administering strattera | ADHD Information
Love all the info and support on here
My ds was just switched to Straterra Memorial Weekend by a developmental pediatrician. He began at 25mg (currently continuing Daytrana, sounds like for at least a few weeks) and was upped to 40mg after a week. They said to continue for about another 2 weeks with a call in to them every week to check how he's doing.
I so loved the patch for him but the doc felt Straterra might be more helpful with his anxiety and tics. Right now I think I'm seeing a bit less fuss, impulsive and defiant behavior - maybe wishful thinking. We'll wait and see.
I had been terrified of this med and as soon as she said Straterra I teared up. She caught this reaction and spoke with me for awhile about it and of course, I've been checking a lot of posts on here. I feel fairly comfortable and just want my ds to not stand out and be the "weird kid" anymore. He has a quarky personality with a zest and hopefully, this med won't hide that fun-loving side, but just tone it down a bit. 
Please keep updating how you're all doing.
My five year old is on strattera, I can tell you it will not zombie him out! He is still the same funny busy quirky kid. In fact the only difference I see is at school. He is able to sit in circle and participate. He still has to sit by the teacher... but sit is the key word here. The blood tests are the problem. My Dr wants them frequently.BL Moretti -
Did the doctor tell you right up front about the blood tests? His dev. ped. hasn't said a word on this - she only said in a study 2 out of (can't remember the exact number but it was large, like maybe 2 million) showed very bad liver damage which improved once the medicine was discontinued.
Thanks.
When my ds began Concerta and lost 13 pounds fairly sudden, his ped. recommended Carnation Instant Breakfast with Vitamin D milk (similar to pediasure and that type of thing but less expensive). If your child likes choc., strawberry, vanilla milk (might have other varieties by now), I'd give it a try in the mean time until you get him to the doc.we use those too. I even add ice cream, what kid wont eat ice cream for breakfast! More vitamins in those instant breakfasts than what she'd eat. I figure she's gettig the instant breakfast in and the extra calories in the ice cream wont hurt!We are constantly working on the weight issue.My son who was on concerta made a whole school year with out gaining a pound! He is off the stims for the summer and I am giving him big calorie everything!
The little one is on Strattera and I have given up the idea of three meals. He has always been a grazer and he has food issues since he was in an orphanage for 2 1/2 years before we adopted him.
So what I do is I do not allow any food I do not want them to eat in the house. My older teenage boys have their stashes and there is big trouble if the little sensitive ones find it! Then I just let them eat when they want and pretty much what they want. Then, I do make them sit down at the dinner table, hungry or not. They don't have to eat, just commune with their family. Some of the Hagen Das ice cream bars are on the Feingold list and at 290 calories a pop it makes a good snack! Add butter to everything! Even tuna or PBJ sandwiches. I found it harder to push calories when we restricted dairy. That did not seem to help and when I did the Alcat test dairy did not show up.
Soon (as soon as I figure it out) we will start Feingold and see where that takes us. In the mean time just let them eat!
watch the weight, 5 pounds in 4 weeks is a lot especially a 5 year old. I would give it two more weeks your 6 week marker, but if he's still losing, I'd check with the doctor especially if you're not seeing symptom relief. Sometimes kids lose weight in the beginning, but it levels off so that is very possibly what is happening.I'm also new at this. My son, age 5, has just rounded up from 18mg to 25 mg. This is the start of the 4th week. I haven't seen any relief yet. I know it takes 6 to 8 weeks, but it is sure a long haul. I can't stand all the yelling. He has lost 5 pounds so far. I know weight lost goes along with this, but I'm wondering how much before I consult the doctor. As far as the pills, I came across a board in here that told me about a pill cup. You can get it a CVS and it worked great. You really need to give it a try.
It is 1.2-1.8 mgs per kilo of body weight. Kilo is 2.2 lbs, so divide weight by 2.2, for instance, a 25 lb child would weigh 11.36 kilo's , 11.36 X 1.2 mgs= 13 mgs, 11.36X1.8= 20 mgs. ( I usually just round it off to the nearnest weight, so it would be 11 kilo's)
at 56 lbs, or 25 Kilo, his target dose would be between 30-45 mgs.
edbson39296.8558680556Thanks I copied and pasted it so now I wont lose it.Would you recommend starting as low as 10 and ramping from there? I have 10's and 18's.
BL
Edbson Some place you posted a formula for stratera dosing. It went like.. multiply the weight by... etc etc. The whole per kilo makes me nervous. Will you post the formula again?
