Why not stratterra? | ADHD Information

Hi There's2! It's great to see the Straterra is still working for you!   I know that earlier you said she was still more hyper than she was on the stimulants.  Is that still true or did that even out with time?

We are going to try our transition to Straterra this Sunday!  I'm biting my nails!!!  On Sunday he's going to get 1/2 doses of Ritalin and reduced Tenex.  Then Monday we'll start the Straterra  with the reduced Tenex and try not to give him any Ritalin.  This is what the doc wants to do anyway.  I don't think he'll be able to go without his Ritalin until the Straterra is in his system longer but the doc wants to at least try it.  She's open to letting him take both for a while though...whewwww! I'll let you know how it goes...

I am curious as to why more people aren't trying stratterra.  I began the medication journey last spring.  I saw my daughter change from a happy, loving (yet dangerously impulsive) kid to a grumpy, moody, defiant child almost immediately after starting stimulants.  She also developed tics she had never had before.  We tried ritalin (short and long acting), adderall (short and long acting) and focalin.  i was ready to pull her off everything and just try to find a way to "manage" her behaviors rather than have her so unhappy.  We put her on stratterra at the beginning of October and she is doing WONDERFUL!  She is back to her happy, loving self but not so hyper or impulsive.  She is actually cooperative for the first time in her life!  She also has NO more tics.  Her teachers have commented on how wonderful she is doing as well.  I am no doctor but, it seems to me, that part of the reason for the success is that she now has a consistent behavior experience and no longer has medications going in and out of her system all day.  Another bonus is that her behavior remains consistent even if she accidentally misses a dose.

So, why are more people not using this?

Thanks for any input you can offer!

Given that my DS is in the 20% of ADHDers who don't respond well at all to stims, Straterra was a god-send. It's true that it doesn't help very much with the hyperactivity, but his biggest problems at school were with impulsive reactions and inability to concentrate. It has helped tremendously in these areas.
We first tried Metadate ER, but the mood swings were horrible, and as it was wearing off he would rock and cry for hours and say he was "just so sad and didn't know why." He tried to "kill" himself by riding his bike off a hill-side, and then cried uncontrollably because it "didn't work."
I didn't want to give-up on him, so we tried a different stim family in the short-acting form, so that the effects wouldn't drag on. This time, I only gave him 5mg of Adderall, and he sure was able to sit still. He sat for hours, in the same spot, hyper-obsessing about his bakugan, with a motor mouth running at top speed. Remember, this med was only supposed to be short-acting. Two days later he "came down," and was so depressed his teacher called me and said he had been crying off and on all day.
Well, I was gun-shy to try another med. Even the ped was confused, because in his 20 years of treating ADHD, he had NEVER had a child not respond to stims (even though the experts say 20% don't). The ped had prescribed Straterra before, so he said let's try this one last med before consulting the psychiatrist.
I just have to say, I was pleasantly surprised that there were none of the nasties, and some of the ADD/ODD behaviors were kept to a minimum. Hyperactivity gone? No, but DS is 6 yrs-old, I think it's ok for there to be some hyperactivity in a little guy like him.
His 2nd quarter report card was greatly improved, he hasn't had one office referral since starting Straterra, he's taking more responsibility for his actions, and is actually making friends at school.
It hasn't been a miracle "cure" by any means, but for us, it's been just what we needed.   The problem with Strattera is that it has some annoying side effects by itself + is not as effective as stimulants.  For instance, it is only slightly better than placebo in treating ADHD symptoms, while stimulants are a good deal better.

25% of people stop taking Strattera because they don't think it works that well.  and it makes a non-insigficnant amount of people who take it suicidal.

(taken from Strattera, side effects, uses)

on the other hand, it can provide full day coverage with just 1-2 doses...


Strattera was the first ADHD drug we tried when my son was diagnosed. We ended up not using it for long. Why? Because it made him unbelievably nauseous. He stuck with it for over 3 weeks, puking some days at school. He stuck with it because even though he was only 7, he was determined to "get better" behavior-wise. :(

After 3 weeks of nausea and puking, with zero benefit at all, we decided to abandon it.

Fortunately, he responds extremely well to stimulants, although the side effects of appetite suppression and sleeplessness continue to be big issues for him, especially the sleeplessness.

Procrastinator, have you tried to add anything to help the sleeplessness like maybe Tenex or Clonidine?  They are supposed to really help for the sleepn issues.

Question to "Logans mom" Just curious on how the Strattera is working?  My son 8 as been on the Vyvansse for about one week and we are noticing an improvement with his impulsivness but not really with foucs.  Since going back to school the teachers have commented that is attitude is "great" but is talking about everything that pops into is mind, very talkative.  We just don't know if we need to continue a while with the Vyvansse maybe even at a higher dose or think aobut switching to Stratera.  As I stated earlier my little guy as a lot of anxiety, separation, OCD, etc. as well as ADD/ADHD What are your thought?

