Biphentin: The Newest ADD/ADHD Medication in Canada
ByDespite there being many medications available to treat Attention Deficit Hyperactivity Disorder (ADD or ADHD) in the US, there are relatively few medicines in Canada. We had one new medicine added to our arsenal in Canada around September 2006 – Biphentin. This article will summarize what role Biphentin can play in treating ADD/ADHD.
What is Biphentin?
Biphentin is a new formulation of methylphenidate. Methylphenidate is the same medication that is found in Ritalin. Methylphenidate has been around for over 50 years. Despite many concerns and warnings discussed in the media, it is a safe medicine, when taken as prescribed and monitored by a physician. It also can work very well. Approximately 70-80% of people with ADD/ADHD will have significant improvement when they take this medicine.
In Canada, methylphenidate also comes as: Ritalin, Ritalin SR, and Concerta.
In the US, methylphenidate also comes as: Ritalin, Ritalin LA, Concerta, Metadate CD, Focalin XR, Daytrana, Methylin and others.
Biphentin is being marketed in Canada, and is made by Purdue Pharma. It is not being marketed in the US. I was told (in a personal communication – certainly not official!) that Biphentin may eventually be marketed in Europe, but likely not in the US. Why not the US? I was told that it is very competitive in the US to market another form of Methylphenidate.
What are the characteristics of Biphentin?
Biphentin is a long acting form of methylphenidate. It lasts 8-10 hours with once daily dosing.
Biphentin is a capsule – with little beads inside. This allows the medicine to be ‘sprinkled’ onto soft foods like: apple sauce, yogurt or ice cream. This can help with children who cannot swallow the pills. In Canada, this is the only medication option for methylphenidate that can be taken by children who cannot swallow pills. (As a side note, Adderall XR and Vyvanse – which are amphetamine medications, can also be opened and sprinkled.)
Biphentin comes in multiple strengths. This flexibility of dosing may make it easier for your doctor to find the right strength for you.
The strengths are: 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg and 80 mg.
Who is Biphentin approved for?
Health Canada has approved Biphentin for the treatment of ADD/ADHD across the lifespan. Specifically, Biphentin is approved to treat ADD/ADHD in children, adolescents and adults (i.e. 6 years old to 65 years old).
What are the side effects of Biphentin?
Biphentin’s side effects are the same as the side effects of the other methylphenidate products. The common side effects include: decreased appetite, insomnia, worsening of tics, approx. 2% risk of slowing growth. There are rare concerns of agitation, mood symptoms, etc. [N.B. This post is for educational purposes only - speak to your Doctor about side effects in detail]
How much does Biphentin cost?
Biphentin will most likely be covered under private insurance plans through your work. If it isn’t, I am happy to report that in general, it is cheaper than the newer forms of ADD/ADHD medication. The price does depend on the strength of the pill.
The cost of Biphentin for 30 days of treatment is estimated as follows:
- Biphentin 10 mg once daily for 30 days: $29.40
- Biphentin 15 mg once daily for 30 days: $38.40
- Biphentin 20 mg once daily for 30 days: $46.80
- Biphentin 30 mg once daily for 30 days: $60.90
- Biphentin 40 mg once daily for 30 days: $75.00
- Biphentin 50 mg once daily for 30 days: $89.10
- Biphentin 60 mg once daily for 30 days: $103.50
These prices are listed in Canadian dollars. These are estimates, and the prices may vary at your pharmacy.
As a brief comparison of cost – here are estimated costs of some of the other ADD/ADHD medications in Canada:
- Concerta 18 mg once daily for 30 days: $71.70
- Concerta 36 mg once daily for 30 days: $90.90
- Concerta 54 mg once daily for 30 days: $110.40
- Adderall XR 5 mg once daily for 30 days: $96.00
- Adderall XR 30 mg once daily for 30 days: $96.00
- Strattera 10 mg once daily for 30 days: $134.97
- Strattera 60 mg once daily for 30 days: $134.97
- Ritalin SR 20 mg once daily for 30 days: $25.20
- Ritalin 10 mg once daily for 30 days: $18.30
When can Biphentin be used?
Biphentin can be used to treat ADD/ADHD at any age – it is approved for the treatment of kids, teens and adults.
Biphentin can be used as a ‘first line’ treatment – i.e. the first medicine given for someone with ADD/ADHD.
Because Biphentin is a once a day treatment – the patient doesn’t have to worry about taking a pill in the middle of the day. This is particularly helpful for children who can take their pill in the morning, and then not have to go to the office at school to get their noon medicine. This makes it easier for a child at school.
If someone has been on a different form of methylphenidate and had problems, it may be reasonable to try Biphentin to see if this long acting formulation may work better.
If your child has trouble swallowing pills, but your doctor thinks that methylphenidate is the right choice of medication, then Biphentin is the best choice.
Can Biphentin Be Abused?
One of the concerns with any stimulant medicine is the risk that it may be abused. If someone takes too much of the medicine, and tries to take it as a drug – i.e. snort it – then it can produce a ‘high’.
I am happy to report, that similar to the other long acting preparations of stimulant medicines (like Concerta and Adderall XR), Biphentin is not abusable. That means that someone couldn’t use it to get a ‘high’.
It is important for you to also know that Biphentin is not addictive.
How does Biphentin compare to Ritalin, Ritalin SR and Concerta?
All of Biphentin, Ritalin, Ritalin SR and Concerta are the same medication – i.e. methylphenidate. The difference is the preparation and how it acts in the body.
Ritalin is a short acting medicine, and is required to be taken two or three times daily for symptom control. The advantage is that it is cheap. It doesn’t work as well as the long acting forms.
Ritalin SR is a long acting preparation of methylphenidate which has been around for a long time. It doesn’t work very well for many people. Sometimes it lasts 6 hours, but often it doesn’t work well at all. The advantage is that it’s cheap.
Concerta is an excellent preparation of methylphenidate. It is a once daily, long acting medicine. It works for up to 12 hours. It is well tolerated and has been a great medicine in the treatment of ADHD for the past 3 years or so in Canada, and longer in the US.
