|
|
Post by Mayleng on May 29, 2005 12:13:08 GMT -5
Thanks for your reply Mayleng. As you can imagine, I'm scared to death to increase the dose. He had this same reaction when on Effexor last year. While reading through this thread I find that both Strattera and Effexor are SNRIs. I decided to pull out my Dr Amen recommendations that I got in 2003...it was one of those on-line survey things. On there I find that my son seems to have an excess of Norepinephrine based on the information I gave. With that in mind, wouldn't a SNRI be bad for him? tater, it's hard to say if he will get the same reaction as on Effexor. I am sorry to say the only way to find out is to try a different dosage and if he continues with the same reaction, to stop. When tics are involved, it is so much harder to find a med that will not trigger the tics. |
|
|
|
Post by Tater on May 29, 2005 12:29:36 GMT -5
Thanks again...I appreciate your advice, but he already is acting like he was while on Effexor....this is why I'm afraid to increase the Strattera. I did not give him his dose yesterday or today, and he's HYPER  but happy. Guess we'll keep plugging away at it.  |
|
|
|
Post by chaknine on May 31, 2005 0:02:02 GMT -5
I have a question!!! B has been on 60mg of Straterra now for about a week. She takes it late afternoon. I have noticed lately that in the eve, she wants to argue about everything and just will not let things go. ( She only does it in the eve.) Do you think I should try splitting her dose up? She is still taking 18mg of concerta in the am.
shelli
|
|
|
|
Post by Mayleng on May 31, 2005 6:46:03 GMT -5
I have a question!!! B has been on 60mg of Straterra now for about a week. She takes it late afternoon. I have noticed lately that in the eve, she wants to argue about everything and just will not let things go. ( She only does it in the eve.) Do you think I should try splitting her dose up? She is still taking 18mg of concerta in the am. shelli shelli, what is her weight? and how long has she been on strattera? |
|
|
|
Post by chaknine on May 31, 2005 13:48:41 GMT -5
She weighs 70# and has been on Straterra since the 1st week in March. When we started she weighed 78#.
thanks Shelli
|
|
|
|
Post by swmom on May 31, 2005 14:53:05 GMT -5
chak - my dd weighs 75 lbs. and is on 55 mgs/daily - 45 in the a.m., 10 at 4 p.m. She's recently gained about 3 pounds, which means it's almost time to up the Strattera to 60. At 79 lbs, I've found that 60 works best. This med is so very sensitive!
Do you think your dd is on too much? I can tell when my dd is on too much or too little when she gets really argumentative and angry.
|
|
|
|
Post by Mayleng on May 31, 2005 15:02:37 GMT -5
shelli, 60mgs may be too high for her current weight. For 70lbs her highest dose is 57mgs. Try reducing it to 55mgs and see how it goes. As swmom said, this med is very dose sensitive.
|
|
|
|
Post by chaknine on May 31, 2005 22:13:16 GMT -5
I am thinking she may be on too much. I think we will try the 45mg in the am and 10mg in the pm. How long should I give it at the reduced dose to see improvement? Will I see improvement in a few days? That not being able to let go of things when you tell her no is definitely worse the last week or so.
|
|
|
|
Post by Mayleng on Jun 1, 2005 6:37:42 GMT -5
You should see some improvements (if any) within a few days. To be sure, give it a week.
