View Full Version : Stimulants Vs Non stimulants

02-25-15, 08:11 PM
My son will be six next month and has Adhd (impulsive and hyperactivity) far we have tried (since Nov.) Vyvanse (major anger issues on it)....quillivant xr (better with anger, but still anger issues) the Dr. has us try folcalin mg....we have been on it 2 in the morning, but afternoons keep getting worse...wondering if the school is seeing the rebound and if anger is again a he spit at a kid at school and kicked a boy.....what other class of stimulants are there? I am wondering if he needs a non stimulant bc of the anger issues that are way worse on a stimulant....why is the pros and cons of both? Would love any advice...he is having a psychiatric evalution next month....they wanted to make sure he was 6 when we did it....we are just making sure there are no other issues.

02-25-15, 08:35 PM
The stimulints don't necessarily cause the anger. To my knowledge Vyvanse won't stop the anger issues. He may be acting out more.
Diet and exercise. Plenty of sleep and fluids.
Might be the way to go.

02-25-15, 08:44 PM
Small changes to the dosage of stimulants can make a night-and-day difference. It can be a long and difficult process to get it right sometimes, weeks or even months, and every person is different. I'm an adult taking Vyvanse, and when my dosage was too high I was noticeably angry. When I had it cut back a bit, it worked much better and the anger was gone.

In extremely broad and general terms, non-stimulant drugs usually don't work as well as stimulants, and IMO should basically be treated as second-string possibilities when the good medications don't work.

There are basically only two stimulants in general use for ADHD right now, amphetamine and methylphenidate, but they are made in a few different versions each. Vyvanse is one version of amphetamine, and Adderall is another in the amphetamine category; Focalin is a version of methylphenidate, which also includes Ritalin and Concerta. Sometimes when one version doesn't work, another one might - for example, some people who have a tough time handling Ritalin do much better on Focalin, and so on.

The different effects of each version of a drug can be predicted to some extent, but variations from one person to the next often cause confusing or unexpected reactions. I suspect that your doctor tried Vyvanse first because it has a reputation for causing less anger (and also in general having less "kick") than Adderall does, but maybe in your son's case there could be some reason why it doesn't quite work that way. It's a similar story with Focalin - it has the reputation among the methylphenidate-type stimulants as being the least likely to escalate a person's problems with anger, but maybe your son's internal chemistry doesn't fit the usual expectations. Dosage adjustment, switching medications, or trying non-stimulant meds, are all possibilities. The best hint I can give is if anything has worked noticeably better than the others at any time, even if it ended up looking like a bad choice, it might be worthwhile to try that one again at a different dosage, or to try something that belongs to the same family of drugs.

Anger is a tricky thing because the source of that anger has a major bearing on what kinds of strategies might work. I agree with Pilgrim that when dosed properly stimulants generally are not the cause of anger; I think it can be possible sometimes for a stimulant to reduce a person's anger because he becomes less frustrated as his ability levels increase.

02-25-15, 09:17 PM
We had the same problem when we started stimulants. We switched to Tenex (short acting version of Intuniv) It is a non-simulant. It helped with the hyperactivity and impulsivity. A couple of years later, when he needed more help with focus, we added a stimulant, but kept with the Tenex. They work well together for us and there is no anger and no rebound when the stimulant starts to wear off. You might want to ask your doctor about Intuniv or Tenex.

03-01-15, 03:31 PM
For children who are ADHHHHD and have anger issues, adding a dose of Tenex can help that a lot.

When something isn't working, and you've given it enough time to see if the effects wear off, it won't suddenly start working.

A trial of supplementary Tenex may be the answer. And if it isn't, then you can just stop.

03-02-15, 07:55 PM
Thank you all so much for your advice and experience...we an appointment with the Dr. next week and will discuss the things you all have mentioned.

03-03-15, 09:00 AM
Yes, I agree that it may not be the particular med, but maybe the dosage. I was diagnosed at 6 and I was on Ritalin. It worked great for me as a kid. But I had crashes and it would wear off too early as I grew. So they started working on slow release and different dosages before we found the right combination.

I also agree that nutrition and sleep are also big factors.