Biphentin is a once daily, long acting medicine. One major advantage over Concerta is that the capsule can be opened and sprinkled in apple sauce, yogurt or ice cream. This will help children with trouble swallowing. It is also approved for the treatment of adult ADHD, and Concerta is as well.
One final difference between Biphentin and Concerta is that Biphentin releases approximately 40% of its medicine in the early part of the day, whereas Concerta only releases 22%. This may mean that Biphentin may work better for ADD/ADHD in the morning, whereas Concerta may last a little longer into the day.
The Bottom Line About Biphentin:
Treatment of ADD/ADHD requires many components – including psychotherapy, behavioral management, academic supports, and medication. This article has been focusing on medication for the purpose of describing a new treatment for ADHD in Canada. For more information on the other treatments of ADD/ADHD: 1) sign up for my ADD/ADHD newsletter at www.TheADHDDoctor.com, and 2) peruse this blog for more articles about ADD/ADHD.
Biphentin is a new great option for the treatment of ADD/ADHD in Canada. It has its unique features, as described above. It is welcomed, as in Canada, we have fewer medicines available than in the US. Biphentin may help in the treatment of your ADD/ADHD (or that of your loved one).
If you are considering the use of Biphentin, ask your doctor. You may want to print this article, and take a copy with you to your next doctor’s appointment.
Hi Dr. Handelman,
My son was diagnosed with ADHD when he was 12 (about a year ago). He was put on Concerta (18 mg) which initially helped incredibly. A few months later we noticed that the Concerta didn’t seem as effective as it had been initially and so his dosage was increased to 36 mg. He has managed very well up until a few weeks ago. Since then he has regressed a bit, i.e. not focusing, being argumentative, getting into trouble at school, not listening or taking direction, etc.
I am starting to feel that his dosage may need to be bumped up but I worry. Will his need for medication just keep going up and up? Is his dosage high for a kid his age and weight (almost 14, 120 lbs)? Will he ever be able to function without medication? I am unwittingly contributing to some sort of addiction? Am I setting him up for a future drug addiction?
We live in a very small town, where despite good intentions, there is alot of gossip. Since several friends and one relative work at the clinic where my son sees his doctor, I am often very hesitant to ask any questions regarding this condition. I would be very grateful for any light you could shed on this for me.
Thank you.
Dr.Kenny,
I have just put my 9 year son on Biphenten and it seems as he might need a higher dose. For his age he should be on 12mg but the doctor decided to start him on 10mg. However, the problem I have is that I purchased 3 months worth to bring with me to Mexico as he is going to school in Mexico this year. We will not be back in Canada until December. He was taking Ritilin SR which I did not like because of the strong rebound effect and was suggested biphenten. My question is can I give him 1 capsule and split the other to make for a total of 15mg? it is not the ideal situation but I feel it is the only choice I have given that Biphenten 15mg is not available here and I will not back in Canada until December. What do you suggest?? please help?? He cannot sit still in his classroom!
Maureen,
Best to talk to your own doctor, if possible. I cannot give you medical advice, but for informational purposes – to review with your doctor – here are some thoughts:
1) Consider adding some regular ritalin or ritalin sr if the does of biphentin isn’t enough
2) open and sprinkle the capsules as you suggest
3) Biphentin can be dosed up to 60 mg. Check with your doctor if it’s OK to raise the dose.
4) The US is much closer to Mexico than Canada. Maybe you can go there? Metadate CD is probably the closest medicine to Biphentin.
I hope that helps.
Dr. Kenny
Lisa,
While some people can develop tolerance to ADHD medicines – this will not create ‘addiction’. If it stops working, please talk to the doctor about options – i.e. dose increase or trying a different medicine.
In general, teens do well on 36 mg, 54 mg or even 72 mg. Despite your concerns that your son’s dose is increasing – you are still in the low range of medicine.
I hope that helps.
Dr. Kenny
p.s. sign up for my newsletter – soon I’ll have an audio CD about using medicines safely – It should be free (at least in the beginning!)
Hi Dr. Kenny:
My 12 year old daughter has been on 20 mg of Biphentin daily for close to a year. She has recently complained of not being able to see the blackboard in class very clearly.
I took her to an optometrist, who after testing, reported he didn’t see a need for eyeglasses, and that her medication could be causing bluriness. Is this possible after all the time that has passed?
My daughter has been on Biphentin 15 mg off and on since May. I gave her holiday free time. Her concentration is better at school but I noticed some side effects that I’m troubled with. At first she was very teary, withdrawn and clingy. That has since changed. She is now quite chatty (manic like), very happy, bouncy and still impulsive. Should I change her to another med? This is very troubling.
I am a 46 year old woman recently diagnosed with ADD. I started on biphentin 20 mg gradually increasing by 20 mg every two weeks to a max level of 60 mg. After being on 60 mg for 6 weeks, I experiened an anxiety attack one saturday eveing at midnight. I was edgy the next day and fine on the subsequent day. On the Wednesday I experienced a second and both my blood pressure and heart rate were (156/88 with a pulse of 90 taken at the local drug store using the on-site monitor). I called my doctor and we agreed to reduce the dosage to 40 mg to see if there was any effect. There are a couple of things that may be contriubting factors — I had anxiety in my mid-20s and it lasted about 5 years and then petered off to occasional incidents. I ate ham on the sunday and the tuesday evening (a rare occurence for me) so I am thinking that maybe the salt was the culprit. My doctor has not come across a reaction like this in other patients. He said I was responding beautifully (and I can feel the change myself). I am loathe to change meds given my positive reaction. Could this just be something my body is working through in accommodating the meds? I have lost 20 lbs in the 10 weeks I have been on the meds (Weight watchers assited). I hae experienced a slight increase in heart burn — more annoying that anything else. Any advice would be very much appreciated as to the reason for the sudden onset. I sleep well on the meds and have no other negative side effects.
My son is 10, about 96 pounds, he has taken Biphentin for about two-three years, a few months ago it did not appear to be working, he was inattentive, agressive and aggitated, the dr. upped it to 40 mg which seemed to work well, now he has been highly anxious, rubbing his knuckles on the carpet till they bleed, (he had anxiety issues but had seizures from the fluoxetine so we took him off)…the teacher said he was extremely disruptive also the past few weeks, making noises in class, acting silly, so the dr upped the biphentin to 60 mg. Is this too much for a child his age, size? His ADHD is pretty severe, he also cannot swallow pills so Biphentin seems to be the only option…what happens when 60 mg is not enough?
