ADHD plus anxiety?

[mctlaw]

So DS has combined type ADHD plus anxiety. He has been in CBT therapy for the past couple months for mostly the latter. We just started a trial of (nonstimulant) Tenex which was the choice due to the anxiety. Too soon in to see the effects yet. The psych. warned it may not help enough with the inattentiveness though. I'm just wondering if anyone has btdt with combined ADHD plus anxiety and what your experience is.
I don't post that often anymore as I recently returned to work FT, but thanks in advance!

[Pepper]

DS! is ADHD combined, with anxiety that is secondary to his RAD (reactive attachment disorder). We have worked out way through AHDH meds (ritalin, Intuniv, Focalin, and now Strattera) and did try something for anxiety (bus par) but poor DS seems to be refractory to most of these things. But, it sounds like my DS is in a different situation as yours since the anxiety is mostly related to the RAD, and was made much worse when DH died last year :(

How long will it be before the Tenex should take effect? One of my friend's kids is on it but just for anxiety, he doesn't have ADHD too.

[KpbS]

No btdt but I know there are some mamas of kids here who have the same combo. I hope things improve for him!

[mctlaw]

DS! is ADHD combined, with anxiety that is secondary to his RAD (reactive attachment disorder). We have worked out way through AHDH meds (ritalin, Intuniv, Focalin, and now Strattera) and did try something for anxiety (bus par) but poor DS seems to be refractory to most of these things. But, it sounds like my DS is in a different situation as yours since the anxiety is mostly related to the RAD, and was made much worse when DH died last year :(

How long will it be before the Tenex should take effect? One of my friend's kids is on it but just for anxiety, he doesn't have ADHD too.

Thanks to both of you for responding. Pepper: he is taking a half dose for one week and then increasing to a full dose, then returning for a check 2 weeks after that. I think it needs to be taken consistently 1-2 weeks to see any difference. We are starting at a very low dose, too.

I am so very sorry for your loss, btw.

[Gena]

DS has autism and received a co-morbid diagnosis of ADHD last September. He also has anxiety, but not as a separate diagnosis, since anxiety is widely seen as part of autism. Additionally, DS has several other diagnoses, including auditory processing disorder, mild visual impairment, and a chromosome anomaly. After years of debate and discussion with the school and DS's medical team, we chose to pursue an ADHD diagnosis because last year DS's inattention had a very negative effect on his academic progress.

Due to other aspects of his medical history, stimulants are not an option for DS (this is one of the few things all his doctors agree on). DS started a low dose of tenex in September. We started at a half tablet in the morning. After two weeks, the psychiatrist has us add another half tablet in the evening. He has stated at that dose since then.

We started to see positive results in after the first couple of weeks of starting the medication. These effects have gotten stronger as time goes on. DS is staying on task better at school and in doing his homework. He is making fantastic academic progress this year. DS's teacher tells us that he has less anxiety and as a result has more shown more independence and better interaction with peers. This has led to more opportunities for mainstreaming (DS is in a special ed classroom).

Because tenex is a blood pressure medication, we monitor DS's blood pressure every couple of weeks (DH is a volunteer firefighter/EMT). His blood pressure is generally in the low range of normal. Since we are seeing good results with this dose, the psychiatrist does not want to increase the dose and risk dropping his blood pressure.

We have been very happy with this medication. Of course it does not solve all of DS's issues, but given his complex combination of diagnoses, we don't expect it to. Tenex does help improve his functioning and we feel it adds to his quality of life.

(I don't post a lot anymore either. I have new job that keeps me very busy, plus everything at home.)

[mctlaw]

Gena, thank you so much. That is really encouraging to me especially that he is able to keep his focus on his work, and I'm glad it has helped your son. That is the same dose my DS is working up to.

[hillview]

DS2 has ADHD and anxiety but current theory is that the ADHD is presenting as part of his NLD (vs it being ADHD really), we've started some meds to handle the anxiety which DH expresses as more acting out vs introverted. We are still sorting out the meds (so far it is unclear if we are on a good path). Good luck!

[egoldber]

Older DD has had a GAD diagnosis for several years. She has taken an SSRI for 3 years. Middle school has been a rough transition for her. We are now suspecting ADHD Inattentive or Combined as well. Before prescribing meds for the ADHD, her psychiatrist wants a more comprehensive neuropsych eval to make sure that we really tease out any underlying issues first. She has not had a full eval since she was 7.

The anxiety/ADHD combo can be tricky because stimulant meds can increase anxiety.

When you say psych, do you mean a psychologist or a psychiatrist? Personally, because of the severity of her anxiety and the SSRI, I am more comfortable with her seeing a psychiatrist for medication management vs. a ped. Who would do the prescribing? I think that this combination can be tricky to dose titrate and also to get the right combo, so I would make sure you see a prescribing doctor who is very familiar with this combination.

[Indianamom2]

I just saw this post, but that is DD's diagnosis as well. She is 9 and we've been trying to figure everything out forever it seems.

What is working quite well for us at the moment is two things. Her anxiety was really bad and had been since birth (I truly believe that). After trying everything else, we ended up trying a low dose of Zoloft (which Dh and I both take). It has absolutely been a life saver and I wish we had tried it two years ago when it was first suggested.

After she had been on that for a while (a couple of months), we added in Vyvanse for inattentive type Adhd. It has made her stomach hurt a bit and she has some issues with her appetite at lunch, but otherwise it seems to be helping her at school.

We tried a couple of non-stimulant options previously, but they just didn't seem to help.

We see a psychiatrist who deals with pediatric patients and I feel very comfortable with her knowledge of the meds. We actually have never seen her in person, we do telepsych, which is where we go to her office and she appears via computer. A nurse writes whatever prescriptions we need and we go about once every 6 weeks.

Also wanted to add that we have taken a very similar path as Beth regarding exhaustive testing before we got to this point, so we finally feel comfortable going the route with meds because we have tried everything else.

[hillview]

I agree with Beth that seeing a pedi psychiatrist is the way to go.

[cuca_]

I have a DD with an anxiety diagnosis as well as ADHD. Like Christina's daughter, she is on a low dose of sertraline and vyvanse. For the moment it works well. I agree with everyone who recommended seeing a pediatric psychiatrist rather than a pediatrician.

[mctlaw]

Whoops, I just saw the additional responses. Sorry for the confusion. DS is receiving CBT from a licensed clinical psychologist, but is also seeing a pediatric psychiatrist (who prescribed the Tenex). Thanks for the additional BTDT too. DS has struggled with issues over the years but they are so overlapping-sensory, anxiety, etc., that it's been difficult to know what and how to tackle.

[willow33]

Just checking in to see how your DS is doing. DS2 (8) started Intuniv over a week ago for ADHD/Anxiety. I think Intuniv is the slow-release form of Tenex. The psychiatrist warned us that it makes some kids very sleepy but so far we have not seen that in our son. I'd love to hear how it's going for you and your DS. We've tried Focalin and Strattera in the past and they didn't work for DS...increased his anxiety/anger.