Thanks

Hi rgtaylor! Right now the Stratter is working very well but it's been kind of a roller coaster!  At first he was very hyper because it hadn't kicked in yet and he was completely off the stimulants.  Then he got better as it started to kick in for a few days and then he got worse again!  We figured out that the dose had gotten too high and as soon as we backed it off a little he got better again.  He's been very good for two days now so our fingers are crossed! 

The main positive that I've noticed so far is that he's much "smoother".  I know that's a weird way to say it but it's true!  He is just calmer- not as rigid, not as emotional...just smoother!  He's still had some episodes where he's overreacted to things and gotten over emotional and the doc is adjusting his Tenex to compensate for that.  As long as we can keep the hyperactivity under control it may work out for us. 

If I had to guess I'd say the excessive talking is either because the dose is too high or it's just the way he reacts to that particular stimulant.  When my son's anxiety was aggravated by Ritalin we added the Tenex and it worked wonders!  But the Strattera has been even better! (so far anyway)  He's still on the Tenex but a smaller dose.  You may want to look into these things for your little guy.  Good luck!

I recently started my son on strattera again. We ahad tried it a couple of years ago and it did not work for him. He had been on concerta for serveral years and was not growing or gaining any weight. Last october 08 I took him off concerta and inthe last year he has gained 35 pounds and grew 6 inches. He is 13 and recently requested that we try something again because he had noticed he needed it to concentrate in school. I did not want to go back to the concerta because of the crappy side effects so we strated strattera. He is doing ok on it now and still has his appetite. The only thing that he complains about is that he gets too sleepy. I definately recommend using this medication for several reasons. He still wants to eat and there are no narcotics in it like the other meds offered for adhd. I know it is not always effective for some children but for those it does work for I would highly suggest it.

New to the board. My son just started with 20mg of Vyvansse along with a year of Zoloft, since he started taking the Vyvansse(day 2) we have noticed excessive talking, along with other common side effects.  My question is does anyone know if the excessice talking will cease? Should we give this medicine a few more days? What about Strattera?  My son is 8 and has had some form of anxiety since a very young age, does anyone think stimulants increase the anxiety?

Thanks for any comment!

Yes they definitely increase anxiety!  That was my son's problem.  The stimulants aggravated his sensory processing problems which made him very anxious all the time.  According to my doc, stimulants are famous for aggravating anxiety.  That's why we added the Tenex to the Ritalin and it works very well calming the anxiety.  But Strattera is supposed to be better for kids with anxiety because it's not supposed to make it worse.  That's why we're giving it a try. 

We are about a week and 1/2 into the Strattera and it hasn't really kicked in all the way for him yet but we already notice that he's not as anxious or emotional now that he's not on the stimulants.  It takes up to 4-5 weeks to get the full effect so we're hoping the hyper activity will get better soon! (Geesh I hope so I'm gettin' worn out! ) 

Stratterra didn't work for us...made everything worse. But she has other conditions besides the ADHD. (Bi polar, ODD) Stratterra can make a child either much better or much worse...for us, it was much worse!

Hi Logansmom!

Thank you for the post.  It is good to hear yet again another positive story of Strattera working.  That will probably be our next step.  We are seeing some positive beahviors with the vyvansse, ex. no more silliness, less hyperactivity, less impulsive behavior but I think b/c of my sons anxiety(OCD) this medicine has made his questions and talking increase which of course it making him have a hard time focusing.  We tried Tenex about a year ago and saw more of a "zombie" effect, i can not remember the dosage though, I would say it was  a low amount.  We are thinking about maybe adding Intuniv with the cocktail of meds he is on or maybe switching to Strattera.  My son is also on Zoloft, which he will be on for a while, that has been the "miracle drug" for him.  His anxiety is pretty high.  Thanks for the advice and hopefully things will continue to improve even more.

rgtaylor

I was wondering how long it took to see the full effects of the Strattera?  My son has had problems with the stimulants (after years of success with them) and is now on Tenex and Risperdal. If this plan doesn't work out the doctor's next line of attack is Straterra.  It makes me nervous because I've heard it can take 4 weeks to see effects.  What was your experience.

Logan's Mom - Why are you switching to Straterra?

It took a little while, but the hyperactivity is definitely under control now!  She is not "passive" by any means but she is now behaving like I would expect any kid her age to for the most part.  We certainly still have our moments.    One thing I didn't mention is that she wants to eat ALL the time!  Lucky for us, she likes fruits and veggies.  She's not gaining weight any more than normal but this is much better than having to time meals based on when she takes a pill!

 

Hope things are going well for you!

Update:

The first day of 1/2 Ritalin was rough. Hyyyyyyper!  Then Monday was no Ritalin but we started the Strattera.  He was unbearably hyper until about 2 hrs after the Strattera then he calmed down a LOT!  I was amazed!  I wasn't expecting that so soon.  Yesterday was a good day but he was sleepy.  Today he's less sleepy, low hyper, but he had a meltdown earlier.  Not sure if that's med related or not???  This med switch thing is so nerve racking!!!

bkrusen, we are trying Strattera because my son has sensory processing disorder and the Ritalin aggravates it.  We've been able to handle it with adding Tenex but as he grows he needs a larger dose of Ritalin.  Each time we try to increase the Ritalin it aggravates him.  He gets anxious and aggitated.  The options were to either increase the Tenex or try Strattera.  The doc didn't want to increase the Tenex yet without trying Strattera first because it is supposed to be better for kids with sensory disorder. So we're giving it a try to see how it goes.  The good thing is that we can always go back to the Ritalin if we need to.