An update to my Oct 6 email. My daughter has been diagnosed with Central Auditory problems. Her left and right auditory systems are out of whack. She also has sensory issues to light and sound. These are problematic but not to the point of screaming or avoiding situations. She also needs to see a speech therapist. Initially she was doing great on Biphentin (only 15 mg) but now I’m not sure what’s going on. She is so withdrawn and speaks very slowly. She is so compliant and nothing phases her. It’s nice to a point but she’s letting things happen and not complain. The work in school is getting done but I wonder at what cost. Should we consider another medicine to address the focus?
Hi Dr Kenny
Just found your website and it is very informative. Thanks! My son aged 11 has just been diagnosed with ADHD. The doctor is recommending putting him on Biphentin. Not being a fan of any mind altering drugs having been on anti-depressants & anti-anxiety meds myself at various times, I am apprehensive to medicate him. Having said that we have tried every alternative over the years (Omega 3′s, Biofeedback, OT etc.) with no luck, and now that he’s in Grade 6 his challenges to focus on schoolwork are greater. So I think it’s time to try it. One of my concerns though is that he is a very small child for his age (60lbs, 53″ tall) and as a result has had some issues with teasing & bullying. From what I have read online it says that growth can be retarded from these stimulants. Is this something I should be concerned about, or should I be focusing on the big picture of him doing better in school? Always so hard as a parent to make these decisions.
Lilly – Talk to your doctor about your particular case. Growth issues are generally thought to occur about 2-3% of the time. This can be monitored.
Dr. Kenny
Greetings Dr. Handelman
I have written to you in the past and appreciate your kind response. We have Vyvance(spelling) here in the US. I know you can not give direct medical advice via the internet but I need a little more information in order to explain the medication to the doctor. Not to sound arrogant but I have been under psyc. treatment for more than 40 years and assure you I have had it all. My use of any stimulant drug would be off label. My DX is Bipolar II, PTSD, and CFS – two tours Vietnam, 30 years 24/7 emergency on call cardiac pacemaker business. The only problem I have difficulty with at present is chronic fatigue and fighting to stay awake. I have in the past abused Concerta (methylphenidate) that was some years ago and have no desire to repeat the experience. I know vyvanse can not be snorted or injected, it must be converted through the liver. The question is will the liver be the limiting organ for the conversion or would increased oral dose lead to tolerance and abuse. I am using Nuvigil (armodafinal) which gives me 4 hours of alertness then stops working suddenly. Splitting the dose, taking at different times makes no difference.
Any information would be welcome – I will not qoute you.
Thank you,
Richard
Richard,
Vyvanse is converted via an enzyme – and research is ongoing as to where this actually occurs. The current thinking is that it happens in the serum (i.e. the blood) for the most part.
My understanding is that it does not get saturated. I suggest you read the comments on this post: http://www.addadhdblog.com/vyvanse-no-addiction-with-addadhd-medication/
My 12 yr old son,110lbs, was recently diagnosed with CAPD/ADD and prescribed with 30 mg of Biphentin. He’s only been on it for 2 days and has come home from school both days complaining of a bad headache especially around loud noises (band class). Today when I picked him up he looked like hell, extremely agitated, stressed and quite emotional. Is there a break-in period for this drug or would this be the “rebound” effect you speak of above? He claimed to feel this way since around 1:00pm and takes his meds at 7:00am which seems too early for a rebound effect. He seems fine now, after 9-10 hrs.
Hi,
My 8 yr old son has been on Focalin XR for about 8 months. He tried the concerta and that did not work for him at all. It made him very angry, oppositional and depressed. The focalin has been working great, however, we have recently found out that we will no longer have access to it as they won’t ship outside the US. We live in Bermuda and have very limited access to meds, our only other option will be regular old Ritalin as there is no way I will put him back on Concerta. I was wondering if the Biphentin is similar to the Focalin, as it sounds very similar. I was also wondering if you knew of any restrictions by the manufacturer in exporting outside Canada/North America. I’d like to approach my son’s doctor as well as those in the medical area here to push for this as a replacement for the Focalin on the island.
Any info you can provide would be great!
Happy Thanksgiving!
My son is 10 and on 20mg of biphentin, I am not finding the dose quite enough. I phoned his pediatritian to see if we could up it to 30mg but he said he was on the proper dose for his weight and would not increase the amount. My son weighs aprox. 75lbs. I was wondering if this is the right dose or can he increase to the next level and should I persue the issue with the doctor more? His eating habits are back to a good level, but he doea not sleep through the night, he is constantly waking up throughout and does get the odd headache. Your oppinion would be greatly appreciated.
Hi Carey,
My son is 7, 8 in March, we weights 48 lbs. He is now on Biphentin 30mg for the past three months. He was on 20mg for 9 months prior to that but we noticed it was working as well as it was before so we moved it up and he is so much better for it. Our Pediatrican recommended a verbal pill Melatonin 3mg for sleeping, we takes it 1/2 before bed and he has had a good nights rest since we started that. With these two combined, I have a happier, healthier boy. I hope this helps you!!
This will be my last try to communicate with Dr. Handleman. I have never been told I have ADHD, although I had all the sysptoms in my years of schooling. I am now at a point in my life (age 65) were I am trying to live out the years I have left in some degree of comfort.My DX: Bipolar II, PTSD, and Chronic Fatigue Sydrome. I currently take the following Drugs as directed:Lamotrigine 200mg, Fluoxetine 20mg, Nuvigil 500mg, Clonazepram 1mg prn (not to exceed 2mg per day) and temazepam 30mg 1 at bedtime. I have been given Nuvigil due to past aduse of amphetamines and Methelphenadte.At a cost of more the $600.00 dollars per month the Nuvigil the is hardly worth the bother. When abused amphetamine and methelphenidate I did no “Snort” or “injet” the drug I simply swallowed too much of it.
