Everything you wanted to know about Strattera

[jenwm]

Thanks Mayleng, i will keep you posted. He said his back is hurting today, he has a headache and is very tired, and coughing a bit. I think he is getting a cold so I will keep an eye on it. thanks for your help.

[Mayleng]

Where in the back? Make sure it is not the kidneys. My son developed a dry cough on strattera, so keep an eye on it. It may not be a cold.

[jenwm]

he seemed much better this morning. he was is a good mood and felt ok. He said he woke up at about 3am and was a bit nauseaus. He said he didnt have the strange dreams like the other nights. He was very moody last night too. He said if the side effects dont go away soon he doesnt want to take the strattera. I told him to be patient.

[Mayleng]

He has to be patient it will take at least 4 weeks to 6 weeks on thereaputic dose to see it work. Meantime, there will be these side effects.

[jenwm]

Hi Mayleng, well my son slept through the whole night! He was in a great mood this morning. I notice he gets very tired and moody come early evening. He did mention that he feels a bit more relaxed than before. He really is doing well considering. Also he is following the routine with homework. He really is tough to get going, but I just lay down the law and he is fine. Thanks for all your help.

[Mayleng]

No problem! I hope it continues to get better.

[jenwm]

hi mayleng, when your son got the dry cough on strattera, did it last long? my son still has a dry cough and it seems to be worse than a few days ago. Just curious.

[Mayleng]

My son developed the dry cough after being on it for 6 months, and it continued until I finally stopped strattera (3 months later). He was on strattera 9 months. He also had trouble peeing about the same time.

Your son's cough may just be an initial side effect of start up or he may be coming down with something ie. allegies (since allergy season will be starting soon). For the time being, just keep an eye on it.

[jenwm]

hi Mayleng, my son just came home from school sick. Bad sore throat and cough. Guess it was a cold after all. Other than that he said he is not as tired today like the past few days. thanks again for your help.

[Mayleng]

His tiredness should get better over time. I hope the cold is just that, a cold.

[kc4braves]

Our new doctor has mentioned several times now that shw would like ds to try straterra this summer. We never really tried it before ( 3 days at age 7 with little info from doc and a child who had issues swallowing pills). She thinks it might help the executive function issues that plague him more than the stims do and that he might maintian weight better. I think she would plan to add a stim if necessary for the hyper/impulsive behaviors.

I have been reading this thread and just don't know if we can/should do it. It sounds like a perfectly horrible summer for everyone includiing him. I know he would stay in trouble. Dh especially only has so much patience....and I would be with him all day everyday. Plus baseball rund through June and in the middle of July we will be visiting family for 3 weeks then school starts back. I just don't know what we should do. I'd love to help him but I guess I'm a bit skeptical and wonder if we should destroy the family for a month - 6 weeks just in case it might work. If it did help executive function, it would probably seem like a miracle.

He is almost 13 and has been on stims since he was 7. They really work pretty well they just don't do alot for some of the executive function issues and he loses weight so easily. With resperdol he is maintaining at 72 pounds but not gaining. He started Daytrana this semester and it has worked well except it kicks in so late that he has to take 20 mg ritalin before school. Lately, we are thinking the 30 mg patchh is no longer enough. He seems to metabolize quickly so we have issues with maxing out. Any thought on whether it is worth it to disrupt everyone and possibly have a miserable summer. If some of the things happen with him that have been mentioned in this thread, he won't even have a friend by the end of the summer. But oh the pull of possibly having a child with executive function. lol

[Mayleng]

kc, I don't know if strattera or any adhd meds would help the executive function as much as we would like. I know routine and structure helps a lot more for my son. Even though he has been doing really well on meds, there are just somethings that needs to be taught and organization, routines and structure is how to do it. It is a long road. I don't think that meds necessarily is the total answer.

[niamariesmom]

A friend sent me this thread and I am most grateful indeed. My daughter started Strattera three months ago. She cannot swallow the pill and so has been biting into them; the taste makes her gag and throw up sometimes. We all dread it so much I confess we haven't always consistently given her the medication. She suffered irritability and tearfulness and tantrums, likely as a consequence of our inconsistency and a lower dose than she needed--she weighs 94lbs but was prescribed 40mg. We have gotten consistent and now she is receiving 50mg which we put in applesauce. She still gags but at least she can get it down. We'll keep watching her (this has been only 3 days so far) and see.

