Strattera for kids | ADHD Information

We took DD off the Strat cold turkey, although NOT by choice. We were evacuated for 19 days after Hurricane Rita, and ran out.....With no electricity no pharmacies were open. We were already in the Daytrana Phase 3 trials, and they wanted her off the Strat anyways.

With Tenex, I backed her 1/4 mg a day until she was off of it( took 2 days). She was having really big spikes and lows in blood pressure, so not going there again.

Thanks for the info.  How was it cold turkey?  Not that I would choose that way!!!  I think things are going so well, then I am a little late with meds on the weekend and I feel that he really still needs them!!! Hey Edbson:  Now that you have gotten my son ramped up to a working dose of strattera, I have a new question for you.  (Just joking, Edbson does not prescribe anything, just has good dosing info)  I had my son tested for amino imbalance and he was really a mess!  We have been working our way through the protocol adding the next thing every 3 or four days.  Finally got through the list and it is going very well.  I plan to wean off of Tenex first, and then after a time wean off of strattera.  How quickly did you back off for your daughter?  I will need to wait until a school break, probably Christmas depending on how slow I will need to go.  He currently takes 40's.   I am in agreement, dosing strattera needs to go very slowly and with each change things can get anxious, however that just seems to smooth out. So I am thinking I can wean off pretty quickly.  Your experience was full of changes and so you really have no idea how it would have gone with the same old boring routine.  I know that weaning off of concerta there are about 2 days that are pretty reboundish. (just making up my own words here)  I can go 40, where we are now...36..30..20..10.  Four days and 16 days for Christmas break.  Just might work out.  I am trying not to get too hopeful for the Amino therapy to work but the Dr said 3 months should make a big difference. Will keep you posted.

She was fine cold turkey, no problems whatsoever. We had No Daytrana with us, and she was off meds entirely for about 2 weeks. DID GREAT!

I should mention though that she was out of school for a month, (hurricane) and was occupied the entire time. We evacuated to a resort camping ground, so she was tent camping for a month, every kids dream come true!

Hello everyone,

Wish I had found this place years ago, but I finally made it.  My almost 8-year-old son has been on stimulant meds since he was 5.  I cannot begin to tell you what a relief medicating him was initially because he had been extremely difficult since birth, which is another long story in itself.  I believe that he is "textbook" ADHD and at the far end of the hyper/movement driven spectrum.  His first medication was Ritalin LA which completely changed our lives -- for the first time we really understood, deep down, that we weren't bad parents but that his brain chemistry wasn't working for him.  Although he tolerated that well, it didn't last long enough, so the psychiatrist put him on Concerta.  That was wonderful until it became a complete disaster.  After about a month, he began hallucinating and obsessing and wanting to put make-up on me (a very weird side effect when he gets too much methylphenidate).  I believe that the Concerta dose was too high and that he metabolized it slowly until he had a larger and larger amount in his bloodstream.  We quit that cold turkey and went to Focalin.  No difference between that and the Ritalin LA.  The best medication so far has been Daytrana (15 mg).

As my son gets older, he has more and more anxiety issues.  Fear of death, fear of bad storms, fear of bees and mosquitoes. He has massive panic attacks that can last anywhere from a few minutes to days.  He has always been moody -- swinging from sweet to angry over the course of the day.

So the psychiatrist would like to try him on Strattera to help his anxiety and ADHD at the same time.  He has had 4 doses of 18 mg. and has had terrible nightmares in the stage between being awake and falling asleep (which wake him up again).  I have been reading the internet for information on Strattera, and everything I have found has been negative.  I realize that people who post tend to post bad events -- why bother if things are going well, right?  This forum seems a lot more grounded in reality than most on the web, so I would like to hear your opinions about this medication and its side effects. 

I personally feel very comfortable continuing with Daytrana and dealing with the anxiety with therapy for now, but I am wondering if the methylphenidate is contributing to the anxiety (he is anxious whether he is on or off the meds, so I don't see a direct correlation).  I feel less comfortable since Strattera is only a few years old and I can't just pull it off or wait a few hours if something starts to go wrong.  The build-up takes a long time and I assume that tapering off would as well. 

