Strattera dosage | ADHD Information

My son just turned 13 yoa, and is 78 pounds. He has tried stimulants as well as Wellbutrin which have exacerbated his tics. The doc wants to start him on Strattera - he is going to begin him on a "starter pack", then titrate him to an ideal dosage. I am curious what your experience has been with Strattera - side effects, ect... and if it has been a good medication for your child.

 

thanks

My son is only 6.5yo, but I'll tell you our experience. He started taking Straterra about 4 months ago. We began with 10mg for one week. There was an almost immediate difference at school!!! We were a little gun-shy after disasters with various stims. That is why we didn't just do 3 days at 10mg before going to 25mg. But, after the positive results with NO side-effects, we upped him to 25mg.

Even though his reports from school were wonderful, I was having some trouble with him at home after school. I realize now, in hindsight, that it was just a release from the pressure of school, but I thought his meds were wearing off so I talked with the ped and he recommended giving a second dose after school. I didn't think he was supposed to have more than 28mg, but since the doc ok'd it, we started giving him 10mg on top of the 25mg.

It took about a month of playing with amounts and time of day taken to realize that anything over 25mg was just too much for my son. SO...here are some of the side-effects he had when the dose was too high:
Finger picking (the cuticles), shirt chewing (cuffs and collars), night-terrors, crying jags, anger outbursts, hitting at school/home, fidgets, no appetite (though this may have been because he couldn't sit still long enough to eat), bed-wetting, and finally verbal-tics.

I might have missed some, but these were the ones that I couldn't live with. The funny part is that he had all of these symptoms to a lesser degree before any meds, so it seemed like too high a dose of straterra just made them come back worse. Just last week we took him off of the second dose of 10mg, and all of these things have gone away again.

Now, is this a good medication for my child? Yes. But, it isn't the perfect example of covering all the bases. My DS is ADHHHHHHHHD (as some parents describe it). The hyper part has been toned down, but not eliminated by any means. Here are some positive results I have noticed:
No more impulsive hitting, no major outbursts of anger/depression, can focus on homework/schoolwork, isn't as mouthy, is making friends, can join in group activities a little better, participates in testing so that scores are more accurate, and other minor areas of better behaviors all around.

Sorry I rambled a bit, but I have seen positive results for my son with straterra, and on the proper dose there were minimal to no side-effects. I will have to see how his school day is affected now that we dropped the extra mgs as he has been on winter break, but if his behavior at home is any indication, then I think we will see the great results he was having when he first started with the lower dose.

I am curious, when do you give the children the Strattera dose? I read that docs will recommend to start giving them the dose in the evening due to drowsiness, and eventually start in the morning.

Do you notice a difference in daily behavior by giving the dose at night compared to the morning?

Thanks

My son just turned 5 and we switched over to Strattera because the stimulants aggravated his anxiety and sensory problems.  As he got older he needed a higher dose of stimulant to control his hyperactivity and impulsivness but it just aggravated him too much so we tried Strattera. 

The only side effect I've seen is if the dose is too high-he gets REALLY hyper.  That went away as soon as we lowered the dose back down. With my son, the Strattera isn't enough for the hyper/impulse problems so we added a small dose of Ritalin and it's been working very well!  The Strattera allowed us to cut the Ritalin in 1/2 and doesn't aggravate him!   

We never tried giving it at night. I've always given it in the morning without any drowsiness that I've noticed. But kids are all different, and my son is sooooo hyper, that I'm not sure a sleeping pill would make him drowsy! Lol

We give my son 2 doses per day.  One in the morning and one in the afternoon.  It's supposed to be a "24 hr" medication but since my son metabolizes the meds soooooo quickly his doc has him on 2 doses per day. 

He did get sleepy for the first several weeks and he'd take naps (which he doesn't normally do) but it wasn't that bad and it went away after about 3-4 weeks. The naps were actually kinda nice!

Here's my update...

Went to the ped neuro yesterday and he changed her dose from 18 mg in the a.m. to 10 mg in the a.m. and 10 mg in the p.m. (with lunch). The hope was that this should decrease the late a.m. sleepiness and keep the results consistent throughout the day.

When I picked her up from school today at noon she was bouncing off the walls. Is it too soon to call the doc and ask to do 18 in the a.m. and 10 in the p.m.? I know you should probably sit on a new dose, but I don't want to be stuck in the weekend w/ this...

Oh, she is 5 years old and 46 pounds, so her target is 25 mg (but we tried that for two weeks and she was overly angry and irritable ).

Advice?

I'm not sure if the doc will think it's too soon but I don't see a problem with at least asking.  When we were ramping up with my son we was stil WILD on 10 mg so the doc let us go up to 20 within days.  We noticed a difference right away with the 20 mg.  So I don't think it's unreasonable to ask about raising the a.m. dose to 18.  What's the worst that can happen?...he says "no, let's wait".

Well, I mentioned before that we dropped my son back down to a lower dose of Straterra. I just wanted to update that right now he is still having some problems with the change. But...in answer to your mg question...it takes a while for things to even out. When my son started he jumped straight from 10mg to 25mg. That transition was smooth.

Now is the harder part. Since he is only 40lbs he was only supposed to be on 28mg, but we upped it to 35mg. Now we are back down to 25mg and he is still having some of the behavior issues he had on the 35mg. We are heading to the doc today to discuss these issues. It may be that a few more weeks are needed to reestablish a nice baseline.

It really does take a bit of time for Straterra to show results, so don't be disappointed if it takes a few weeks. The problem with this is that it can be such a subtle shift that you don't think it is working, or you don't notice the negatives. Either way, I'm sure you will be keeping a close eye on things so that shouldn't be a problem.

Best of luck to you. Keep me posted. I know our son's are in different weight classes, but I'd be interested to hear your opinions on/results with this med.

OK,

We met with the psych today and he gave us a starter pack. My son is 78 pounds, so his target dose is going to be 40 mg. The starter pack contains the following:  5 x 10mg, 5 x 18mg., 5 x 25 mg. and 15 x 40 mg.

Is that common for a starter pack? - I don't think the 10 mg or 18mg is going to do much.

Thanks

We tried giving it at night to counteract the sleepiness around Week 2 or 3. Never again! It seems our daughter metabolizes quickly and it was out of her system by the time she woke up. Crazy, crazy day!

After it has been in her system longer, we might try the night dose again, because she does have a period of tiredness in the late mornings.

I agree w/ the posts that say watch carefully to see if the dose is too high. We worked up to our target dose of 25 mg. and noticed moodiness, etc. We are now back down at 18 mg. and things seems to be going better, although the results are not yet consistent. Still hyper periods at different times of the day, but periods of focus, too, even into the evening. This suprises us because up until last week we didn't think it was lasting through the day. Now we are thinking it just takes a while to get a consistent result. FYI, we are wrapping up Week 5.

It does take a while to see any results with Strattera which can be really frustrating!   But we noticed at least some change within the first week or so.  It just wasn't consistant (at all) until we got up to the right dose and he'd been on it for a while. 

We started with 10mg (my son is about 50 lbs) and very quickly went up to 20mg.  I think it was within a few days...then after about 1 1/2 weeks we tried to go up to 30 mg for the first time and he got really hyper! We went back down to 20 for another week or so and tried to go up to 30 again and the same thing happened.  So we've stayed at 20 mg since.  It took us about 6 weeks to see the "whole" effect.