Please don’t treat me like a idiot, I don’t think I would be bragging if I told you I know more about these drugs than my psychiatrist does I have been doing the research for 40 years. I have finally convinced my psychiatrist to take some classes in retro-viruses (I had Mono in 64 and the antibodies show up in every blood test). Also had exposure to stuff in Vietnam, worked 24/7 emergency on call Cardiac Pacemaker business. I don’t expect any doctor to feed a bad habit but I would like to see some meaningfull treatment for CFS (the rest is under controll). Let’s stop the ask your doctor nonsense – I have to tell her what to do!
Thank you for your kind attention,
Richard
Richard,
Thanks for the comment.
The issue here is that I don’t know what to tell you. I can understand that you don’t want me to say ‘ask your doctor’. The fact is that I don’t think I can give a competent medical answer to help you out.
As I’m sure you know – Vyvanse is less likely to be abused than the others, though if you swallow more of it then you should, then it can lead to symptoms of being high on it as well.
I’m not an expert in Chronic Fatigue Syndrome, so I don’t know what to say.
Tricyclic antidepressants can work for ADHD, though they could potentially destabilize your bipolar II, and may cause fatigue as a side effect.
Obviously, there is no easy answer.
I wish you well.
Dr. Kenny
How long does a child need to be on a 10 mg daily dosage of Biphentin before one can evaluate its efficacy?
M
I AM RAISINGMY GRANDSON WGO HAS ADHD .HE IS VERY HYPER AND TALKATIVE.HECANT SIT STILLFORVERY LONG.TODAY IN SCHOOL HE BECAME VERY AGGRESSIVE AND STARTED HITTING HIS TEACHERS.THEY COULDNT CONTROLL HIM AT ALL.HE WAS PUT IN TIME OUT BUT STILL HE WAS AGGRESSIVE.HES TAKING RITLIN SR 20MG.I HAVE HAD HIM ON CONCERTA STRATTERA AND REGULAR RITLIN.NOTHING SEEMS TO BE WORKING.IS THERE ANYTHING ELSE THAT I CAN DO TO HELP HIM.HES NOT CONCENTRATING IN SCHOOL AND IS HAVING DIFFICULT WITH ANY AND ALL SCHOOL WORK.
Hi June,
Of course, talk to the doctor.
When it comes to the medicines you’ve listed – you haven’t tried a medicine in the ‘amphetamines’ category – i.e. Dexedrine or Adderall. Consider one of these with the doctor.
All the best,
Dr. Kenny
http://www.safeadhdmedication.com
Dr. Handelman,
My 16 1/2 yr old son was diagnosed with ADHD at age 6. He was not put on medication until the age of 7. He has been under the care of the same psychiatrist for med management since diagnosis. He was started on Ritalin and eventually started on Concerta at the lower dosages. He has been taking 108 mg. Concerta in the AM since he was 10 1/2 yrs old. He has done very well with this dosage At age 14, he was diagnosed Bipolar on top of the ADHD. As my son grew taller and bigger (now 265 lbs and 6′ tall) , we have found that it is difficult to keep him focused depending on what he needs for classes thru the day at High school. The doctor added standard short acting Methylphenidate to his 108 mg. in the AM and another 40 mg in the afternoon. It is now finals time at school. He took 108 mg Concerta, plus his 20 mg methylphenidate at 5 AM. He called me at 9:30 AM requesting another dose of Methylphenidate. I said no as the Concerta hasn’t peaked yet (half life of Concerta is about 6 hours, isn’t it?) and didn’t want him crash later today or rebound. I also called his doctor and asked if it was permissible to give him another 20 mg of methylphenidate 5 hours after his first dosage. Haven’t heard back yet. I am curious as what your input is on this. He is also on Lamictal 100 mg b.i.d. for bipolar disorder, and celexa 40 mg once a day for anxiety. FYI- I always consult with the doctor for any titration advice, just curious what you think. That is all.
Patricia,
While it can be OK to combine long acting and short acting Methylphenidate – the main concern is the combined effects on the cardiovascular system. This all comes down to the total daily dose, and what your doctor feels is safe for your son.
He’s certainly in the higher range of doses right now.
Dr. Kenny
http://www.SafeADHDMedication.com
Good morning Doctor Kenny,
My son (now 7 and 44 pounds) was diagnosed with ADHD when he was 6. At first he was on 15 mg of ridilin. 2 pills at 8 am and one at noon. However, after 2 weeks on that we had to switch his meds as he was an emotional rollercoster wreck. As such, the doctor put him on Concerta 18 mg which seemed to work well for almost a year. This past fall, we had to up his concerta to 27 mg, and found that he was beeing overdosed. He was very lethargic and sad a lot of the time. He had no personality. I took him back to the doctor and we have put him on Strattera, 10 mg for 3 days and 18 mg for 20 days. Since he has switched his medication (December 9th) , he is suffering from insomnia, waking at 4 a.m. and not beeing able to fall back asleep. I am returning to the doctor this week, but wondered which medication you would recomment that we try next.
Thanks and Happy New Year!
As a mother to an 11 year old boy with classic ADD, I can honestly say that Biphentin has brought him from struggling in school to being on honour roll!!! It’s been a lifesaver in these past 12 months since he started, and he’s so much more self-confident and happy. He doesn’t pick apart erasers into a million pieces during class anymore, or doodle cartoons on his assignments instead of doing his work. He’s finally not hassled by his “brain having a party he can’t stop”!
He’s got a bit of a loss of appetite, but not enough to be losing weight….
It’s been a godsend for us!
BTW- for any sleep issues, our doctor (child clinical psychiatrist) advise melatonin about 30 minutes before bedtime. Works like a charm!
Happy New Year Dr. Handelman,
My 5 1/2 year old son was diagnosed with ADHD approx. 5 months ago. We tried Ritalin for a few months – saw improvements in the beginning but then wore off so pediatrician recommended Biphentin which he has been on for approx. 3 months. About 1 1/2 months ago he developed tics – some horrific ones such as eyes rolling uncontrollably up into his head and a gasping for breath sound. That lasted weeks and reappears every few weeks and in between other tics appear such as tugging at the neck of his shirt or arm every minute or sniffing uncontrollably all day long or the constant blinking of his eyes. The pediatrician has said to make them invisible, which we have done, but are extremely concerned about them. When he wakes in the morning the tics seem to not exist until he takes the Biphentin and then they appear. About a year prior to any diagnosis or medication he did have the ‘blinking eye’ tic constantly that would come and go. The pedicatrician also indicated that the only other option – that is said not to develop/increase tics – is a medication (Strattera, I think) that has to be swallowed whole which he wouldn’t be able to do. We do have an appointment with a child pychiatrist set up for an assessment but in the meantime are extremely worried about the tics and hope they are not in some way harming him – they are so noticeable.
