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Post by Mayleng on Nov 13, 2006 17:58:40 GMT -5
jellyben, at 66lbs his minimum dosage is 36mg and maximum is 54mgs, even if you push it 60mgs would be the highest. If at 50mgs you are not seeing any improvements, I doubt this is the right med for him. There is also concerned of liver problems, and I am not sure I would go up to 75mgs because of that.
My son tried Concerta too, and it did nothing for him except give him side effects. You might want to try the other stimulants. My son has done well on Metadate CD, good for his attention with no side effects. You could also try Adderall Xr or Focalin XR. Every child is different, one med might not work but another might.
Good luck.
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Post by momw3kids on Nov 21, 2006 13:09:02 GMT -5
Just a quick question............. Does anyone know if it is ok to take Strattera and Melatonin?? No one has told me differentlly but a relative said their pharmacist told them it is not safe??
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Post by VaMom on Nov 21, 2006 14:15:13 GMT -5
I sure hope it is okay! Our psychiatrist told me ages ago melatonin was fine, he certainly knows ds is on Strattera, since he is the one who does our rx! Ds takes a combo of Strattera and Focalin XR, and he often takes .5 mg melatonin at night. Mayleng, do you know anything?
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Post by Mayleng on Nov 21, 2006 15:30:35 GMT -5
I have not heard that strattera and melatonin are not supposed to be taken together. Our Peds also knows that my son takes melatonin and he had been on strattera for 9 months a couple of years ago.
Melatonin is a hormone, so I don't know what interaction that would be.
Momw3kids, did the pharmacists give you any reasons or documentation as to why it is not safe? Is he saying the combo is not safe or that melatonin is not safe?
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Post by momw3kids on Nov 22, 2006 11:43:00 GMT -5
Mayleng
Hi. It was not told to me. My sister in law said her pharmacist told her that ------ just to let you know I did not believe she was told that ----- my sons doctor knows he is on both also and has said nothing. SO I told my sil that my doctor said it is ok ----then she said oh, I guess i will talk to his doctor ----------- so my guess is that she did not really get told this by her pharmacist. Long story but she does make up things...........dont know why but she does. And instead of asking my pharmacist I thought I would write to you all and see if any one has heard that. Thanks!!!!!!!!!!!!!! Andrea
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Post by mariaven on Dec 5, 2006 7:18:28 GMT -5
My son tomorrow will have two weeks since he started the Strattera new dose. I haven't seen much of a change in concentration. I usually study with him in the early afternoon ( at about 2pm) and I still find it difficult for him to keep his eyes on his school stuff. He is usually a quiet child in the morning and early afternoon. I don't have complaints from school about behavior up to now, but since the dose was slightly increased I have noticed that he is becoming too hyper after 6pm. He is about 24kg and was previously taking 18mg that was too low; his dose was increased to 25mg, but now I have noticed that afternoons are making a big difference , he is too hyper. He is even starting to have a hard time falling asleep; he goes to bed and keeps talking to me, making comments. Yesterday I asked him why was he awake and he said he wasn't sleepy at all. This was obvious after having a hyper marathon before bedtime.
Well, I really have many questions. My son is on Strattera because he has shown mild tics before. I am afraid this med is not working for him. Don't see progress in concentration and is more hyper in the afternoons.
Is there somebody whose kid has tics and is on stimulants? I really want to do my own research before calling the doc.
Thanks for any advice or comment you can make about this.
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Post by Mayleng on Dec 5, 2006 7:24:14 GMT -5
Yes there are kids who have tics and are on stimulants. One is trying Daytrana with some success now. Daytrana is a methlyphenidate patch. Here's a site for Tourettes, they info about Tics and stimulants. p069.ezboard.com/ftourettesyndromenowwhatfrm1 |
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Post by horst1 on Dec 7, 2006 12:24:06 GMT -5
Hi All,
After taking some time off meds, my son's grades prompted me to try again. Our doctor put him Srat 18 mg to start. I just gave him his first dose this morning. I made the "mistake" of reading the info in the bottle - some scary stuff. I know all meds have side effects but the one that frightens me the most is suicidal thoughts. I had a bi-polar brother-in-law commit suicide so that warning really stood out to me. Have any of you seen anything like that with Srat.? This may have been addressed before, but I read 5 of the pages of this thread and thought I'd just skip to the bottom:)
Thanks for any help.
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Post by Mayleng on Dec 7, 2006 13:09:50 GMT -5
horst1, there have been reports of kids who have been on strattera suicidal thoughts, thus the warning. Strattera is a relative of SSRI. Is the brother in law who commited suicide a blood relative ie. your husband's brother? If so, is the doctor aware of this. BP tends to run in families and Stimulants and SSRIs can cause activation of mania.
Keep a close eye on your child.