I am thinking about trying Strattera for my older son. We have been happy with if for the younger one. He weighs 56 lbs.
We are using Desipramine, a tricyclic antidepressant. It will hopefully help us with all of the above, impulsiveness, attentiveness, anxiety and tics. We're still building to therapeutic dose.Hello my support group...
I just wanted to give a brief update on Jacob's switch from Adderall to Strattera. He is now on week #3, on his target dose of 25mg. If we give it to him in the AM he has stomach aches and is lethargic. If we give it to him at night before bed, then he sleeps well and has a pretty good day.
His tics are gradually decreasing. His anxiety has gone away. It seems as though his fun and confident personality is coming back and shows no signs of depression or suicidal thoughts.
I understand it may take up to six weeks to get to full benefits and are looking forward to continued improvement.
God bless you all and hope you are all having a great weekend!
If you have an interest, check out my pretty flower photos on http://community.myfoxcleveland.com/blogs/AkronPhotographer
I'm curious about what people switched to once Strattera proved to be not the med for them?
My ds dev. ped. says if it doesn't work for him, we'd talk about putting him on zoloft, and I'm not sure I like the way this is "progressing". The switching from Daytrana to Strattera was to hopefully ease his social anxiety (he is not comfortable in large groups/crowds) and improve tics. I am very leary about antidepressants, and I'm sure he'd have to go back on Daytrana (or another med) because his impulsiveness and attention span need major help during the school year.
Great News! 
It's also encouraging as my ds has similar areas we're hoping to improve. Please keep us updated.
My son, age 5, nearly 6 is taking 20 mg Straterra. He weighs 41 lbs. The meds seemed to be helping and I felt it started to be helpful right away.
Lately, I have seen much more defiance and talking back. The old behavior of hyperness, hitting and being too rough is back. In addition I am seeing lots of sneaky behavior. Sneaking into his brothers rooms, sneaking and watching where I put something I have taken away from him and getting it later when I am not watching.
Yesterday, he found a can of silver spray paint and painted a pillar and the handle of our front door.
I am beginning to think this is more than ADD. We will talk with the Psychiatrist soon.
Thanks just typing this out has made me see it much more clearly. This is post institutional behavior.
Any parenting tips for sneaky behavior?
As far as the talking back and being and sneaky, that just might be the age. My son does it, I don't believe at all that it's ADHD. My son, if he has a chance he will sneak scissors. He has even cut the cats whiskers and fur. I just put ALL the scissors up high . I think it's just being this age.
If I were 5, nearly 6 and found a can of spray paint I would probably spray something too. Sounds like somewhat normal behavior for a 5-6 yo boy.
What about raising the dose? He has room....his target at 41 lbs is 21-32 mgs.
Yeah, the range is 1.2-1.8 mgs per kilo, so he has a bit of room for his weight. IMO optimum dose is 1.6 mgs per kilo.Ok... so the silver is a pretty color.But... the Meds are not working for him. He is my fourth boy and the second was/is a real challenge.
I was at one of my older boys baseball game and the weather was nice and there was a lady with two little boys watching. The boys were goofing around and but when something happened in the game they watched and the mom got to watch too. I was thinking, I wish I could take my little ones to a ball game.
So you are saying he could go up to 32?
Well there are appetite problems.. They started before the strattera. My six year old sort of ate less in the beginning but now after 3 months he is back to eating lots. Not real gain though but taller.
The one that worries me is the older one. He gained 6-7 lbs coming off concerta and starting tenex and then suddenly no appetite. Anyone else experience this. Now that I have started the strattera it seems to be getting worse.
You have to start at 10 and ramp, but I would check with the Psych first.My psych, although I really like him, started my 5 year old on 18. I was lucky there was only a few moments of weepines. We eventually went up to 28. He is doing well.
I plan to get an amino blood test done for my older son and then start the strattera. He is taking tenex as well. So I like the idea of going soooo slowly. I am hoping not to go back to concerta.
Concerta works very well for school but... he has no appetite. He went a whole school year without gaining a pound! He started out in Russia and after 8 months ended up in an orphanage. When I got him just before his 3rd birthday he was 24 lbs and had paper thin nails and his hair broke off when I combed it. I have no idea of his familial potential for size but I believe he is mostly caught up. He did not even make the growth charts ... so the idea of no appetite in his case can't be good. Hopefully the strattera will smooth him out with out the loss of appetite and rebound.
HI!
I am new to this so bear with me. I have a daughter (5) recently diagnosed with ADHD and she has been prescribed Strattera. Any advice on how I can administer her the medication???? She can't swallow a pill and when I open it up and put it in yogurt, etc. it is too bitter. Please help me. Thanks!
