I promised to follow up on Strattera, and here is my son’s experience. Strattera has only been partially successful with my 10-year old son. Let me first say a little about my son. He has ADD/ADHD combined and has a reading disability although with much tutoring he reads at grade level. He is quite bright IQ-wise but never achieves academically at his ability. Without meds he is quite motoric and, at times, quite silly with impulsivity and lack of organization . A plus for my son is that he has good social skills, is liked by other kids, and has good friends. His mood is positive, loving, and upbeat and always has been. For these strengths, I am very grateful.
My son got past the early withdrawal from Adderall with some real difficulties—irritability, hearing ‘conversations’ in his head, etc. Within two weeks, these symptoms passed. The plus with Strattera is that he eats and sleeps better. The negatives is that it does not control his hyperactivity. My pediatrician is considered an expert in ADHD and just attended the Harvard 3-day conference on ADHD. Fascinating information is emerging from all the research on the neurobiology of ADHD. The researchers are finding that ADD and ADHD kids have differences from one another with different neuropathways involved in each disorder, and kids with the combined type have their own unique issues.
The members of the conference agree that a certain percentage of kids do not have their symptoms controlled well on Strattera, however these experts want to continue Strattera (less mood swings, better appetite, and better sleep) and add another drug to go with it to control motor behavior. If I remember correctly, Strattera deals with one receptor site and drugs like Ritalin deal with another one (Adderall deals with both). My son’s pediatrician is going to add Focalin which I believe is a dopamine receptor site drug seen as particularly aiding with attention and motor control.
My son will take Strattera 40 mg. in the morning along with 5 mg. of Focalin. Between 12-1pm, he will take another 5 mg. of Focalin. He can take a third 5 mg. at 4:30 to 5:30 pm if he has a big school project to work on. I started him on Focalin today and his teacher saw an immediate improvement in motor control, attention, and less silliness. He did get a 3rd dose, and I saw the same improvement this evening. Unfortunately just like with Adderall, he didn’t want to go to sleep until 11:00 pm!!
I also understand that a ritalin-type patch to wear on the back (and to be taken off at night) is coming out in a month or so. Also, Focalin will be long-acting in 6 months or so.
I’ll report back in a month on how this new regimen is working out. As I learn more about the Harvard Project, I’ll share what I learn. I know that the various brains scans are still only used for research purposes, and genetic markers are still a ways down the road. Two longitudenal studies with large samples of ADHD kids is yielding some very useful information about how the symptoms manifest in adult life.
Well, it time for me to nod off. Unlike my son, I’ll be able to sleep immediately!
Re: Seven Weeks on Strattera
I read your message with interest. Is Strattera more effective then for ADD-inattentive kids than those with hyperactivity as well? Some of the reading I have done suggests that kids with ADD-inattentive (no hyperactivity) respond less well to stimulants. In other words, a much larger percent do not respond positively than those with combined ADHD. Perhaps Strattera will work for those kids?
My son is ADD-inattentive, much improved after IM, and we’re still debating the medication issue.
Beth
please keep us posted
the brain stuff fascinates me- I would enjoy reading about it even if I didnt have an ADD child!
It makes sense that there is a definitive reason some drugs work for some kids and not others(other than we are all different metabolicly)
Re: Add't Info
My sense is that most of the current data floating around on Strattera is anecdotal. I believe the anecdotal data from the Harvard meeting is that many hyperactive kids are being helped by Strattera. There is a subgroup of kids on Strattera—like my son—whose attention is just OK but whose hyperactivity is bad. He needs meds that operate at both the dopamine and norepinephrine receptive sites. This may be an aspect of a combined ADD/ADHD diagnosis but nobody knows for sure at present. Focalin is a very clean ritalin-derivative, operating very specifically at the dopamine receptor site and targeting very specific symptoms, e.g. attention and motor control.
Now, I believe that I am already seeing improvement in my son—more focused, less motoric, less silly-Billy. Unfortunately, his sleep was disrupted last night, e.g. at bed at 11:00 pm and up at 3 am for one hour. I have yet to see if the school gives the last dose at 1 pm in the afternoon if my son goes to sleep by 9:30 pm. And, if I don’t give a dose at 5:30 pm, what will my evenings be like with him?