|
|
|
|
Post by kalissa on Aug 27, 2005 15:55:03 GMT -5
Hi, Newbie to the board here happy* I am soooo happy I found this board by chance. I've been lurking for a while now... there is so much good information here. Thanks to all the input from you ladies, I put my DS, 6, back on Strattera. 45 lbs, just turned 6 6 wks ago. He was diagnosed ADHD hyper/impulsive in Jan 2005. Kindergarten teacher waited 5 mos to notify us that there was a problem in class. Since k-garten started, he'd been having problems controlling his behavior in class, outburts & fidgeting, excessive talking, using repetitive 'nonsense words', sticking arms out the bus windows, etc. Took him fer-everrrrrrrr to finish meals because he was too busy kicking the table, tipping the chair, singing, humming, etc. He'd been like that since age 2 or so. We thought it was just us, because when we took him visiting to places we don't go too often, he behaved OK. But then when we heard from the teacher, we knew something wasn't quite right. That's what led to the Dr. visit to ask for help because discipline didn't help at all. It was like DS lost his concept of consequences. And to make matters worse, the school actually insinuated DS's behavior was due to lack of discipline and bad parenting! Can you believe THAT?  I thought, you people have NO idea of what an evening in our home for the past 3 yrs was like!! Telling DS like 25 times to sit down and quit running in front of the TV, stop talking, quit kicking the sofa, stop throwing things, quit humming, don't tip the chair, hurry up and eat, etc etc etc. AARRRGGHHH!!!!! Reprimands, talking, yelling etc had no effect on the child. I digress- So our doc prescribed 18mg Strattera, DS was only 40 lbs @ that time. He was lethargic the 1st 2 days, but after that it was like the bodysnatchers took our son and gave us this 'perfect' little boy in his place! After about a week, it appeared to stop working so his dosage was incr to 25mg. Same deal, after 7 days it again appeared to have stopped working. We stopped the Strattera (no ins coverage for it and it's EXPENSIVE) and put him on a low dose of AdderallXR. WRONG MOVE! He took it for 2 days- the drug literally turned him inside out! He hallucinated 24 hrs a day and cried, saying his whole body hurt. He ate nothing in 2 days. We went 'natural' on fish oils, magnesium and B6 for 4 months, and didn't see any improvement so we stopped supplementing. DS was then started on Concerta. Didn't do a darn thing except make him even more emotional. Stopped that after 3 weeks. We took a 2-wk break from meds during which time we decided, due to reading this board, that we gave up on Strattera too soon the last time and since it was the only thing so far that worked even remotely for DS, we needed to try again. I read on this board how the doses need to be ramped up constantly to keep up with the child's growth, and that if you do not, it will fool you into thinking it wasn't working. Our DS @45 lbs has been on 10mg Strattera for 3 days now and other than a teensy upset stomach about 3 hrs after taking it, he's able to control his behavior and is a sweet 'normal' little boy once again. He will go to 18mg in 4 days, then onto 25mg in 7 days, and beyond that we will have to see how much higher a dose he needs. I also saw the posts on fish oils- I was definitely under-dosing him and now understand why we weren't seeing any benefits from it. A great big THANK YOU!!!!! to everyone on this board.  There is once again harmony in the house and DS will be doing well I am sure in 1st grade. School starts monday so we re-started the Strattera in the nick of time. I do think DS is sensitive to sugars. His behavior (since age 2 anyway) seems to be so much more wild after consuming sweet things. We've been doing our best to cut all sweets out of his diet (not ready to do total Feingold). DS will also be starting him back on the Omega 3's @ a higher DHA/EPA as soon as my order comes in. Thanks again! I'll definitely be spending a lot of time here from now on! ((hugs)) |
|
|
|
Post by Mayleng on Aug 27, 2005 16:56:14 GMT -5
 Kalissa, I am glad all the information here on the board helped you. I hope that the strattera works out for your child. 
|
|
|
|
Post by Mayleng on Sept 29, 2005 13:44:45 GMT -5
There is a strattera warning put out by the FDA today.
|
|
|
|
Post by Beverly on Sept 29, 2005 19:47:56 GMT -5
I wish this had been out before my ds and I had to go through what we did while he was on it. I know there are many parents out there who have had great results but this would have made our pediatrician and I think twice before putting him on it. Thanks for the info Mayleng. I did file an "adverse Event" form with the FDA earlier this year, it looks like many others did as well.
|
|
|
|
Post by ashelton on Oct 5, 2005 5:18:22 GMT -5
My son has been on Strattera for over 2 years...I have been away for this site for quite awhile but was now wondering about a med change. my son is 11 and starting 5th grade. The Strattera worked well up until this year but he has complained about difficulty concentrating and irritability over noises (when faced with challenging assignments, like math). His ped. brought up the FDA news yesterday and suggested we see a psychologist for possible med change/other anxiety issues. Could the Strattera be exacerbating the issue here? What meds have some of you switched to from Strattera? He tried Adderall many years ago but it didn't seem to help him then. Thanks for any suggestions....