I have noticed something else: Nia had really red flushed cheeks after the dose was increased and is now regular. It lasts for a few hours and then goes away as suddenly as it appeared. Has anyone else noticed this side effect?

Thank you for your information. With it I feel better "armed" to take the right steps to ensure that we try Strattera the correct way for Nia. I plan to give her 25mg in the morning and 25mg at night to see if we can keep the dose even that way (the tabs come in this dose) and doesn't require two different prescriptions (insurance issue) from the doctor. So far, we don't have enough information to tell whether we need to go to twice per day; I appreciate knowing that is possible though.

Thank you! And I look forward to reading more and sharing more about Nia's experience for other mothers.

NiaMarie's Mom

[healthy11]

Niamariesmom, My child takes a different medication than Strattera, so I can't comment about it, but I just wanted to say "welcome."

[Mayleng]

Welcome, as you found out the key to strattera is consistency and being on the right dose. I am not sure if the flush is a side effect, but it would well be, you should keep an eye on it and tell the doctor if this persists. As for splitting the dose, is there any reason you want to do that. Most split the dosage to try and reduce side effects, if there is no need to do that, then just keep it to one dose. No need to make your dd suffer taking it twice a day. Can you hid the entire capsule in a lump of ice cream instead of opening it and putting it in applesauce. It is easier to swallow ice cream and she may not notice the capsule embedded in there. This way she won't get the horrible taste.

[dwolen]

This is an incredibly information rich thread. It is really fantastic. I have forwarded small parts of it to my 21 yo dd, who is starting Stratterra this weekend so far away from her parental home.

[michellea]

I hope it goes well, dwolen. Please let us know.

[kc4braves]

Well, my almost 14 yr old son started Straterra today. He has been on two Daytrana patches and two 10 mg ritalin boosters in teh morning. We decided to try it in the morning first. If he has problems we will move to evening. He took it with eggs and toast this morning and 4 hours later has had no complaints. We started a bit higher than was suggestted in this thread so I'm really watching for side effects. The doctor gave us a starter pack for a bit heavier kid becasue he falls between the two starter packs. He is still taking very low does of Seroquel at night. Doc wants to keep him on it until the first 6 weeks of meds are complete. He has been growing and gaining weight over the last two months. He has grown about 3 inches and gained over 10 pounds...and he sleeps at night. If straterra goes well, we will drop the Seroquel.

I know it is time to try this med. It is really the last one to try. I am praying for good results and for patience for the family. We have a family trip coming up in less than two weeks and I hope it will be ok. Not sure what to expect without the stims. But it has to be done. We will go back to concerta probably if this does not work for him. If nothing else, at least we are getting him off stims for a month or two. I guess you can tell I'm having a hard time being optomistic.....but, although, reading the thread was helpful, it also makes me wonder if it will work for him. Trying to have faith.

[Mayleng]

Goodluck.

[kc4braves]

No complaints today and behavior not too bad. He did fall asleep about 2:30 for over 2 hours. Odd for him but.....I guess if that's the worst thing, we are good. He and i had a nice evening walk after dark with our pups. I treasure moments like that. He was really rather sweet and easy to be with.

[kc4braves]

Well, day 2 is upsetting my son. All he does is sleep and eat. He fell asleep in the floor playing with his dog early this morning and slept for two hours, got up and ate, traumatized his sister then fell asleep again trying to play a video game. I woke him up to ask him questions periodically but he falls right back to sleep. He tried to read his new book but fell asleep again. I figured it will improve but....now he is saying he hates meds that make him sleep and doesn't want to take it anymore.

So, is this sleeping just part of the process or do we need to back down to a lower starting dose? He has had no other complaints. The sleeping is not a bad thing if it is short term but he will not make it too many more days sleeping like this. And waht about church? Do we just skip it Sunday or feed him a Mt. Dew before and hope he doesn't fall asleep and snore? I have a call into the doc. but it's Friday so who knows.

[Mayleng]

It is an initial side effect and could last for a week or so, depends on the individual. It will go away in time.