Any advice that you could offer would be much appreciated.
Thanks in advance for your time,
Lee
Lee – tics can be worsened by stimulant medicines, especially when someone is prone to them.
To make it very simple – you can either stop the stimulants, try the non-stimulants, or take a medicine with the stimulant to try to lower the tics (i.e. clonidine or risperidone). Of course if you add a new medicine, you can have other side effects too.
Talk to your doctor about these options.
All the best,
Dr. Kenny
http://www.SafeADHDMedication.com
Hi,
My 16 years old daughter 85 lbs is currently taking biphentin. She has been taking this for a year and a half, but I find the side effect of it with her is too much, she had lost a lot of weight and vomits. Our doctor had her checked if there is any problem with her vomiting. Our doctor had prescribed Nexium to stop the acid reflex but it doesn’t seem to stop it. My daughter wants to stop taking it and see how she will be able to handle the focusing in class and sick and tired of feeling nauseous.
Is there any other alternative thing to do.
and in addition she is taking 60 mg of biphentin.
Thanks,
Cecile
Wow, my son is also 85 lbs and has just been bumped up to 40 mg…. could 60 mg be too much for her tiny frame?
I’m no doctor, though… will let Dr. Kenny answer that!
My daughter is 6 years old, and was “officially” diagnosed with inattentive ADD by her pediatrician yesterday. It wasn’t her behaviour that prompted testing for ADD, it was her daytime wetting – she wets her pants 3-5 times daily. I read that daytime wetting in schoolage children is 10 times higher in those with ADD. But I was actually surprised when her diagnosis came back positive.
In the last 1 1/2 years, she has seen 2 pediatricians, 2 child pshychologists. Her ECE teachers,caregivers, me, grandparents, father, family doctor, etc. have not been able to figure it out. We’ve tried ALL methods of potty training with no improvements.
Several urinalysis tests have ruled out infection, her ultrasounds show a healthy bladder. Psychologists had ruled out ADHD and any other emotional distress or trauma. The general consensus is that she simply chooses when to use the washroom by herself, usually when not engaged in something else. So we know she can do it…when she wants to.
I’ve had to put her back into training pants, which she hates and she is embarassed by the accidents.
She has been prescribed Biphentin 10mg for a month’s trial. I have not yet started her on the medication as I wanted to know as much about it as possible.
So finally, my question…..has anyone else been experiencing this with their children?
Dr. Kenny, in your expert opinion, could her daytime wetting be directly related to inattentive ADD? Have you had experience with these circumstances?
Has anyone had experience, or are currently dealing with, daytime wetting in their school age children with ADD? My 6 year old daughter was recently diagnosed with ADD by her pediatrician and he’s prescribed a month’s trial of Biphentin 10mg for her. My daughter wets her pants 3-5 times a day – a symptom of her ADD her doctor says. He believes the biphentin will give her control over her accidents.
Dr. Kenny, do you have an experience with this? Any insight?
Shara, I have had patients who have done better with stimulants when they have wetting. And then there are some who don’t. If your daughter’s wetting doesn’t improve when her ADHD symptoms improve, then you on solid ground to challenge the doctor to get other help.
Dr. Kenny
heeeey, im not trying to be rude but concert aderallXR and espicially biphentin can be abuded ive try snorting them all them all, concerta gives you a little buzz but its pointless, because you have to work so hard just to take of the two layers of wax and cut the wax off the pill so you can get the little bit of methylphenidate,rush it and sniff it, you get a light pointless buzz and a block nostral full of wax.aderallXR i find is stupid because you barely get a high feeling by snorting it, and if you snort it at night it very difficult to fall asleep for about 6 to 8 hours, and if you do end up fall asleep before 6 hours, your lucky!,now we get to biphentin, ive been doing biphentin for about a year, and i do about a percription bottle of 60mg a month, now biphentive is very easy to abuse and addictive, the way you abuse bifent is by pulling apart the capsule and dumping the beads out, then you crush it in a pill crusher or anything similar to that or else the little beads will fly everywhere once your done crushing it you snort one or two crushed up pills. depending how fast you do it you can start the high while snorting it,and or if you snort it fast the buzz will come shorty after. snorting the biphence give you a really good and very strongh high, most people become very talking, and happy, and some creative, and kind. what snorting biphentin does to me is, it makes me very happy, very talkative, loving towards important people to me,it makes me creaative, very determined to figure things out, for example an old favorite song i forgot many years ago. but when you snort it it last for about 8 to 10 hours so if you do it at night, dont expect to fall asleep any time soon without sleeping pill. As great as biphentin is its its my seconde favorite, ritalin/methylphenidate, come in only 2 different mg, 10 milligrams (the little blue pill) and 20mg (the bright yellow pill) this is my favorite drug and gives the best and greatest high, its simmilar to biphentin in the majority of ways, but the effects are better with methylphenidate, if you dont believe me people try it for yourself. im not trying to encourage it, but im not a liar and i know what im talking about. i dont control anyone, do and say what you want, i was just letting you know.
Hi.
My son just turned 7 and is in grade 1. He weighs about 45lbs. He is officially diagnosed with ADHD combined and gifted (though giftedness is not recognized in the public schools until grade 4). His biggest problem in school is his impulsiveness. It is making life impossible. I must mention that at home he is manageable and over the winter break he was not on meds and was very manageable.
He is currently taking 30mg of biphentin. It ‘smooths’ him out during the day, but doesn’t really do anything major with the impulsivity. We had tried concerta. 18mg didn’t do anything and 27mg made him very angry frustrated.
