|
|
Post by 2boyz4me on Dec 13, 2006 11:38:32 GMT -5
My 8 y/o ds had his med check last night. He's currently on Concerta, 27 mg/day and doing wonderfully with the exception of meltdowns in the evenings and not being able to go to sleep or wake up. After discussing this w/ his dr, we've decided to give Strattera a try, in addition to the Concerta. The dr prescribed the lowest possible dose, 18 mg/day, and he will start them today.
Anyone else have an ADD/ADHD'r on both Concerta and Strattera?
|
|
|
|
Post by d on Dec 13, 2006 11:44:46 GMT -5
My dd was on a Strattera/Concerta combo for a while. In terms of effectiveness for her, it was the best meds ever. She's primarily In and needs the most ADHD help in school. She has some hyperactivity which doesn't bother us.
We tried Strattera alone and it didn't do enough for her school and homework focus. But both of them together were great.
Unfortunately, we had to take her off it bc both meds negatively affected her appetite. It was a double whammy.
|
|
|
|
Post by VaMom on Dec 13, 2006 16:14:26 GMT -5
My ds takes Strattera and Focalin XR (Focalin is a methylphendinate medication, as is Concerta). It works well for him.
|
|
|
|
Post by Mayleng on Dec 13, 2006 16:19:48 GMT -5
2boyz4me, Pls read up on our strattera thread. It is weight dependent and has initial side effects, needs to be build up. It is a quirky med so you need to know what to do and what to expect, and what his target dose is.
Vamom, is your ds using target does of strattera or a lower dose? Just curious.
|
|
|
|
Post by RobbysMom on Dec 13, 2006 19:22:16 GMT -5
My ds is on his third school year taking a Strattera/Concerta combo. Our doctor also suggested using the combo even though we tried Strattera alone with no success and had many inconsistancies on Concerta. It's worked great for him so far! For my ds, the Strattera evens out the "peaks and valleys" he had with Concerta by itself. Also, were able to lower his dosage of Concerta when the Strattera was added.
FYI -- he had a rough time between his 2nd and 3rd week of ramp up on the Strattera, then something "clicked" and it's been wonderful since.
Good luck!
|
|
|
|
Post by 2boyz4me on Dec 14, 2006 9:06:31 GMT -5
Thanks everyone  I did read the Strattera thread (fantastic info!!) ....his dr has him on a lower dose than what his weight calls for (18mg as opposed to 25mg). He did warn us of the side effects that could happen and that it will take a few weeks to get into his system. He took his first pill last night (I read on that thread that it may be best to do it that way since tummyaches are a common side effect--he had no complaints so we'll keep doing it that way) on a full tummy. What we're hoping to accomplish is to even out the meltdowns/rebounds in the evenings and the dr said it's possible that it will help with the sleep issues we're having as well.... I hope that's true! RobbysMom ---- what does ramp up mean? So, we're on a wait n see deal now.....we'll be going back in about 3 weeks to see what the results are and is it going to work for him. |
|
|
|
Post by baysmommy on Dec 14, 2006 9:42:11 GMT -5
He would also need to be started on the 10mg dose? and ramped up......dd took Strattera for a while with Metadte, but we had issues with them together. Now she is doing quite well on Daytrana, but we may add the Strattera back soon.
|
|
|
|
Post by baysmommy on Dec 14, 2006 9:43:06 GMT -5
ramp up means, start at the lowest dose(10mg) and gradually raise it to the target dose. HTH!
|
|
|
|
Post by 2boyz4me on Dec 14, 2006 11:03:34 GMT -5
Yes, that helps alot LOL...I wasn't sure what it meant at all! I'm not sure why his dr isn't starting at the 10 mg dose.... we've started up with the 18mg and, unless there's a need to move it up at his med check in 3-4 weeks, he'll stay at that dose. His dr told us that for his weight -- 46.5 pds --- 25 mgs was his target dosage but because of the reasons for adding it to his Concerta he wanted to try the lower dose first....
|
|
|
|
Post by baysmommy on Dec 14, 2006 11:31:38 GMT -5
In my experience when Concerta, or another stim is added the STIM dose can be reduced, not the Strattera. maybe your dr has it backwards?
|
|
|
|
Post by d on Dec 14, 2006 12:23:38 GMT -5
In my experience when Concerta, or another stim is added the STIM dose can be reduced, not the Strattera. maybe your dr has it backwards? That's why my dd's doctor did also. |
|
|
|
Post by Mayleng on Dec 14, 2006 14:33:02 GMT -5
Yup, Strattera works on a weight to dosage not like the stims. So it needs to be at the right target dose, or you will see mood issues on too high or to low. If the strattera is working properly, then it is the stimulant that can be lowered.