[kc4braves]

He is up to 40mgs. Only sleeps in the car. So far no horrible problems but no great results. He IS eating more than ever. I see a few good things, i guess, like the ability to laugh at himself more easily and getting up much better in the morning. However, he is more repetitive (I'm hungry, I'm hungry. I'm hungry...... or reading ALL the business signs up and down the road.) He seems to want to argue first and will do most anything I ask but certainly not with joy. lol Everything you ask of him is a major inconvenience for him and he tries to make everyone miserable. He and his sister fight more. He seems to focus on the wrong things. For instance, we were bowling today at bowling league and he decided he was hungry. Well, that was ALL he was focused on for the next hour. How much money would it take to get a cookie, when could he get it, why wouldn't we buy it, how big was it, would his sister buy for him....and so forth. Not sure what to make of it but we are hanging in for now.

We are going out of town for oour anual visit with my parents for three weeks. We see them other times but we go there every summer for 3 weeks or so. Hope he can handle it appropriately.

[healthy11]

kc4braves, what you describe (I'm hungry, I'm hungry, I'm hungry) could just be the start of a regular teen growth spurt......

[Mayleng]

It takes time to see how well it is working ie. 4 to 6 weeks on the right dose.

[kc4braves]

So...once we get to target level....4-6 more weeks? Ughhhh. Hopefully, we start the target dose today. It is actually a tad high but at the rate he is growing upwards and gaining weight, it may end up just right. So 6 more weeks after today before we can say.....it works or doesn't?

I was ready to give up yesterday. It is a good thing that I purposely left all the stims at home when we left for my parents. I miss the dramatic change I saw with the boosters...sigh. He really does tend to make much better...wiser...descisions with meds ( stims). If things don't change in teh next 6 weeks, we will either have to go back to stims or I will be back to having to monitor what things in life he is exposed to ( to the best of my ability anyway.) Since changing to the patch a year or so ago, I had been able to quit worrying about every factor that came into his life and the timing of every situation...how it would affect him, what he would do, whether he would lose his mind and make stupid decisions that would get him in alot of trouble or get him hurt...we actually foucsed more on school and grades. Now.....I don't think he thinks about consequences at all or what his goals are.... He seems to go with the flow of whatever is around him...good or bad...calm or wild...dangerous or safe. Maybe just Mom remembering the past places that we do not wish to return.

He is on board with this med now that he isn't sleeping all the time, though, and actually comes to get it from me in the mornings. I know he is happy to be growing, although, at this rate, he will be overweight...which is a strange thought since he has never been over 5% for weight since age 7 and even before meds was only maybe 30%. But he thinks it's great. He looks down and sees a stomach and just smiles. I have never seen anything so funny. He has gained 20 pounds since Christmas and is up to about 90 pounds....and almost 5 feet tall. He is been striving for that mark for years....so he sees benefits, although, some must be contributed to the Seroquel he has taken since around Christmas and with puberty.

Sorry to ramble. He will be up soon and fighting with his sister or telling me what he's not going to do....or wanting to hang out with the nearly 20 yo delinquent down the street. I really miss the good relationship we had. He'll come hug me later, I'm sure, and tell me he loves me just before he tells me he is NOT going to take a shower or change clothes or whatever I may ask of him. ;-)

[Mayleng]

Yes, 4 to 6 weeks after you are on target dose before you will see consistent results. You could add some stims if you think it will help. Check with your doctor first.

[kc4braves]

She talked about the possibility of adding stims but wants to wait till we get on the target does and see how things go without the stims. I also mentioned that I had read that some people split the doses taking part in the morning and part in teh afternoon. She said she is open to that later on but that she has mostly seen the need for that in younger children. Not sure what age has do to with it. She indicated that younger kids tend to metabolize the meds faster. That has surely fit my son to this point.

[kc4braves]

Well....we have been on the initial target dose of straterra about 6 weeks. Not sure what to say. Our psych providor had her baby 4 weeks early so we did not get to have our follow-up visit with her after starting straterra the first part of June. We finally got scheduled in with the providor taking her place and saw her today. I was a little concerned with having to try to explain EVERYTHING to a new person. You know how it is with many of our kids...it's a bit complicated, especially after 7 yrs. But we had to try straterra in the summer before school started ( 9th grade) and she had to deliver her baby and we planned as best we could. I was told by one of the nurses in the group that we would like the new providor that was filling in for her....she was " older, motherly and very concerned..." about her clients. So we took both kids and went to the appt today anticipating discussing mostly the straterra and how to get ready for HS in 3 weeks!!!