Could his dose maybe need increasing? He is tall but quite slim so he’s not a heavy kid to begin with and I know dosing is typically 1mg/kg/day. Of course I will consult with his Dr., but just looking for another opinion. Also, we stopped the 27mg of concerta after 3 days since we couldn’t handle the anger levels (which we never see when not taking the 27mg). Should we have tried the 27mg longer to see if things leveled off?
Is there a better drug option to deal with impulsivity?
Thanks for you response.
Tracy
My son is 11 years old and has been on Concerta 54 mg for the last 3years. I suggested to his doctor that we change to another medication and we started Vyvanse. That last 2 weeks he had the headaches and said he felt disconnected So I switched back to the Concerta same dose. It is not working as great this time and would like some suggestons on what to change too. I like the one time a day dosing and the great coverage it gives. But we also have the problem with insomina. Any suggestions? Thank you
Good afternoon (this is a complex problem re: inattentive-type ADHD)
My son is 6 (just turned in Jan.) and is in grade 1 (weighs 45 lbs).
Current situation: started on 10 mg. Biphentin for diagnosed inattentive ADHD (also assessed as gifted). This dosage produced 3 late nights the first 3 nights, along with minor hallucinations. On 4th night, seemed to settle. Decreased appetite, minor increased agitation. Kept on 10 mg. for 10 days and moved to 20 mg. First few nights were late then seemed to adjust. No hallucinations. No increase in appetite, same as when on 10 mg. Not usual appetite.
Met with teacher today (after 20 days of medication) to see if she’s noticed any improvements with attention (note, he’s never misbehaving, nor is he disruptive, only very very absent-minded and extremely well liked by classmates). I called our family dr. and she said to take him off and we’ll meet next week to discuss other options.
I’ve read a lot about ADHD medications and I think I have a fairly good understanding of the differences and the side effects, options, etc.
Background on son: spoke very complicated words at age 10 months. Self-taught reader, fully reading at 3.5 yrs old. Currently reading at an assessed (via private psychologist) grade 4 level, but teacher said reading is much more advanced. Psychologist assessment in academics were gifted but not across the board (i.e. math scores low) although she thinks it’s due to the inattention. Teacher thinks he’s gifted across board and so does Psych. but can’t show it on results. An IPP is in place to help him get organized. Cannot follow simple instructions (i.e. take out a red crayon and your blue book) but can recite news events (and comprehends what is happening).
Here is my question: Is it possible that although he displays most of the characteristics of inattentive type ADHD (and one characterstic of the hyperactive kind) that he does not have ADHD at all and that is the reason that the med’s are producing these side effects without any noticeable improvement? I am a common-sense person and if the professionals are saying he has ADHD (with all the testing in place), then I would like to put my trust into them as they have both the stats and the experience to support the findings. However, my gut, is telling me quite possibly that the situation might be more simple than what is being diagnosed. Could it be possible, that he has been mis-diagnosed due to inattention and that it is simply a case that he’s smarter than the average person, but can’t pay attention to the simple things in life (i.e. organization, verbal task requests, etc.)? And if that’s the case, then we don’t want to use him as a guinea pig to see if there’s another medication out there that might help him get organized? Sorry, I know this is longer than I intended but with the lack of response with Biphentin (which should have worked under his circumstances) it really makes me question if he is in fact, inattentive ADHD. I know he fits the boxes, but the boxes don’t necessarily fit him, if that makes sense. We have an app’t next week with our doctor and I obviously don’t want to medicate if I can avoid it. Do you have any experience with other kids with similar situations and what has been done with them?
Thank you for listening.
p.s. – the only reason we considered med’s is to get him on par with other kids so-as-to prevent behavior problems in future. I think you will understand what I mean by that.
i have a 6 year old son, i have just been told that it looks like he has ADD and was wondering if anyone has tried any alternative actions ie diet extra help or any natural meds instead of jumping into meds like Biphentin or such? if so how have they worked out and what course did you start with
Jennifer – I’m just putting the final touches on a CD product which will address alternatives for adhd. You can go here: http://www.alternativesforadhd.com to learn more.
Dr. Kenny
Thom Hartmann seems to have an interesting perspective on alternatives to medicating children and adults with ADD. Dr. Kenny – what is your opinion of Thom Hartmann’s work on ADD?
My daughter, 6, is in her last week of her 1 month trial of biphentin 10mg. I had only agreed to the medication in the hopes that it would help her with her daytime wetting. Unfortunately, it has had no effect on the wetting and her symptoms were manageable at home and school before the meds, so I will not continue the medication when the trial is over.
Dr. Kenny, as you suggested, I will challenge her pediatrician to find other help for the daytime wetting. Any suggestions are welcome.
Daytime wetting – this can relate to ADHD only if she’s too inattentive to get to the rest room. Strattera actually causes some urinary retention and may help. Ask the doctor!
Thom Hartman – I like his theories, though they aren’t scientifically based.
Jennifer – regarding gifted and ADHD – it can be both. Just because one medicine doesn’t necessarily help doesn’t rule out the diagnosis.
I was just reviewing this study:
http://www.ncbi.nlm.nih.gov/sites/entrez
Best,
Dr. Kenny
Hi there,
My adoptive son is 5 years old and has been diagnosed with ADHD. Both his biological parents also had a history of ADHD so we are thinking genetics have played an important role with my son. This past week he started his first medication which is Biphentin and is on 10 mg per day. Prior to starting the medication he was a very loving child and was never agressive. After starting the medication he was a totally different child but it seems for the worst. He has become aggressive with me and his peers at school. I have called the doctor but she is not in today. I am wondering if it would be harmful to stop the medication while I am waiting to hear back from her?