Anna
|
|
|
|
Post by Mayleng on Oct 5, 2005 6:23:04 GMT -5
We switched to Metadate CD, and have had been successful with that. There is also Focalin XR (which recently was approved by FDA, the shortacting one had been approved a while ago). Both Metadate CD and Focalin belong in the same Methylphenidte family as ritalin unlike Adderall which belongs to a different family of meds.
Could your son just be needing a dosage adjustment due to weight etc?
|
|
|
|
Post by ashelton on Oct 6, 2005 5:25:14 GMT -5
Thanks Mayleng for the med suggestions... My first thought was that he needed a dosage adjustment due to weight, but the ped. seemed concerned about even continuing him on the Strattera. I called the recommended Psych. office and made the appt. to see the doctor who strictly deals with medication (didn't know there was such a thing/person!) We fill out a bunch of paperwork and see him later this month. The caseworker gave me the impression that Strattera would NOT be a med of choice as none of this doctor's patients were on it due to the possible side effects. SOooo, next step is the appointment & all the paperwork. I did like the idea that this doctor requires weekly followup appts. to insure that the med. is working, child is adjusting, etc. I will do some research on these meds and that way hopefully will appear knowledgable at this appt. Thanks! and I'll let everyone know what happens.....
Anna
|
|
|
|
Post by Mayleng on Oct 6, 2005 6:29:19 GMT -5
Good Luck Anna. I hope this doctor is good. There are alot of info on other meds here on this board too.
|
|
|
|
Post by Mayleng on Dec 9, 2005 14:16:31 GMT -5
FDA recently alerted health care providers that treatment of children and adolescents with Strattera increases the risk of suicidal thinking. Strattera (atomoxetine) is approved to treat ADHD in patients 6 years and older. The increased risk of suicidal thinking was identified in a combined analysis of 12 placebo-controlled trials lasting six to eighteen weeks. This analysis showed that 0.4% of children treated with Strattera reported suicidal thinking compared to no reports in children treated with placebo. A similar analysis in adults treated with Straterra for either ADHD or major depressive disorder found no increased risk of suicidality with use of the drug. A new boxed warning will point out that children who are started on Strattera therapy should be observed closely for suicidal thinking or behaviors, clinical worsening, or unusual changes in behavior. This is especially important during the initial months of therapy or when the dose is changed. Families should contact their child's doctor if they observe any of these signs. Eli Lilly, the drug's manufacturer, will also be developing a Patient Medication Guide to provide this information directly to patients and their caregivers. Additional Information: FDA MedWatch Safety Alert - Strattera (atamoxetine) www.fda.gov/medwatch/safety/2005/safety05.htm#Strattera |
|
jmom
Member
Posts: 1
|
Post by jmom on Jan 19, 2006 14:44:15 GMT -5
This site has been invaluable to me since my 6 year old son was diagnosed ADHD combination type in November. I've read through many of these posts several times, but now I have some questions of my own.
Our pediatrician gave us the options of medications and we chose Strattera. I liked the idea of it working 24 hours a day (I have since learned that is not ENTIRELY true) and the non-stimulant aspect of it.
We began at 10mg a day for a week, then 20 for another week, and then finally to 30 (his target dose). He is 52 pounds. We saw positive effects almost immediately. The day we increased to 30mg we saw huge steps backwards and began to wonder if we should've stayed at 20mg. At that point we were still taking it at night. We waited until the next week (Christmas break) to move him to the mornings. There was an improvement, but we have since moved to 20mg in the morning and 10mg in the evening. This also avoids the nightmares, as long as we give the 10mg dose before 6pm.