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Post by kylesmom on Dec 20, 2006 22:18:59 GMT -5
I am new to this site as of tonight. My 7 year old son, who has multiple disabilities, has been on Strattera since October. He weighs 60 pounds. We had leveled off at 30 mgs, and our doctor then told us that we most likely had not gotten to a therapuetic level and advised us to go to the 1.2-1.8 mg/kg range. We have been on 35 mgs for about two weeks.
Since my son has very immature communication skills, he cannot tell us how he feels on this med. Everything decision is based on observation. It's really hard.
He has been very, very tired and irritable for the last couple of weeks. One night he even slept for 14 hours and we were sure he was sick. However, he had no real symptoms of illness other than being tired, ornery and not hungry. We are driving ourselves crazy trying to figure out if he has hit his 'max' dose and we have run into side effects, or if he is just sick. And if they are the normal strattera side effects, should he be having them after just an dosage increase to this extreme?
We are considering 1)waiting it out; 2) dropping him back to 30mgs; 3) splitting his dose or giving it at night. We are worried and frustrated, and forever feel like we are experimenting on our adorable son.
Advice?
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Post by d on Dec 20, 2006 22:29:30 GMT -5
The symptoms you described are typical of a ramp-up/increase adjustment period on Strattera. But they're supposed to be short-lived (maybe gone by now?). What are his other dx's? Maybe they have something to do with it.
Giving it to him at night should help through the adjustment period but that should be switched to the am when that is over.
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Post by kylesmom on Dec 20, 2006 23:49:30 GMT -5
He has epilepsy (well controlled on low dose of meds), verbal apraxia, sensory integration issues, and a mix of possible learning disabilities that we are still trying to figure out.
How long do side effect symptoms typically last on a ramp up? We had actually been down to 25mgs a day from 30mg (trying to see if we could get away with only one pill) and then stepped up to 35mg. Does illness seem to have any effect on the kids when they are on Strattera? Sometimes my son does seem to "backslide" developmentally with illness, but we have been unable to pinpoint a specific illness this time and were finally just wondering if what we were seeing was med side effects.
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Post by Mayleng on Dec 21, 2006 7:30:09 GMT -5
It sounds like med side effect. Normally, it takes 4 to 6 weeks on Target dose to get consistent results but since he has not been on target dose yet, then you might see some side effects. The higher the dose the harder it is on the kid initially. I suggest you give it to him at nite, so that he sleeps thru' the initial side effects. Give it to him after dinner. His target range for 60 lbs is - 36 mgs (minimum dose) and 54mgs (maximum dose). As you can see you have quite a range to try and find his right target dose. 40mgs is normally hard on the kids. So give it at nite for a couple of weeks and then try switching to morning dosing.
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Post by swmom on Dec 21, 2006 8:53:13 GMT -5
Yes! If my dd was sick with a cold or a virus, the Strattera basically stopped working. No question. I began to dread the times when she was sick because I knew the medication wouldn't work at all.
HOWEVER, Strattera also seems to be a very sensitve drug. If dd gained a pound or two, we had to readjust the dose. Or, if she lost a pound or two, we had to readjust the dose. While Strattera helped her tremendously for almost 2 years, it did require a lot of maintenance.
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Post by kylesmom on Dec 21, 2006 11:12:09 GMT -5
We just talked to our doctor who said that it sounds as thoguh he may have hit his max dose in terms of side effects that he can tolerate, and suggests that we drop him back down agin. If we do that, we will be below 1.2 mg/kg. I suppose it is possible that he is a strong metabolizer of Strat and doesn't require as much, or maybe that there is only so much gain we can get out of it due to his other conditions.
At 25mg, all teachers noticed improvements but with certainly room for more. Maybe we will just never get the "more". Also, he has lost a couple of pounds since increasing the dose, so the drop in appetite led to a drop in weight which led to the dose being even higher. Ugh. I hate this stuff. Why can't something be easy for once?
Karen
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Post by swmom on Dec 21, 2006 11:51:06 GMT -5
Strattera is not an easy drug to manage. However, when it's working IT'S WORKING. Better for us than all the stimulants we tried. It's worth the effort. We will most likely add it back into our mix of meds because it controlled dd's impulsivity and inattention so well.
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Post by RobbysMom on Dec 21, 2006 16:19:05 GMT -5
My ds needed more of a significant change of weight to see the side effects of Strattera. We didn't adjust the dose until he gained about 10 pounds (about 1 1/2 yrs after he started Strattera.) He gets angry when the dose is too low. He also takes Concerta and when he doesn't have the stim he's more hyper on the Strattera alone than I remember him on nothing at all!
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Post by kylesmom on Dec 21, 2006 17:33:33 GMT -5
My son is definitely angry and in general just more "rigid". He gets mad when he doesn't get his way or when plans change. He is more disagreeable with his teachers. Because of his multiple disabilities, his personality has always been his biggest asset. Happy-go-lucky, friendly and sweet would have been the words everyone used to describe him The one thing I need to make sure we preserve at the end of this medication odyssey is his sweet temperment.