One other issue that I have is that his psychiatrist is part of the drug trials for Strattera.  I feel that she pushes drugs very quickly but is not as fast to recommend therapy.  I know that our son needs a medication, but I am wondering how smart it is to keep switching, especially since methylphenidate is a well-known, well-researched, old drug and Strattera is too new to know how kids' brains will deal with it in the long term.  I am starting to consider switching doctors to someone more conservative and more willing to consider non-drug interventions, although our current one is a very well-respected person in the field.

Any opinions would be appreciated, especially if you have a child who went from a methylphenidate based med to Strattera.

Thanks -- Joy
Hi Joy and welcome. My daughter has been on quite a few different meds for the past 4 years. Most with significant side effects. We are looking to possibly begin Strattera over the next few weeks if what we trying now doesnt work (it's not going to, by now I know). So although I cant give advice what to do, I can say I'm sort of in the same boat. We discussed going to either Strattera or Daytrana next. I'm very worried about reintroducing stimulant due to her horrible side effects and how much her anxiety increases on stims, so my choice is the Strattera. Anything you start you can stop. One of the reasons we kept sticking to different stims was becaue we could start and stop all with quick answers. For su that didnt work. So we will now just try to be patient. There are lots and lots of people who have good success with both Strattera and Daytrana.

Yes, the initial dose was too high. Seven days at 10 mg is where you should have started, then go to 18 mg for seven days. If you don't ramp slowly you get side effects.

Hello Diane and everyone,

Well, I guess I've answered my own question.  After 4 days on Strattera, my son became extremely angry this morning (as in seemingly possessed) because he couldn't watch TV for an hour.  He is very intense and has tried to hurt his sister.  Luckily, he is able to tell me how he is feeling and said that he liked the new medication because it helped him sleep (he is sleeping very soundly and too long) but he said that he felt like he "wanted to hurt [his sister] again."  This is completely bizarre and unacceptable.  Give me the anxiety any day over these kinds of thoughts. 

Now I have to keep him busy and contained until it's out of his system.  Uggghh. 

Joy2

oh boy, that's discouraging .

Good luck

Strat is extremely weight/dose sensitive, started too high( 18 mg is too high) it will cause problems. It HAS to be ramped from 10 mg. to the target dose. Target dose is 1.2-1.8mgs per kilo of body weight.

It is a good med, and it does work for some, but it has to be dosed properly.

Thanks for your replies.  So, now what do I do?  Go to this well-respected psychiatrist and tell her that the dosage was too high?  Cut him off cold turkey?  That is my tendency right now since he can function pretty well with Daytrana.  He is telling me that he feels "very crabby" and "angry" today.  Not good side effects, I would say.

He has never had a full work-up, although he obviously has ADHD.  Maybe I need to try a large hospital child psychiatry department (which I do have available, since I'm in a large city).  I'm at a loss right now.  I feel like we are being used as guinea pigs.

Joy2
I agree with No tellin, start low and slow, and keep in mind it takes about 4 weeks onvce you reach the target dose to see actual results. I am new to this forum, but my daughter has ADHD, and has been on Adderall XR for 3 years, and she started having some pretty major anxiety issues, so now her doctor is trying her on Strattera, he started her at the lowest dose and worked the way up 40mg this week, it seems like it is helping, but it has not completely controlled the problem. I am desperate for help, I am on the verge of losing my job for being late, and calling off because she won't get ready for school.

Joy2 We've never tryed strattera and know that it can work for some but it does take a long time to see the results. Our child pyschiatrist says it only works in 10-15% of patients. It seems as though you have not tryed adderall XR or vyvanse. Both are long acting stimulants in a different class than the ritalin drugs. I would be more likely to try one of those as sometimes a different stimulant can work wonders. Both of my kids have had great success with adderall. Vyvanse is not supposed to cause as much anxiety.

Good Luck!

We added Stratter to Concerta for ou dd -it took about 2 weeks before changes, then a full 2 months before it reached max effectivenes.

It didn't happen over night and it is ever changing to fogure out what motivates her in the am- we finally hit upon it after frustration with her sneaking down to help herself to fridge items (ice cream, cake, and cookies!!!).

We found a behavior mod plan, in addition to a set am routine really helped my dd get going in the morning. Now that she is 8, we have taught her how to use the microwave to heat up her own breakfast - she LOVES that. She can have leftovers, microwaveable breakfast items, you name it. As long as she make reasonable progress and minnimal drama in the am.