Since he has began this medication, he has been very emotionally...well best way I can word it is he crashes. Completely and totally over little things. Not all the time or I wouldn't even say daily, but it is absolutely gut wrenching when he does. He has also been very argumentative. Appetite has been fine; he has been claiming to not be hungry at lunch in the past week. Right now I am not sure if this is a med effect or something at school or just a phase.
Per the advice of many on this board, I have forged ahead with this medicine. My husband is epileptic and one thing we have learned is that a great many of these "brain" drugs have kind of a bell curve and you have to just deal with the bad side effects for awhile and they do eventually go away. Is this the case with Strattera? Or has it been long enough that these are no longer temporary effects of the med and instead a reality of how he reacts to it? I know for his weight he is at proper dosage, but is there any reason to think it's too high? Is there anything else we can do to help this?
Other than the emotional side of it, we have really been happy with the results of Strattera. Obviously though, the emotions are very important; but I don't want to give up on this med till I have made sure I have given it a 150% chance to work. I truly appreciate any insight anyone may have!
|
|
|
|
Post by Mayleng on Jan 19, 2006 20:00:34 GMT -5
How long has he been on 30mgs? Consistent results only happen 4 to 6 weeks on target. His target range is 28mgs to 42mgs. So if he has been on 30mgs for at least 4 weeks, start playing around with the dosages ie. bring him to 35mgs and see if this helps with the emotions. On too high or too low, you will get emotional issues - the key is the find the right dose for him within his range.
|
|
|
|
Post by gubbs10 on Jan 23, 2006 12:47:48 GMT -5
Looking to change meds. THe strattera seems to have stopped working. My 7 year old has been on it for 1 1/2 years. He is at the right dosage for his weight, and his mood swings amd defiance have gotten worse over the last month. Has anyone taken their child off strattera? How was the transition?
|
|
|
|
Post by Mayleng on Jan 23, 2006 13:00:18 GMT -5
My son was on it for 9 months. I took him off with no problems - did it cold turkey.
If you are concerned, you could wean him off slowly, ie. reducing the dosages over a few days. It will take a couple of weeks for strattera to be completely out of his system.
|
|
|
|
Post by gubbs10 on Jan 23, 2006 13:13:55 GMT -5
Thanks Mayleng.
When you took him off cold turkey- how long did you have to wait before starting him on his next meds?
I'm nervous to change meds in the middle of the school year, however, I really think i have no choice. In two weeks they are off from school for a week, and I thought that would be a good time to make the change.
|
|
|
|
Post by Mayleng on Jan 23, 2006 15:19:26 GMT -5
I didn't wait. I started him on ritalin the next day - short acting, then ritalin la. They both worked but he had appetite and sleep issues and then we found Metadate CD, and it worked really well for him. No appetite issues and a little sleep issue.
There are some people using a combo of strattera/and a stimulant with success, so there is no problem trying a stimulant now that he is off strattera if you want to.
|
|
|
|
Post by gubbs10 on Jan 23, 2006 15:29:02 GMT -5
Oh that's good to know. I thought it had to be out of his system for awhile before we could start something else. We are going to a new doctor on Monday- and I will see what he suggests trying after the Strattera. He is also on 10mg of Prozac, which I would really like to take him off of.
|
|
|
|
Post by kalissa on Jan 29, 2006 14:15:29 GMT -5
Has anyone had experience with Strattera seeming to conk out when the child is going through a growth spurt? DS6.5 has grown an inch in the last 8 weeks, and has also gained 2 lbs. He's been holding at 40mg Strattera for 5 months. Lately, he has been much more argumentative, talking back a lot. He has also been a real brat in the sense that if he doesn't get exactly what he thinks he should have (be it a certain food at supper, or doing a certain craft etc.) at that moment, he breaks down and cries. He gets upset over nothing. And that is unlike him. That is how he was pre-Strattera. I am thinking he is one of those fast metabolizers and he needs more. He gets 40mg in the morning with breakfast at 7a.m. and it's usually worn off til 2:00. Mornings have become really awful (more and more goofing off, not following directions, poking around eating meals etc.) and its not only at home, it's in school too. He's had 5 bad behavior warnings in the last month! A teacher found him rolling around in the hallway singing when he was to be using the bathroom.