I have read on this list that kids can be ornery when the dose is too low or too high - so in our case I have no idea which it is. And whenter at the end of a ramp up my sweetheart would return. Or if dividing the dose would help with personality or tiredness.
So many questions...so much guesswork.
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Post by Mayleng on Dec 21, 2006 18:22:51 GMT -5
The best way is to bring him to the target dose according to his weight. Then stay on that range for a while and see if the moods go away. Some side effects do go away. Try giving it to him at nite until you feel comfortable that all side effects have gone and then change to morning dosing.
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Post by kylesmom on Dec 21, 2006 22:59:26 GMT -5
Do most people that split the dose do it for sustained attention in the PM or side effects? Is there any published material about splitting the doseage, because I don't think our doc does that very often.
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Post by RobbysMom on Dec 22, 2006 0:47:31 GMT -5
We were seeing 2 different doctors when my ds first started Strattera and both told us that they don't like split dosing unless the child is having abdominal problems and even then, they would eventually like the dose to be taken just once daily.
Anger is very hard to deal with. We have a very sweet natured boy also and I'm always second guessing the meds (and myself) when things are not going smoothly. Even after 2 1/2 years on Strattera I keep going back and forth on whether or not I want to try another med or just take a med break and see what happens.
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Post by swmom on Dec 22, 2006 8:00:04 GMT -5
We started off with one dose in the a.m. and it was too much, gave her a headache. So, I asked the doc if we could split the dose. He didn't want to but I begged. So, we dropped the amount of the morning dose and added a small one after school.
Was better but she was a nightmare in the mornings( before meds). So, we split things into 3 doses - one in the morning, one in the afternoon after school and one before bed. Worked nicely. Doc insisted that this wasn't necessary. But it clearly was. Three times a day was required for sustained attention.
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Post by Mayleng on Dec 22, 2006 8:26:31 GMT -5
There is no proven study done on split dosing, however, it seems to help some.
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Post by kylesmom on Dec 22, 2006 8:58:02 GMT -5
Wow, maybe if we split the dose I could actually get him out the door for school in the morning without pulling my hair out. He is SOOOOOO distractible in the AM that helping him with getting dressed, eating breakfast and brushing teeth makes me feel like I've run a marathon. Nothing like starting the day stressed out.
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Post by Mayleng on Dec 22, 2006 15:33:34 GMT -5
Worth a try.
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Post by mariaven on Dec 28, 2006 22:41:09 GMT -5
Hello:
Here I am again with the Strattera issue. My son was upped his dose to 25mg (he weights 23kg) four weeks ago. I still see problems in attentiveness and he has mood issues: he is defiant sometimes, answers back, and very irritable; he has also lost his appetite. Today I had an appointment with his neuroped due to the symptoms I have just described. He told me to wait for two more weeks, since 6 weeks should be fair to see if Strattera (the dose adjustment) is good for my son. However, since my son still shows mood issues, he suggested adding a very low dose of Risperdal along with the Strattera to see if the combination works better for him.
Now, I am completely confused, my idea in today's appointment was to get a change of meds. I was told to keep trying Strattera and adding another element that completely disturbs me, this med is intended for psychotic behaviors (I knew this after doing my own research when I got home).
What feedback can you give me? anything will be welcome.
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Post by Mayleng on Dec 28, 2006 23:24:14 GMT -5
I can only tell you that if it were me I would not add another med to counter the side effects caused by the first med. It does take 4 to 6 weeks ON TARGET DOSE to see if strattera is going to work. However, if you add another med, how would you know if it is the strattera working?
For your son his target zone is 27mgs and 40mgs, so at 25mgs he is still below his target zone. On too low a dose, you will also get mood issues with no benefit to his attention. So why not raise his dose to 30mgs and see how he does. If that does not work, you can go up to 40mgs to see if you see improvements. So play with the dose between 27mgs to 40mgs until you find he right one for him.
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Post by mariaven on Dec 29, 2006 7:39:22 GMT -5
ok, if I wait two more weeks and if I don't see benefit then I should try 30mg. That dose is not available. So in that case I will have to try three 10mg for 30mg or two 18mg to make 36mg. That would be way too expensive.
I guess I will have to wait and see, I guess I will better have to consider a change of meds.
Thanks for your advice!!
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Post by Mayleng on Dec 29, 2006 11:14:26 GMT -5
If you use 30mgs (three 10mg pills) it shouldn't be more expensive unless Venezuela is different from the U.S. For the U.S. if it is the same dosage (ie 10mgs), insurance here will cover it with the same co-pay even if more pills are needed.
There are very few stimulants that is available for kids who suffer from Tics, so your choice is very limited.
Good Luck.
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Post by mariaven on Dec 29, 2006 11:34:43 GMT -5
No insurance coverage for adhd here. The pills just come in boxes that have a specific price. To triple them I will have to be paying for three boxes per week. Well, let's see first what is the outcome, then I will see what can be done. I have also been told lately that stimulants aren't out of the question completely; they idea is to try them and see what happens.
Thanks for your help.
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