Straterra Dosing Question | ADHD Information

My teenage son has been medicated for ADHD for almost five years.  For the first four of those, he took Adderall and then Concerta.  Both of them were extremely effective in helping him with his academics, but they were severe in the way they impacted his appetite (he frequently ate part of ONE meal a day, skipping both breakfast and lunch), his social skills (he had basically NO friends), his self-esteem (almost constantly depressed), and his growth (he was in the bottom 20% for both height and weight, and grew something like 1/2 inch in 2 years.

We switched to Straterra as a way of getting away from the Stimulant related side effects.  He is happier than he's ever been in his life.  He sleeps better, he has tons of friends, a very positive self-image, and has grown 3 and 1/2 inches in the seven months on the new medicine!

But his academics are not even close to as good as when he was on the stimulants.

I know that with Adderall and Concerta, the dosage was a big experiment.  With Straterra he is still on his original dose.  What are the "normal" doses?  Are they age dependent?  Is there a time release factor?  Are they weight dependent?

Thanks for any tips or links.

ADHDad

You don't say what dose of Strattera your son is taking.  My 8 year old 47 lb. son is taking both Strattera 40mg and Adderall XR 10mg (also, Lexapro for OCD tendencies).  both of them are timed release medications.  He takes the Strattera and Lexapro in the evening and takes the Adderall XR in the morning.  We are using both because of weight loss and sleep loss associated with a higher dose of the Adderall XR.  Since taking the combination he is still doing well in school and doesn't have the bad side effects of no appetite and sleeplessness.  Also, the rebound in the evening isn't so bad.

I just spoke to the pediatrician about upping his does of Strattera to completely eliminate the Adderall XR.  We are going to try Strattera 60mg over the summer.  Since he won't be in school I won't be able to determine the effects on his academics but I plan on talking to his teacher for next year and letting them know of my sons condition and letting them know we have changed meds over the summer so they can let me know right away if they are seeing any problems.  My sons pediatrician told me that he knows they are working on getting the dosage formula changed for Strattera to up to 2 and 1/2 times what it is now.  My son is currently kind of in the middle of the dosing by weight so he could up the dose.  We are hoping for the best with the increase.  My son has always been just barely on or below the growth charts so the possiblility that the stimulant medications could may his growth even slower concerns me greatly.

ADHDad,

My son has been on Strattera for nearly a year, and the first few months were wonderful!  He had no side effects, he was doing great in school, and he was a pleasure at home.  From what I've noticed and from what I've read on here from a lot of other parents, is that after an extended period of time, the Strattera simply doesn't work as well as it used to.  You can have the dosage increased, and you can play with the times that you give your child the Strattera to find the right dosage time.  My doctor told me that it was supposed to work for up to 12 hours....well, if he had to sit with my kid through dinner, he would know this is not true.  I think the dosage time plays a big part in the use of Strattera, it just all depends on when you need your child to be the most controlled, whether at home or school.  I have heard that with the Strattera, grades do suffer as compared to a stimulant medication.

hello i am the mother of a 20 year young adult who has had adhd..tried ritalin when he was little and to  no avail was a zombie so i took him off the medicine and just winged it..now i am paying the price..in the 2 years quit college joined the military and got out ..got married and divorced 4 months later...i am so worried about him..he does not want medicine he thinks that it will alter his personality...he needs medicine to cope in life...he also bounces checks very impulsive... he is now living again with us..trying to get straight ...but he is still so hyper..always moving around... can't sit still..i need help i want to get him on straterra..need ya'lls opinion..i feel like i have not been the best parent by trying to get help before now..luckily he is not involved with drugs or drinking yet....i worry about him going through life..he won't make it without help...can someone help please..thanks...adhd mom

Debbie,  You should tell your son that the ADHD meds have changed a lot since he was little.  In my experience the current meds to not have the zombie effect unless the dose is too high.  Can you convince him to at least give them a try?  Does he have insurance because they are very expensive?

Hi
I have been reading all these post and I just want to say that Strattera is not like stimulants...Straterra is a weight based medication...meaning that how many mgs goes by how much your child weighs...if you look in the insert and all the trials that were done your child should be taking anywhere from 1.2mg per kgs to 1.8mg per kgs...if you give less or more you will have many more sideeffects such as moodiness and aggression. Straterra must be ramped up meaning that you start low and with 3-4 days you go to your target dose...once you are at your target dose it can take anywhere from 6-8wks to see all benefits of this drug...at the beginning is when you see most side effect and most of the time they go away after a few days. I am not an expert but I have been reading everything I could find about this medication because I believe Dr's do not know all they should about this med and sometimes prescribe it like a stimulant..Please talk to your dr and call eli lily if you have any questions
good luck
Jackie

[QUOTE=debbie]hello i am the mother of a 20 year young adult who has had adhd..tried ritalin when he was little and to  no avail was a zombie so i took him off the medicine and just winged it..now i am paying the price..in the 2 years quit college joined the military and got out ..got married and divorced 4 months later...i am so worried about him..he does not want medicine he thinks that it will alter his personality...he needs medicine to cope in life...he also bounces checks very impulsive... he is now living again with us..trying to get straight ...but he is still so hyper..always moving around... can't sit still..i need help i want to get him on straterra..need ya'lls opinion..i feel like i have not been the best parent by trying to get help before now..luckily he is not involved with drugs or drinking yet....i worry about him going through life..he won't make it without help...can someone help please..thanks...adhd mom[/QUOTE]

Hi Debbie,   my 18yo started on Strattera about 6 months ago.   We also had tried Ritalin and Clonodine (he also has Tourette Syndrome),  and neither one was tolerated very well because of the zombie effect.   So we too just winged it for many years.  The strattera has made a big difference for him.  He is still in high school...his grades are improving,  his concentration is better,  he is less impulsive and hyper,   and much more pleasant (and HAPPIER.)   The main problem he has with the strattera is it made him sleepier,  but he now takes it at night and is now sleeping better and that in itself is helping him.   Explain to your son that it is not like the stimulants.   I know from reading some forums that there are some people who experience side effects from it but they sometimes go away,  but he won't know unless he tries it...and stays with it for a couple of months. 

Don't beat yourself up about his situation....kids don't come with instructions,  and we all just do the best we can.  Good luck to you and your son!

Another Debbie

[QUOTE=wtwingduv]if you look in the insert and all the trials that were done your child should be taking anywhere from 1.2mg per kgs to 1.8mg per kgs...if you give less or more you will have many more sideeffects such as moodiness and aggression.
Jackie [/QUOTE]

Hmmm I am thinking that I am not takin enough then... I go to see the Doctor today, I will be inquiring about this as I am on 60mg a day, I was on 40mg for 4 days, and now i have beena week on 60 mg.  I weigh about 225lbs,  just over 100kgs,  I am getting just uner 0.6 mg/kg, or less than half the recommended dosage??? something is not right, no wonder it does not seem to working as well as the Ritaling ER was for me.

Chris