I have a 7.5yr old son whose been on increasing doses of Biphentin since he was just over 4yrs old (currently taking 20mg/day). (This is a possibility of Asperger’s and we are currently waiting for ADOS testing)
Over the past year we have noticed a HUGE increase in his dietary intake (never had a problem with nto eating) to the point of eating more then my husband of teenage son. He’s now started loosing weight and just can’t seem to eat enough. Now we’ve also noted for the past month that he’s getting increasingly aggressive/agitated at school and home. We’ve done the usual bloodwork and other then a slightly elevated TSH (did not check glucose) all labs were normal. Could these symptoms be side effects of meds or should I be looking for something else. His pediatrician won’t see him before May despite me calling with these concerns. He’s fallen off his growth chart (only in the 3rd% now) and I’m worried about his aggression. Thanks
Forgot to mention “there is a possibilty” not “this” and in the previous years he seemed to be well controlled by Biphentin
My son was diagnosed with ADHD when he was 7 yrs old and the doctor prescribed Ritalin, after taking Ritalin for two weeks his behaviour changed completely. He was angry, started swearing and even had thoughts of suicide. He would get so emotional and angry that he would get a knife and hold it to his neck. I immediately took him back to the doctor and he prescribed Resperdol and referred us to a psychiatrist who told me that the Resperdol was to strong and I should stop it. I’m afraid to give him any stimulant medication because of the side effects he had on Ritalin and he to is against taking meds. But he is now 15 and continues to have problems with behaviour, impulsivness, attention etc (he seems to have it all). It is also hard to tell the difference between ADHD and being a teenager. I’m considering Strattera because it’s a non-stimulant but still sceptical and afraid it will have the same side effects. Plus I don’t think he will take it. Is there anything you can recomment that is natural?
I’m going to be candid. The more I learn about ADD/ADHD, the more convinced I am that the problem is not with our children. The more I’m convinced that ADD/ADHD is NOT an affliction or a disorder or a condition. It’s human nature. If you haven’t picked up a Thom Hartmann book or read one of his articles or blog posts and you question the reasoning and logic of medicating our children to “conform”, then you should, you must. If there is a shred of doubt in your mind then you need to know what’s happening on the other side of the fence, because there’s a whole lot of great minds, leaders, visionaries who are trying to tell you, truthfully, that your “ADD” children are fine, it’s society, us, that’s the problem. I think Tom Peters (author of In Search of Excellence, 1982, and Re-Imagine, 2009) summarizes it quite well:
http://www.youtube.com/watch?v=h_w4AfflmeM&feature=channel#watch-main-area
I work in marketing and everyday my “creative” is swept under the rug, obliterated from the “idea” pool and crushed underfoot by those who work to maintain the status quo. I fight this everyday, with great verve. What hypocrisy to go home at the end of my daily battles and switch sides so to speak, to tell my exceedingly creative 6 year old that she needs to listen and conform and if she doesn’t, I’m going to drug you until you do.
I’m no doctor, but I had doubts about medicating my daughter and was refreshed to find a group of professionals out there who shared my doubts at some point and have shifted attitudes including mine.
Consider nutritional alternatives:
http://www.how2quit.co.uk/content.asp?id_Content=2141
Consider the way your children are taught. My daughter is a great student – doesn’t fit the norm of ADD at all – her grades are good. She doesn’t get frustrated by school work, she becomes fully engaged – moreso engaged in doing math work than playing with her barbie dolls! It’s because she’s taught differently than the norm. Because the principal of her school decided that the children at his school will be “graded” based on merit not memorization and he ensured that the teachers at his school knew the difference. My daughter NEVER colours in the lines, she writes most of her numbers backwards, she loves school, she loves her teacher, she loves homework.
This post is not intended to discredit anyone in anyway. It’s all very subjective. But I read a lot on this blog about parents who aren’t sure about the meds. That’s why I feel comfortable visiting Dr. Kenny’s site, putting my name to my comments and hopefully letting you know that it’s ok to doubt and there are professionals out there who support your doubt if there is doubt.
Know all perspectives before making your decisions, especially if you feel medication is not the right solution for you or your children.
my son is new to this biphentin and he just started it today the thing is how long does it take for the med to kick in. if any one knows please let me know thank you
Hello everyone. I am a 25 y/o male, 185lbs, 6’4″, diagnosed with depression (at age 15) and ADHD (today!). After today’s visit with the psychiatrist, I was prescribed Biphentin (10mg/day for one week, then 20mg/day). At first I was a bit hesitant to try anything from the Ritalin family, considering the general ugly stigma surrounding it. But logic must triumph in the end. Whether you’re a parent (deciding to give this medication to your child), or an adult who is taking the meds yourself, you must not let mass hysteria misinform your decision. The truth is, very few depression/ADHD medications on the market today have long-term study results (beyond say 75-100 years). Your doctor’s advice is only as good as the information science has uncovered over time. Some individuals have rather nasty reactions to medications, but that alone should not dissuade you from considering them as options. The choice you and your doctor have to make is whether or not the possible benefits of a drug outweigh the possible side effects. If your child has impaired daily functioning, then you must ask if a drug like Biphentin is suitable for their circumstance. If you just want your child to stop misbehaving, well, get over it. That’s what being a kid is all about.
Drug companies often abuse their power and influence over the public. They exploit vulnerable groups of people by ensuring the most necessary drugs are the most expensive. Doctors have, on occasion, been known to prescribe or promote certain medications in return for perks from the drug’s maker. This does not mean you should distrust the medical community entirely. Remember, the majority of doctors out there hold true to their Hippocratic Oath. And the science behind each drug is usually a labor of love–it’s the financial game of Twister afterward that causes distrust.
Just be wary of who is prescribing what to you or your child. If you don’t like one answer, go out and find another. We are fortunate enough to live in a world where we can thoroughly research our intentions and come up with a multi-faceted, well informed decision.
On that note, it’s time to take my first pill! I shall update soon.
Update:
Day one on Biphentin yields no noticeable results. As with most medications, it takes a bit of time to adjust.
I’m updating again to respond to an earlier comment that suggested ADHD is somehow an inherent human trait.
Wow.
I’m always amazed at how cavalier people can be toward medicine. We have created drugs that cure deadly diseases, have nearly perfected pain relief and palliative care, made incredible strides in medical technologies–allowing us to perform surgeries and operations for life-threatening illnesses. We depend on the medical field daily for ourselves and our families. Without these advancements, many of us would be lucky to live into our 40′s.
And yet, armed with anecdotal evidence, these champions of herbalism try to peddle their snake oil, believing they the answers to all of life’s questions reside in some Chinese vitamin.
Stop spitting in the face of medicine and try to have at least an OUNCE of faith in the profession that works tirelessly to enhance your quality and quantity of life.
One more peep about homeopathy (the most laughable hoax of the modern world), and you should be forced to relinquish your right to use antibiotics.