Strattera CANNOT be opened.DO NOT OPEN THE CAPSULE! IT CAN CAUSE blindness, AND IS SERIOUSLY TOXIC IF INHALED!( sorry for yelling, this is important)
If she cannot swallow pills you will need to look at another med. How long has she been on it? what is the dose? and how much does she weigh?
Didn't your Psych know she could not swallow pills?
There are other alternatives, patches, and meds that can be opened and sprinkled.
http://www.strattera.com/index.jsp
http://www.strattera.com/1_2_taking_strattera/1_2_5_take.jsp
roughly in the middle of this page it says don't open it. There is more info on this in the physician precribing info.
edbson39159.7688194444The child neurologist that we saw told me to administer it that way too her. I will double check with her pediatrician tomorrow. We have tried Daytrana and Adderall and she seems zombie like and picks her fingers till they bleed. Right now she is on 18 mg of Strattera. She is 41 pounds. Thanks for your input.Was this her staring dose? Her target dose would be somewhere between 20 and 30 mgs, how long are you ramping?
One good thing is, the Strattera capsules don't really get bigger the higher you go.
Have you tried M&M's? or Tic tacs? They work well to get kids to swallow pills....if they can swallow a whole M&M they can swallow Strat.
I would defininetely speak to the Neuro, and point out that is specifically says on their website and in the dosing info that it cannot be opened.
On another note, if she is "zombie like" on stims I would have an evaluation done by a board certified Child Psychiatrist, it very well may not be ADHD.
What was included in the eval?
What does ramping mean? I am supposed to switch her over to 25 mg in a few days. She loves M&M's and tic tacs but she eats them by chewing. I don't understand why Strattera hasn't came out with a patch or something to make this easier. My daughter is also language delayed so I can't do a lot of explaining to her. She wouldn't get it.She was diagnosed by a Child Psychologist but I do think I need to take her to a Psychiatrist too.my daughter takes ritalin LA and she sprinkles it on a a tablespoon of flavored applesauce. ie. grape or strawberry are her favorite flavors. she doesn't complain about the taste at all.
my dd also picked at her fingers on adderall and had the dilated pupils, etc. on ritalin she doesn't have any of these side effects. i know that everyone reponds differently, i just thought i'd share:)
good luck!
shelley
I taught my son to swallow capsules at a young age by using yogurt or ice cream! Bury it in that and try to swallow it!She should have been started at the lowest dose, 10 mgs, for several days, then slowly, gradually ramped the her target dose. The available dosages are 10, 18, 25, 40, 60, 80, and 100 mgs.
Target dose is 1.2-1.8 mgs per kilo (2.2 lbs)of body weight, a too low or too high dose will cause mood swings, and other undesirable side effects. it takes 6-8 weeks to see full effects of the med.
It really REALLY is a tricky med, it takes SO long to actually start working, and is extremely weight dependent. The dose for my dd had to be changed constantly, and I frankly got tired of the bloodwork every 6 months for liver enzymes.
I would agree with taking her to a psych, they know SO much more about available meds,side effects, co morbids, etc.
and with her being only 5 I would very much question the ADHD diagnosis, she is really too young for that, most psych's won't diagnose util at least 7.
Thanks for the input. It is nice to know that someone out there knows my pain. It's been unbearable at times these last few months and trying all the different medications and hearing about all the side effects and dealing with all the people saying that kids just need to go outside and play more. You all know what I am talking about.
yes, i KNOW, BTDT for several years now.
But honestly, once you find the right med, and it works well, it is all worth it.
I just wanted to wish you luck through this tough journey. edbson is right about finding a psychiatrist for med managment. It can take a while to find a good one and get into the schedule. In the long run someone with more med managment experience will be valuble; as your daughter's needs change and as she changes.Straterra is extremely weight /dose depnedent. A too low dose is not going to do anything, but possibly cause adverse side effects.( mood swings or worse). a Ttoo high dose can cause even worse problems. I would speak to your psych as to why they didn't do the recommended ramp period, which is essnetial.
To give 20 mgs you use 2/10 mgs pills.
The dosing for Strat is 1.2-1.8 mgs per kilo, (2.2 lbs body weight)
BL Moretti,
for a 39 lb child the target dose would be between 20 and 30 mgs.
He should have been started on 10 mgs, as stated in the dosing info on Straterra.com.
The reason you are seeing hyperactivity , and other side effects is because it was started too high.
