My 7yo daughter w ADD was just told to increase her Strattera to 60mg. Does that seem a little too strong? She weighs 56lbs. Her pediatrician first prescribed 18mg for 6 WEEKS, then increased to 25mg for the last 3wks. He said that he did not feel comfortable prescribing any higher than 1mg/kg.
Soooo.....we saw a pediatric psychiatrist who said that her target dose was 60mg. She said to increase to 40 for one week, then go to 60mg. She said that she usaully prescribed 2m/kg. That would be 51mg for my daughter if you do the math. I'm just wondering if 60mg is too strong?
How many of you have children on 60mg Strattera and if so, what is their wt?
Thanks
MK
Here's the math:
The target dose should be at least 1.2mgs for
every 2.2 lbs of body weight. If you aren't good with
formulas, you divide his weight by 2.2, then multiply
that # by 1.2. That will give you the mgs you need to
work up to.
That's for the low end of the dosage range. Then for the upper end multiply by 1.8 instead of 1.2. So your range is 30 to 45 mg.
At 56 lbs her target dose is minimum 30 mgs and MAX 45, at the recommended 1.2-1.8 mgs per kilo.. 60 mgs is too high, dangerously so, and she WILL experience side efffects such as mood swings, anger issues and possible lethargy. I would speak to the Psych about this rasie in dosage and ask the reason, also ask if they have read the Strat prescribing info that is readily available on their website.
She should have been started at 10mgs and ramped much more evenly,I would see a Psychiatrist instead of a ped, as they know alot more about ADHD meds and aremore qualified to diagnose and prescribe.
edbson39312.8287847222Look for a more experienced child psychiatrist who specializes in medication management....My son is 5 yrs old, and 55 lbs. He is on straterra. 10 mg morning and 18 mg in evening. From what i've read, I guess his mg is low and should be around 30 mg for his weight. He's taken it long enough I can tell he needs more mg.Thanks for the info! Very interesting.
Edbson and NoTellin
I just wanted to share with you a little info that my pediatric psychiatrist shared with me in response to questions regarding my daughters high Strattera dose.
She said that 60mg would be considered an "off label" use but this dose is routinely prescribed with good success when pts do not respond to the target dose. She mentioned something about how each body metabolizes this drug differently and some people can't break it down as easily as others. She said that in doses higher than 1.8mg/kg, side effects often occur more frequently in the average population but not in kids that experience few side effects initially.
I contacted Eli Lilly, the manufacturer, to see what they had to say and they basically confirmed that information. They have tested Strattera in drug studies up to 3mg/kg and have published the results. It does appear that side effects often become too bothersome in doses higher than 1.8 and that's why it is the maximum recommended dose.
The medical information dept emailed me info from the drug studies using higher doses of Strattera. I think that there were 3 drug studies completed. I would be happy to email them to you if you're interested. I noticed that both of you seem very knowledgeable about Strattera.
After much thought, I decided to slowly increase the Strattera up to 50mg. She just started that dose Fri night and is doing fine. I will keep you posted as to the side effects and effectiveness.
Thanks for your advice
MK
I have a dosing question for edbson and all. Everywhere I've looked it says start Strattera at .5mg/kg for three days then go to target dose. You guys are saying it's better to continue to increase the dose in increments???? Example, 10mg, then 18mg, then 25mg like that? Or am I mistaken? If so, where did you find that information and how does it get prescribed? I wouldnt want to fill 3 or 4 different prescriptions for three pills. We see p-doc next week and I think my daughter and I have come to the decision that Daytrana is just not working ideally for her, at least not Daytrana alone. I am pretty sure we'll be going to Strattera. She seems a good candidate for Strattera. It sounds like it works very much like the tricyclic antidepressants and she did very well on those (just not quite enough for focus and attention for school).
Also she is 80 pounds so if I figure it right her target dose will be 50mg?
Thansk in advance!
Diane V39396.5101041667Lily my daughter is 54 pounds, 7 yrs. old also. I would be concerned with why they want to up her dosage? Does the 25mg's seem to be taking affect ?
I would not be comfortable with 60mg's either. My daughter is on day 5 of Straterra, her Pedia did 3 days of 10mg, 3days of 18mg and ending up with a target of 25mg. And staying on track with 25mg. I've already seen a change for the better in my daughter. Other than the tiredness but it only comes in periods, its not all day.
I do not also like the idea that Physchiatrist are doing it two increments in one day. One in the morning, and one in the evening. I don't know , I'm new at all this and my child was just diagnosed. But Straterra is an all day working medicine. I don' know, I guess different kids/adults obsorb these high dosages badly sometimes, so maybe thats why I keep seeing that kids are taking two pills a day??
well Diane, my daughters pedia gave me the samples of 10mg, 18mg then 25md...ending with target dosgae of 25mg's. I will settle with that dosage, because I also do ADD natural parenting process on my own with my daughter. So I'm not going any higher, I don't care what they say. I don't want the pill to fix everything and make her perfect, I'm doing med's and my own strategies with her. IT'S WORKING!!!!