He is constantly making interruptions for the teacher when she's giving instruction. He constantly pesters the other kids when they are trying to complete an assignment. He is bugging the kid next to him when they are at lunch, yelling in his ear and blowing at him with his milk straw. He's always making some sort of noise or flapping his hands around and making what he thinks are funny faces. ARRRGGGHH!! I am so frustrated!
These behaviors have worsened since just before Christmas. This is just how he acted before he was on medication. DS has also become increasingly sensitive to noise when he's trying to concentrate. The teacher set up a study carol for him on his desk (one of those wooden hinged screens) to help him concentrate and he likes it. He acts up so much in a group setting. The school psychologist gave him a rubber ball to squeeze during reading group but DS still makes noises, faces, etc anything to break the quiet. He knows he shouldn't but can't help himself. Why is it he gets so agitated over other people's noise but yet he constantly talks & makes his own noises? LOL I am so confused.
He is age 6.5, 45 lbs. He has not lost any weight on Strattera & eats healthy with a good appetite. Not much junk food, juices or sweets.
Any suggestions? We go see the doc on Feb 6th and I would really like him to have 18mg Strattera at bedtime as well to help mornings til the 40mg kicks in.
|
|
|
|
Post by Mayleng on Jan 29, 2006 19:47:25 GMT -5
Since he has grown, he might need a dosage adjustment but raising it by 18mgs might be too high. I would increase it by 5mgs at a time, to see if it helps. You don't want to get to high since there is a risk with strattera on liver damage.
|
|
|
|
Post by rmhinson on Feb 13, 2006 9:59:53 GMT -5
Hi! My 11 yr old son has been on Stratterra since July. He started on 10 mg (6 weeks); then 18 mg (2 months); and now 25 mg since November 17th. He has become depressed in the last few weeks, his tics have worsened, and OCD is somewhat worse. 2 questions: 1) Do you think he may do better on higher dose? 2) Do you think his neurologist should have increased dosages quickly like most of the Dr's. you have dealt with? DS is 72lbs. ADHD inattentive; he is not a behavior problem.
Thank you
|
|
|
|
Post by Mayleng on Feb 13, 2006 13:12:11 GMT -5
First of all, he was on too low a dose for too long. Strattera's dosing is weight related (unless he is taking Prozac or Paxil at the same time - then the dose would be halved of what is the target dose). It would have been better to increase the dose gradually like they did but not for so many weeks, I would have got him up to target within 4 weeks.
Now at 25mgs he is still way below his lowest minimum dose for his weight:
It should be between 40mgs (minimum) to 60mgs (maximum).
To find out his target zone, take his weight divided by 2.2 multiply by 1.2 (for minimum) and weight divided by 2.2 multiply by 1.8.
On too high or too low a dose, he would have mood issues. I would think the depressed mood would be he was on too low a dose. He should be brought up to his minimum dose of 40mgs at least.
|
|
|
|
Post by hippygal on Jun 9, 2006 5:30:06 GMT -5
Wow have just read all 9 pages what an interesting thread..... we are in the process of deciding to start my son on Strattera instead of Ritalin (due to tics becoming worse)........
This has given me a lot to think about.
Cheers Jaxx (New Zealand)
|
|
but happy.
There is once again harmony in the house and DS will be doing well I am sure in 1st grade. School starts monday so we re-started the Strattera in the nick of time.
Kalissa, I am glad all the information here on the board helped you. I hope that the strattera works out for your child. 