The bonus for us is the skinny little thing actually gets some calories in and there is not a battle over the breakfast menu, plus, she learns some independence. So what that yesterday she had mashed potatoes and turkey sausage for breakfast and pizza today? She eats breakfast, she gets ready on time, and might even put on a little weight.

Your child may have no interest in control over breakfast, but maybe it is something else - you fixing her hair special, packing her own snack, money, stickers,  or something along those lines...

Joy 2

My daughter is presently on 50mg of Strattera.  She is doing pretty well.  I can't say that all of her ADHD symptoms have improved but the ones that did, have gotten signicicantly better.  PLUS, she has no more anxiety. 

She tried concerta for a few months and had severe anxiety.  Her anxiety regarding insects inevitably worsened to hallucinations involving spiders.  It was very scary. 

Then she tried focalin.  Immediately she became anxious about flies/bees.  We knew that it had to be the medicine so we stopped it as well.  The anxiety resolved almost immediately.

We consulted a pediatric psychiatrist who recommeded strattera.  When she first started the medicine, she was very irritable for a few days.  It seemed to happen with each dose increase as well but usually only lasted for a few days.

My daughter is now on 50mg, which is higher than the recommended dose.  However, the psychiatrist prescribes it as "off label" because there have been several clinical trials that have studied strattera is doses all the way up to 3mg/kg with success.  Beyond 1.8 mg/kg many kids start experiencing side effects such as fatigue so 1.8mg/kg remains the highest recommended dose.  My daughter never had any side effects except for dry mouth in the beginning and irritability.

There are some parts of her ADHD that remain almost untreated because Strattera doesn't control all symptoms like the stimulants do.  It's just a trade off.  I prefer some ADD and and no anxiety rather that no ADHD and high anxiety.

I just got my daughter's midterms on Friday and so far she has straight A's.  She quite messy and disorganized still but she is able to focus.  She still talks a lot but we're trying to manage that with some behavior mod. 

Good luck to you.  It is a very difficult decision.  It seems even more difficult because our children are in school and so much more is expected of them.  You might always wonder if it would have worked if you don't give it a try.  I let my daughter's teacher know right away that we were experimenting with some new meds and that she might need some extra help at school.

 

 

 

 

 

I would talk to the doctor and tell him/her that your child is having major side effects and that you really want to start at a lower dosage, and work your way up as slowly as possible. That way you can give the med a legitimate try. If the doctor will not do it (says you are wrong or whatever), I'd find another doctor.lori603, if the morning routine is the problem you might want the check the marbles thread and get a similar rewards program in place. Just make a list of each activity and how many marbles she gets for each. Like brush teeth in 5 minutes, etc. Then she comes up with some rewards and you assign a marble value to the rewards so that she can earn them. Worked like a charm for me, and our mornings used to be horrible.

[QUOTE=lori603]I am new to this forum, but my daughter has ADHD, and has been on Adderall XR for 3 years, and she started having some pretty major anxiety issues, so now her doctor is trying her on Strattera, he started her at the lowest dose and worked the way up 40mg this week, it seems like it is helping, but it has not completely controlled the problem. I am desperate for help, I am on the verge of losing my job for being late, and calling off because she won't get ready for school.[/QUOTE]

 

What is her weight? Strat is dosed at 1.2-1.8 mgs per kilo, so if it has been more than 6 weeks, and is not working chances are the dose is wrong. Doses beyond 1.8 mgs can cause liver problems, thus the reason to ramp Start.

edbson39343.5386342593Hi Lily,

Happy to hear that Strattera works very well for some kids.  We have gone back to a methylphenidate regime.  My son has also had the fear of insects with Ritalin -likeproducts, but only when the dose gets a little too high.  There is a fine line with him.  When the dosage was really too high (Concerta and also Daytrana once on a very hot day), he started to hallucinate as well.  At least it's out of the body within hours, not days or weeks.

It's interesting that so many kids get the bug anxiety and hallucinations on methylphenidate.  Wonder why that is, neurologically speaking?  Seems like something left over from our reptilian brains.

I made an appointment for us/him to have a comprehensive evaluation by a developmental team.  Luckily, we have a very large hospital close by that can offer something like that.  It will take a number of days to get through, but we will hopefully have a much more complete picture when it's done.

I really appreciate this forum and all of the great information on it.  It's wonderful to have a place to speak neutrally about medications and alternatives without people who don't understand or live with the condition questioning our decisions.

Joy2