|
|
|
|
Post by 2boyz4me on Dec 14, 2006 14:54:53 GMT -5
In my experience when Concerta, or another stim is added the STIM dose can be reduced, not the Strattera. maybe your dr has it backwards?  I don't know, I'm confused now.... DS is already taking 27 mg/day of Concerta ---which is a stim, yes? And we're adding 18 mg/day of Strattera ---which is not a stim? What is Strattera then? All I know is the above which is what dr told me.... he said that because we're just using it to even out the meltdowns/rebounds and help with the sleep issues, he wanted to start with 18mg and then, if needed, he could bump it to ds's target dose of 25mg.... I just want to be sure and do what's right for my son..... |
|
|
|
Post by Mayleng on Dec 14, 2006 15:33:28 GMT -5
Strattera is not a stimulant, it is a cousin of the Anti-Depressant. It is supposed to be a 24 hour medication, which is why there aren't supposed to be any ups or downs. But on it's own, it doesn't seem enough to help attention issues.
27mgs of Concerta is low, so it's good he is doing ok with this dose.
With the strattera, he should have started your son on 10mgs first, but since he is already on 18mgs, just let it be but keep an eye on any side effects - moodiness or anger issues. If you see this on a consistent basis, then request that he be brought up to his target dose of 25mgs. You should raise the dosages slowly, so since he just started, don't be in too much of a rush to raise it. What time are you giving the strattera?
|
|
|
|
Post by RobbysMom on Dec 15, 2006 2:05:23 GMT -5
It's been awhile, so I may not remember this right, but I think my ds used the Strattera "starter pack" which consists of 18mg for a few days, then 25mg. His target dose had been 40mg until we bumped it up to 50mg last spring. Use the formula on the Strattera thread to give you a guideline of where you think he should be.
I also agree that you should keep to his target dose on Strattera and lower the stim if you see side effects. My ds went from taking 36mg and then 45mg of Concerta by itself, to now taking 27mg during the school week and 18mg on weekends and holidays (with Strattera.)
|
|
|
|
Post by VaMom on Dec 15, 2006 9:42:55 GMT -5
Mayleng,
My ds is on target dose of Strattera. He has been on 50 mg. for a long time.. when he started on this dose, he was bumping up to the 1.8 mg. per kg. mark, now he is probably around 1.4mg. per kg., still in the target range. We will reevaluate when his weight goes up enough that he would be below 1.2 mg. per kg.
|
|
|
|
Post by Mayleng on Dec 15, 2006 9:51:29 GMT -5
So from all your inputs, most are definitely using target dose for Strattera, and stimulants hopefully on a lesser dose than prior to adding strattera (I am sure the stims dosage depends on whichever is the most effective level).
This is good to know.
|
|
|
|
Post by 2boyz4me on Dec 15, 2006 10:09:29 GMT -5
Strattera is not a stimulant, it is a cousin of the Anti-Depressant. It is supposed to be a 24 hour medication, which is why there aren't supposed to be any ups or downs. But on it's own, it doesn't seem enough to help attention issues. 27mgs of Concerta is low, so it's good he is doing ok with this dose. With the strattera, he should have started your son on 10mgs first, but since he is already on 18mgs, just let it be but keep an eye on any side effects - moodiness or anger issues. If you see this on a consistent basis, then request that he be brought up to his target dose of 25mgs. You should raise the dosages slowly, so since he just started, don't be in too much of a rush to raise it. What time are you giving the strattera? How early would one normally notice any side effects? He's only taken 2 doses...and I give it to him at bedtime, as I'd read here about it making the kids so tired..... Your thoughts? |
|
|
|
Post by Mayleng on Dec 15, 2006 10:56:51 GMT -5
Side effects may or maynot happen. Since you are giving the meds at nite, chances are he is sleeping thru any side effects. It takes time for the med to build up so you may not see any side effects yet. My son did not have any side effects because his increase in dosage was gradual. Most kids have a lot more problems when they get to 40mgs. But since that is not your son's target dose, you may not see any initial side effects. I suggest you keep giving it to him at nite for about 2 to 3 weeks, and if all is OK, then maybe change it to morning dosing if you want. But if it is helping at his current dosing schedule, then keep it as it is.
|
|
|
|
Post by RobbysMom on Dec 17, 2006 11:18:06 GMT -5
Every so often my on 40mg (and more frequently in the beginning when we upped to 50mg) my ds would have horrific stomach cramps on Strattera. It didn't concern me on 40mg, but when his dose was raised I was definitely wanting to try another med! I felt awful to give him a med that put him in such pain -- even if if was only for a short time. He would get the a stomach aches within minutes of taking the med. Since he wasn't getting the pains every day, we stuck it out a couple of weeks and everything smoothed over once again.
|
|
|
|
Post by Mayleng on Dec 17, 2006 11:34:06 GMT -5
After being on strattera for 9 months, once a month, my son would throw up in school out of he blue. He did not get stomach pains etc, just the monthly upchuck.
|
|
I don't know, I'm confused now.... DS is already taking 27 mg/day of Concerta ---which is a stim, yes? And we're adding 18 mg/day of Strattera ---which is not a stim? What is Strattera then?