Good luck and keep us all posted! We switched because the Ritalin worked very well for the hyperactivity/impulsiveness but aggravated his anxiety and sensory processing disorder.  As he got older he needed a higher dose of the Ritalin to control the hyper/impulses but every time we tried to increase the Ritalin it made him way to anxious.  The two options were to raise the Tenex (which the doc is hesitant to do because he's so young) or give Straterra a try.  It's supposed to be much better on the anxiety.  We didn't ever try Concerta but we tried the Adderall family and that wasn't good!  I think Concerta is the long acting form of Ritalin isn't it?  If that's true that may be why the doc never tried it because my son doesn't do well on the extended release meds.  If the Strattera doesn't end up working for us we will go back to the Ritalin family along with the Tenex.Thanks for replying.  I have a crazy question to you and others.  It seems that there are several children that do not do well on extended release medicines/stim.  How do you know if this is your child and how do you then determine that you need to switch to a short acting stim.?  We are of course new to the ADHD medications, so along with my sons anxiety, are trying to fiqure out which route to take.  thanks for the inputrtaylor...my DS(11) does not seem to do well on extended release meds because he metabolizes meds very quickly.  On Ritalin LA he was showing signs of his med wearing off about 7hrs after taking it, and it was very obvious.  Same with Intuniv.  It is supposed to be a 24hr extended release, but it seems to wear off after about 9hrs or so.  It also did not control his tics as well.  He is back on Tenex twice a day, it just works better for him.  Also, the Daytrana patch has worked very well for DS.  It bypasses the stomach since it is a transdermal patch.  This works much better for DS. Okay, so with the extended release pills, there is a chance of the meds wearing off and with a short acting med. you then have the possiblity of adding a second dosage?  So I am quessing with meds such as Concerta, Vyvanse, Ritlain LA, these are extended release meds. that cannot be given twice a day.  And with  the short acting  there is the possibilty of taking a second dosage if needed.  It is nice to have this message board, especially since my DD has never explained this to me.  Also, do you see any difference in the meds, such more foucs with one than the other, lack of appetite with one than the other, etc.  thanks for your help

With the long acting meds there are two types of "beads" in the capsule.  One set disolves immediately and goes into the system.  The second set is supposed to disolve hours later. With Adderall I think it was supposed to be 6 hours later. The idea is that you get 12 hours of "steady" coverage of medicine.

My son's problem was like heatherr1's.  My son metabolizes the medication super fast!  The first beads were supposed to last 6 hours before the second ones kicked in but my son had metabolized the first beads in 3 hrs!  So this left him without meds in the middle for about 3 hours.  It wasn't pretty!  Then after the second beads kicked in he would only get about 3 hrs.  We went back to the short acting so he could take a pill every 4 hours.  We eventually switched to the short acting Ritalin and sometimes he needed it every 3 hours.  The short acting allows you to put the doses closer together.  And yes sometimes kids can be on two long acting doses per day it just depends on the child and the doctor. It can interfere with sleep more than the short acting though because it's in the system longer into the evening if the child takes two doses per day.

As for the side effects on different meds it is truly individual to each child.  What works for one may not work at all for another so it's hard to say what side effects you may get on a certain med.  That being said...my son did much better on Ritalin vs Adderall.  He was less emotional, less rebound, his appetite was better etc.

Hi everybody!

With Alyssa, it wasn't a problem of the med wearing off.  The ER meds actually aggravated the tics that had been caused by the stimulant in the first place.  She had no tics, tried ritalin.  The ritalin appeared to be working so we went tothe extended release.  Right away she developed a tic of clearing her throat.  Went back to the regular and the tic did not go away so we switched to adderall.  The tic didn't go away so we thought it was just something new she was developing bc her hyperactivity was controlled (though she became very angry and hateful!).  When we tried an ER adderall, she cleared her thraot as much as 18 times PER MINUTE!  We gave it to her one day only!  We tried other stimulants but they just made her anxiety and mood horrible.  We finally switched to stratterra.  It took a few weeks but guess what, NO MORE TICS!  They have completely disappeared.

SO, there must just be an ingredient that makes it time release that some kids just can't tolerate.

To Logan's mom,

  I'm glad things are working well for you and your son, I know it has to feel so good knowing that you are now on the right track.  A few questions I have is why did you stop the Ritalin?  Did you ever try Concerta (from what I hear it is in the same field as Ritalin, just maybe a bit "softer")?  We have currently stopped taking the Vyvanse (ocd was too much) our DD wants us to know try Concerta along with the Zoloft with the possiblity of adding Tenex/Intuniv if needed.  This combo does not work then I think our next option is Strattera.  Just curious as to why you switched from Ritalin to Strattera, where you still seeing lots of anxiety?  thanks