and is scatterbrained.  At home he seems to be doing great....but then again, I don't mind him interupting me if it is replacing aggressive outbursts....guess I got that from the "choose the lesser of two evils" technique I finially had to resort to when he was 18 months old.

Carrie

--

“Weeds are flowers, too, once you get to know them.”
― A.A. Milne

Carrie - 34, Mom to 3 boys, PTSD (childhood sex abuse victim) no meds
ACE - 5, Georgia Pre-K, IEP, Adopted, DX ADHD, ODD, Sensory Integration Disorder, Speech Delay, Possibly Autism (Bio mom and bio grandmother are BP) --- Meds: Clonadine & Intuniv
JJE - 4, Gerogia Pre-K, IEP, Speech delay, Perfectly Healthy
GRE - 3, Perfectly Healthy
Jon - 29, Dad / Been with mom for 7 years (not married YET)
Scooby Doo (mini dauchshund) and Ms Kitty (calico cat)

Tried Intuniv 1st...up to 2 mg, just way too sleepy...couldn't stay awake in school.  Then Tenex 0.5 mg 7am, 0.5 mg noon, 1 mg bedtime.  Great response and not sedated at all.  Just much less aggressive.

--

Sarah K
------
4 children: 2 boys, 8 (schizoaffective disorder, bipolar type and Autism) and 15 with childhood onset schizophrenia(COS): both on Clozapine plus other meds. 13 yr old Daughter anxiety, possibly bipolar vs ADHD,not on meds. 16 month old daughter developing normally. Maternal depression, anxiety. Oldest son in COS studies at the NIMH.

Carrie, thanks for sharing that link.  After two denied prior authorizations, I called his pdoc today about this.  She agreed to fill out her portion of the application, which I just scanned and sent to her via email.  I hope this works!  She may have to send in another prior auth to get it denied, because that's part of the application.  If only I knew that I'd need that I would have kept it.  I keep all his paperwork, just didn't see how I'd need the denial letter.  Oh well.  She's trying. Thanks again.  I figure if we can get them to cover it then Intuniv would be worth a try at least.  If worse comes to worse we can always put him back on the regular Tenex. --

Seekingsunshine76 from MA
Email: seekingsunshine76@yahoo.com
Co-Mod Very Young 2 with Erica
Co-Mod Support 3 with Carolyn and Cindy
Chat Mod

Mom to:
"Honeybunches" (9 y.o) DX: PDD-NOS, BP, SPD, ADHD, GAD, NLD, Receptive-Expressive Language Disorder, delayed but making steady progress. MEDS: Abilify 5 mg 2x day, Tenex 1 mg 3x day, Lithium 300 am/pm, Clonidine .2 mg, Cogentin .5 mg 2x day. DIET: Mostly Vegan. SCHOOL: 3rd grade Substantially separate Classroom, IEP, Speech, PT, OT, Counseling, Social Skills group, 1:1 aid, safety plan, BIP; ESY services; In counseling and has a therapeutic mentor.

"Shnooks" 17 y.o stepson. Currently in BTR under DCF custody... DH & I got full sole custody in 2004. DX: BP, CD, ODD, PTSD, ADHD; CHINS in DCF custody; BTR Placement; probation until 18. Current meds: Loratidine, Claritin, Adderall, Zyprexa, Trileptal, Trazadone and Zoloft; WILL NOT BE COMING BACK HOME.

"Angel": age 15; No diagnoses; Signs of depression; substance abuse;
"Princess": age 13; No diagnoses but behavioral issues at school and has other concerning behaviors;

Blog: Wonders in the Night http://www.wondersinthenight2.blogspot.com which is about raising 2 boys with alphabet soup and being a Vegan.

"And when it rains on your parade, look up rather than down. Without the rain there would be no rainbow." Jerry Chin
"Sunshine is my quest". ~Winston Churchill

--Have you gone to the intuniv website? They have a discount card availableright now, it is worth a try.

Stephenie

R 15 high school freshman bipolar, aspergers, ADHD and generalized anxiety
R was just diagnosed bipolar/ rapid cycling Jan 2012
Lamictal 100mg, Prozac 40 mg, aderall 40 mg, intuniv 3 mg, ability 30 mg
A 13 7th grader neurotypical
Supportive husband, Tony of 22 years
St Charles, IL