Let me just say, this was the worse appt I think we have ever had. I would use different adjectives like bulldog with a sore tooth, warden, etc. Thank goodness my husband came with us. I think I was so shocked at her demeanor and the attack I felt I was under, that I really didn't function well. I was sitting there using self-talk to keep from crying, screaming at her or just generally making a scene. I know we had no other choice, no other out. They have no other porvidors that see kids and take our insurance. I felt I was over a barrel and was totally unprepared for the way this appt went. I wanted to stand up, take my family, and stomp out...but then what? I was shaking so bad, and so disagreeing with 99% of what she said that I could hardly speak.

My son has been on 60 mgs of straterra for 6 weeks. No stims whatsoever for about 9 weeks or so. I expected her to try to just manage the straterra until the other providor comes back...maybe talk about adding a stim for school since our providor doesn't come back till after LAbor Day. I thought maybe she would listen to my concerns and make some suggestions or something. I mean, she doesn't know me or my child at all, right? I never even got to say much about the straterra to our time was nearly up. Our providor listens alot...then talks. This woman came in all abrupt and talked most of the visit. My husband later said he knew from word one that we were in trouble. Not only did she make me feel like a bad parent she also acted like we were dumb. Then she said somethings I just don't believe are right. I was blown away. She pushed and pushed diet on us and handed me papers that she said were the "rules" for ADHD as if we knew nothing. She was very accusing that our kids are not on the heart diet and that we didn't seem to know that" blood sugar controls ADHD." She said our kids should use diet Dr Pepper and Diet Mt Dew as a med and should have no other sodas or drinks with sugar. On and on she went. Oh and did you know we should all cook from scratch and make our kids meals days in advance and never let them eat fast food or any school food...OMGosh. Most of what she said was not appropriate for a 15-20 min visit when had bigger things at stake and she knew NOTHING about us. I'm sure some of her ideas would be great but.....I basically got a lecture on how to be a good parent and how I don't measure up. ( though not in so many words)

Then she started lecturing my son. She asked how he was and he said "sleepy" which is a very important answer being that we are on a new med. She basically said she didn't care about that and treated him very abruptly, telling him how he had to take responsibility for HS and so forth ( which I don't disagree with but she had little idea about any of that and really set him against anything further she might say) and then went off about how he needed to stop popping his knuckles and what a terrible habit that was and how much arthritis he will have etc. I did not go there for her opinion about his joints....or to hear a lecture about responsibility. I needed to talk about Straterra. Then she told him his evening med ( 50 mg of Seroquel) was to take care of his aggressiveness but that he had to take meds for focus for school, etc. ( She had misunderstood a comment he made about not liking to take pills.) I was very upset but she kept lecturing him/us and didn't let me jump in. He is not taking Seroquel for aggressiveness and she should know that at only 50 mgs. Even if not, it just proved she knew nothing about him and she was acting like God. He takes Seroquel for the dual purposes of sleep and weight gain---absolutely no other reason. And 50 mgs is not a therapeutic does at all. It was working well for him WITH the stims and his providor continued it with Straterra.

Finally, I got to mention that i wasn't sure Straterra worked for him and of course, she was like, " and what makes YOU think that?!" She said it like I was not qualified to know this. When i told her, he can't read a book...can't get through one...has dropped his bowling average by over 50 points since changing meds and is always "bored" i think becasue he can't enjoy activities he did on stims; she handed me paperwork on the correct diet to go with straterra and said if it wasn't working for him we must be letting him eat something that is "blocking the drug". She made it sound like it works for everyone unless you feed your kid junk. We went into this with us and our providor fully aware that it was a long shot...a possibility...never a probability. We went into it with the idea that we had nothing to lose...could go back to stims if need be and, at worst, we got him off stims for the entire summer. So I was really taken aback by her attitude that it is the way he eats keepiing him from focusing.

Then she told me that he should take the straterra at night. She said not only would it help him sleep but she emphacized that the optimum effects would be felt the next morning if we did this. Ok.. that is when i nearly started bawling. First of all, our providor only suggested evening IF he was too sleepy after a few days to continue taking in the morning. She was also afraid that taking the seroquel and the straterra together would keep him awake....kinda like benadryl has on some kids if you give too much. This woman said..."well you won't give them together, straterra will be taken at dinner and seroguel 3 hours before bedtime." Ok...at our house that is often the same time. The thing that most got me was that i had read, I think on here, that taking it at night meant that the optimum time for good results at school, etc. would have mostly passed by the time he gets up. That some people split the doses so they take some in the afternoon after the morning does has 'worn off". Did I misread that or misunderstand? I wanted to tell her she was wrong but no words would come out. Her attitude did not allow for parent opinion, etc. I did not agree to give it at night, though.