I am realizing that! We did have a couple of days that were antzy!!! But now... he is so great! How do you give a 20 dose when it does not come in that dosage. My dr told me 18 was the lowest but I now know there is a 10. Maybe 18 will be enough untill he grows. Ths for the info we have a call scheduled the first of the week.Hi,
We just went from sprinkling Metadate in stuff to swallowing the Strattera.
Justin is 6 and the neurologist told us not to open Strattera and when I asked him how to get my son to swallow the pill, he said to "grease it" with butter or oil, so we are dipping it in Canola oil first and it seems to help. Just an idea that I haven't seen on other posts.
Also, our neurologist said to give it in the evenings after dinner, not in the a.m. I don't know why he prescribed it this way, but it is a lot more mellow around our house in the p.m.
Val
Ok, now it's our turn to try Strat. Wetook Jacob back to the neuro a couple days ago. We told him that Adderall was helping with his hyper traits, but causing anxiety (fear of partication in activities, not wanting to go outside because people would see him, etc...)The neuro is starting him on 18mg and ramping up to 25mg whicj is good for his 49 lbs. We have read all the important info and cautions about Strat and feel prepared for the time needed to get to his target dose.
The neuro suggests waiting til next week when school is out to start the switch.
I guess I'm just asking for your thoughts and prayers as we change meds. But I am always interested in your thoughts.
Love you all, and appreciate your posts. This is my support group. Happy memorial day!By the way, I'm a professional photographer and I have some of my favorite photos on this web site...
http://community.myfoxcleveland.com/blogs/AkronPhotographer
It's a safe site. It's part of the Cleveland news television station (Channel 8).Good luck with that. My 5 year old, six in Sept, started strattera two months ago. I have to say I like it. He is still the funny quirkey child he has always been but it is easier for him to sit in circle time and he remembers better not to push his friends. The changes were subtle and started to happen only a few days into the ramping process. However he is only on 20 so there was not too much ramping available. Hopefully this will be what you are looking for! Zjmom:
Yes he did tell me right up front about a blood test and then my sons billirubin (sp) was high so now we get another. All other liver functions were great and some Russians just seem to have a high count so... I am glad he is on the cautious side. I do not knowhow often he will want test. I wish I had asked.
Oh my psychiatrist gives my son 20 mgs. Two 10 tablets. he said we could split and give one in the evening and one in the morning or both at any one time. I am a spaz so I give them both in the morning.
Thanks for the info - I'll be sure to ask his dev. ped. when I talk to her Tues.
She also told me I can give him the meds at supper - mostly due to my dh "forgetting" to give him the meds in the morning (dh is extreme ADD but will not do anything about it 
). He does have difficulty sleeping and since Straterra isn't a stimulant, she said there shouldn't be a problem. Works out well too because he eats better at supper.
BL Moretti,
All I can offer you is that my daughter is 5 she weighs about 41 pounds and we started her at 18 mg for about a week and then took her up to 25 mg. We have had a great week so hopefully that means the Strattera is working. I would think he would be on about the same dosage. Keep in mind, with this drug it takes awhile to take effect. Good luck.
Well I am happy to say that yesterday and today day 5 and 6 have been amazing! I know that we are not supposed to see anything for some time but let me tell you he still talks a blue streak but he has been so much more cooperative and not so goofy!! A real pleasure!Off to put him to bed!
Boni
We got our daugter to swallow a pill last night. My husband did one first (of his medication) and I gave him some M & M's. Then we told my daughter it was her turn and she did it!!!!!!!!!!!!!!! Thank you for all the encoragment that I received on here. Hopefully Strattera will work for us. Tired of trying and switching medications.
My ds was put on Strattera last Wednesday. His doctor told me the same thing that I could sprinkle it on his food. My ds didn't want it on food, he just asked if he could try to swallow it and he did. How scary, I even read the package info and went online to Strattera and still missed that warning. Thanks for the info Edbson.
L~I know how you feel. Keep up the faith and you will find what works. I am still waiting to see if Strattera is going to work. My ds doesn't seem has implusive as he was before the med but I have noticed he is more talkative but it hasn't even been a week.
nsquaredma39161.346875My son age 5 1/2 started strattera 18 Sunday. This is day three. I asked the psyc about ramping and he said 18 was the lowest dose so it was not needed. My son weighs 39 lbs. He said 18 should be the right dose for his weight.
So far today, day three he is more hyper and implusive than ever. My DH came home and tickled him and went out for ice cream and generally got him riled up but he was out of control even before that. It is only 3 day any one have any ideas?