Don’t bite the hand that feeds you!
My son is 5 years old and has been diagnosed with ADHD/Autism. He is currently taking 10mg of Biphetin and its working really well. His appetite hasn’t changed much but he is having a lot of difficulty settling at bedtime. I’m wondering if Melatonin is a safe and positive solution to help him get to; and stay asleep?
generally melatonin is a safe option. check with your doctor for any concerns.
Dr. Kenny
Jake- While I agree with most of what you are saying, there is some truth to herbals. They don’t all work for everyone but if they do why not try a none chemical route? I’m a registered nurse who works cancer/palliative and believe me I totally advise use of drugs when necessary. For some, it’s as simple as that certain element missing from their diet like those who see results with the use of Omega’s.
Well we’ve decided to switch to Adderall XR. First dose today. We took my son of all meds during the march break and he finally gained a couple lbs. (Almost 8yrs old and finally at 49lbs) The teachers said he had a very good day at school today and was finally staying in class (used to run out all the time and not participate) for all his classes and focused very well. I hope this will work for as long as he needs it.
We’ve also tried melatonin for 2 yrs now and we noticed that it wasn’t working lately. Our pedi mentioned that some kids need to be “primed” As in taking it a couple of hours before bed. Finally it is working again. He mentioned that he might need a second dose before bed but so far it’s been working with just one dose. Hope that helps for some.
Dr Kenny- Do you have information regarding ADHD/autism together? Has Aspergers always gone hand in hand with ADHD? Is this a new trend that we are seeing or something that has been under-diagnosed?
I am a 44 year old man who was recently diagnosed with ADHD. I am on Concerta, which seems to be working. I live in Simcoe county and was wondering if anybody knows of a good local doctor or a source of education that can fill in some gaps of knowledge for me, or maybe help in guiding me in learning how to deal with this condition. I look forward to any suggestions.
John,
Dr. Bilkey is in Barrie: http://www.bilkeyadhdclinic.com. He may be a help to you!
Best,
Dr. Kenny
Afternoon all,
Just to start things off, my son who is now 9 has ADHD – Combined. He was diagnosed when he was 5 by our family GP. He was started on Ritalin then changed to Concerta, for which he has been on for the past few years. Our new GP, has recommended that he come off the Concerta and start on Strattera. We just stopped his Concerta on Monday while he has gradually been on the Strattera to where he is now taking 25mg/day. Since he has stopped his Concerta, his problems at school have started up again (i.e. interrupting the class and teacher, not raising his hand, answering out of turn and very hyperactive at school and even worse at home at night). The problem we are facing is that he has reached the maximum dose of Concerta for his age/weight of 54mg/day.
We have seen a psychologist for him,which did not help at all. He is now scheduled to see some ADHD experts in May through a program in Quebec called “Le Copin”, which are pediatricians that deal with ADHD. We are seeing our GP on Monday and I plan on asking her to put him back on the Concerta in the meantime, as his issues at school cannot continue.
My question is, since he is at the maximum of Concerta, will increasing his Strattera help or should we try something else all together (either change Concerta or Strattera or both).
We need something that will control his ADHD all day to allow him to focus his attention, control his hyperactivity and respond to what we ask him to do and to follow the rules at school and at home.
Evenings for us are usually terrible, as his Concerta usually starts to wear off around 4 – 6pm, then he is most times uncontrollable and defiant. Trying to get him to come in from outside is almost impossible and bedtime, boy let’s not get me started. I usually liken him to the Energizer bunny, he just keeps going and going….
Any thoughts?
Rob W: here are a few points to consider when talking to your doctor.
If you look at the CADDRA guidelines (i.e. Canadian ADHD experts guidelines for treatment) http://www.caddra.ca/cms4/pdfs/caddraGuidelinesChapter01.pdf – see page 13 – the recommendation is that concerta can go up to 72 mg.
If the end of the day is a problem, you can ask your doctor for a short acting methylphenidate at 5 or 10 mg to be taken at 4 pm to balance things out.
If you want to try strattera – don’t stop the concerta until at least 4 weeks of strattera is taken. That will give the strattera time to ‘kick in’.
Also, some doctors will use a combination of strattera and concerta if needed.
There are a few things to consider…
Best of luck.
Dr. Kenny
my son is five and was recently diagnosed with adhd. we decided that we would probably try biphentin just prior to grade one. My son asked us why we were going to wait. We knew thn that it was even bothering him – the inability to control his impulsivness. He’s very smart with alot of potential IF he can only focus. Without the teachers knowledge we decided to start right away. I could not believe that the very first day (starting at 10mg, and weighing 66lbs) the teacher approached my to ask if we had started it early. She said it was the first time in 3 months that my son sat the table in a group and completed a task without being seperated. we are now at 15mg and there have been no negative side effects at all. only that he has more control over himself. he’s the same outgoing boy that we love.
Hi
My son is turning seven in a few months. We have struggled with his hyper nature since he was two years old. He struggles in school as far as keeping his hands to himself and not distracting the other kids. His kindergarten teacher last year struggled with him but handled him well. We’ve been called to the school for appointments with the teacher this year and the school aid as well. They’ve considered that he had ADD and we’ve already been thinking it for quite some time now. A psycologist came to the school to sit in the classroom and observe him and she filled out a sheet for the doctor about his behavior. My husband and I filled ou the same sheet as well as the teacher and we came to very different results. He’s very emotional and he can’t seem to control himself in any environment. He has an appointment with the pediatrician on wednesday but I’m afraid that I am going to be told to put him on Ritalin like the doc said the first time i went with our concerns. Is Biphentin a good choice for our son? Thank you Carrie
Hi
My daughter is an adopted child and lost her adoptive mother 2 years ago to illness. At that time , I had her checked and she was diagnosed with ADHD. Her natural brother has the same diagnosis. she has all the symptoms but somehow I cannot rule our other “loss” causes. Is there a chance their could be psychiatric treatments to deal with the grieving as well?
Also , she is on 40 Mg of Biphentin and has night fears , occasional hyperventilating when active , and is now developing a blinking and lower jaw twitch(combined) when she is quiet. Could this be an absence seizure symptom?
The meds help but are not to a level where schooling is a huge challenge.