So, then, she asked me why did we take him off stims if they worked. I tried to explain that we had maxed out pretty much and he lost weight at higher doses anyway...that we had not seen much change at a higher does, etc. He had been taking 20 mgs of ritalin in the morning then wearing a 30 mg and a 15 mg patch which is a pretty high does and we weren't seeing the best results anymore. I didn't even get to say all of the snetence above before she said, " He was not maxed out on Vyvanse. He can got up on it." Ok...we had horrible experiences on that and quit taking for that reason over a year and a hlf ago. "She said well lets go to Concerta then. He can go up to 100 mgs." DS said "No." rather abruptly and she took offense, but he really doesn't want to take umpteen boosters and should have a say as much as possible.

So...it boiled down to this. She will consider adding a stim to the straterra for school, but not until he goes up to 80mgs of Straterra first. When i asked what his target dose should be based on his new weight of 94 pounds ( he has grown several inches and gained 20 pounds since spring), she told me that she does not go by weight becasue it doesn't take metabolism into effect. So she completely threw out the formula and I don't know what to think. I don't want to ever set eyes on her again but I have no choice. We go back in two weeks which I don't think really shows us much about the 80 mgs but...we have to go back before school starts. I treid to voice my concerns but we were at the end of our time and she just ended the appt. I made it out of the room without choking her but was in tears making the appt. They said my kids could not see our reg providor till OCT becasue Sept was all full and I said "No. That is not acceptable. He must see our providor when she returns. I will not see (name of providor we saw today) after the two week appt." So we just didn't make an appt for dd until Oct and they squeezed ds in right after labor day during the middle fo school, but what else could I do?

I know I will probably be remembering more comments she said for the next few days but right now, I would just love some thoughts on what I have remembered so far. Am I wrong to be so upset and to think that she is wrong about alot? I know his diet is not perfect but we spent years just trying to get him to eat anything. So if she doesn't like that he prefers sugar filled jelly with his peanut butter and not sugar free, I can't help that. He also hates brown bread so I let him eat white bread. She made me feel like a criminal. I let him eat brownies tonight which I'm sure would make her ill. I also don't know how you'd make a 14 yr old eat sugar free everything, brown bread and rice, and only drink diet Mt Dew , milk or water, if he doesn't choose to. Both kids are picky. My dd continues to lose weight on the patch but she eats more than he ever did. I agreed that she probably needs to add more protein to her diet but my dd loves cereals, cream of wheat, oatmeal and very seldom wants eggs or bacon. I make her brother eggs and toast ( white) and sometimes bacon every day all year. So is the fact she eats a carb breakfast a problem when she is doing great on her meds? She is ADHD-innatentive and was never hyper. I mentioned that she seems a bit hyper when the meds wear off and the lasy told me to give her a diet Dr. Pepper. Isn't that going to keep her up at night too? I'm sorry to ramble but I'm still trying to find a place where I can move on from this day, if that makes sense. My wonderful hubby, said i had reason to be upset but not to be tearful at the desk. I said he should be proud of me that I didn't lose it in the office. So...again, sorry for rambling, but please, I need some feedback.

Thanks,
Kathy

[kc4braves]

I don't think anyone ever saw my post. I know it is long but I would love some feedback before we have to go back in to see this providor again.

My son is 14 and I know since his voice has been deepening that puberty is upon us. So some of our issues may be related to that more than the meds. However, I don't know that i can accept that all the changes are hormonal especially since he has been on stims for 7 years before trying straterra this summer. It has been an interesting summer with the highlights being that he has grown. He has grown probably about 4 inches and gained about 20 pounds ( since spring). He will get to start HS a bit over 5 ft tall which I never thought would happen and he isn't so sharp in his features and ribs can no longer be easily counted from afar at 94 pounds. Mornings are no longer a horrible struggle off the stims but otherwise, I'm not sure we see many good things with straterra. Most of the things that require focus in the summer have decreased significantly like his bowling avg ( he was getting ready for the HS team now he is bowling 80;s frequently), reading books is a thing of the past and I see him struggle to listen in church, etc. Just really different. Attitude is different too but maybe be hormonal or a mix of hormones and different meds.

He ist aking 80 mg of Straterra this week. Would love to hear any thoughts.

Thanks.