The longitudinal studies are yielding interesting findings. So far only around 5% of kids with the disorder are symptom free as adults. The most common adult symptoms are statistically more divorces and changes of job. The Conner [ADHD] Adult Scale is currently considered the best for diagnosing adults. Also, we all need to keep an eye out for comorbid psychiatric conditions, e.g. Anxiety, Depression, Obsessive-Compulsive Disorder, Bipolar, and Conduct Disorder since they frequently go with ADHD.
I think I’ll stop here. I don’t think I can stand to dispense any more ‘cheer’ tonight.
Re: Add't Info
Am I understanding correctly. The general thought is that strattera works better or provides more benefits to ADHD children as opposed to ADD children I’m sorry i just getting a little confused. I some questions if i need something to keep me focused. I don’t mean to make light of it but I’m sure you all understand the mind gets boggled we are on our 5th med in less then 6 months so the brain is a littel fuzzy„,
Re: Add't Info
My son just turned 12 and is ADD inattentive only. This diagnosis is less than 3 months old. Up until middle school we could manage the lack of focus, etc. I have been working with the resource room and guidance counselor at school on behavioral/envoronment changes since last Fall with some success but not enough to avoid the meds. issue.
First 2 weeks of metadate which had no effect except but to keep him up until all hours. Then 2 weeks of Adderall (10mg. in the AM only-extended release)with good results during the school day, some support at home at night but still the sleeplessness until 11-12 every night. Then Strattera (40mg for 4 days then 60mg. once in the AM). What a nightmare!!!!! Falling asleep at school 2-3 times per day, immediately once he got in the car, etc. etc. He is not very verbal about the meds. stuff but he hated this. He said he felt like he was in a fog, couldn’t focus and was very embarrassed he was falling asleep at school. Despite all this day time sleeping he could get to bed by 10pm. After 4 days of thistried switching meds. to night dosage. Things were a litttle better but still not good. After a total of 7 days on Strattera I called doctor and said I wanted to go back on Adderall and I would deal with the sleeplessness at night until our next appt. the end of the month.
I’m concerned that after a total of 7 weeks on 3 different meds. a good solution hasn’t been found. Any thoughts????? Thanks for letting me vent.
Tom’s Mom
Re: Add't Info
WE too are experiencing “naps” all the sudden and my daughter seems a little quieter then usual and sleepy I am hoping that within the next few weeks these symptoms will pass. I’m not sure but it sounds like maybe you are switiching too quickly, I think that some symtoms reach their peak and then their little bodies adjust and the symptoms seem to decrease as they get used to the meds. This is just my feeling Tom’s Mom I am determined to give Strattera the 30 days that everyone says in necessary. Then and only then will we move on to the next adventure…i mean drug… if necessary. Good Luck
Re: Add't Info
I started my ADHD eight year old on Adderall yesterday (5mg once in the am 6hr) he had a decent day in school but after the 6hrs he became violent and so angry that he couldn’t explain it and he hit another child and was disrespectful to the adult which is so out of character for him. I decieded to go ahead and give him his med again today to see what happens. But has anyone else expeirenced uncharacteristic violent behavior with meds?
Re: ADD vs ADHD & Strattera
I am not sure anyone can answer your question about Strattera being better for ADHD than for ADD. Strattera advertises itself as good for attention and hyperactivity. That indicates to me that they think it works for both ADD and ADHD. But it takes at least one year of being out in the market place for a drug’s side effects and limitations to become clear. Then research needs to be done to see how the anecdotal data holds up when tested in a double blind study with a normal control group. I would imagine that in several years we might have some preliminary answers to your question.
In the meantime, what are we parents to do? What I did was give Strattera a really good trial of 7-8 weeks. It was hard on me, and I suffered a lot. When it worked just OK for my son during school hours, I decided to add an additional drug to the mix. I’ll try that for 6-7 weeks and make a decision based on what I observe with my son. And the new mix is doing pretty good except for the return of delayed sleep problems (just like Adderall) which I may have to live with.
I do know that with my son I cannot go without him being on medication. It is too disastrous for his schooling and for our homelife. After adding Focalin to the Strattera for the first time in 8 weeks, we had a pleasant evening together, e.g. he did his homework in a fairly focused way, we had a pleasant conversation about several topics of interest to him, we played a game together and laughed till we cried. It was wonderful! He still has ADD/ADHD but it is so much better with the new medication regimen.
If I learn anything about kids with only ADD and meds from the research literature, I’ll post it on this bulletin board.
Good luck with your search for what works with your child.
my 11 yr old is ADD inattentive
and takes AdderallXR 20 mg
It did effect sleep for 2-3 wks but the effect wore off steadily. What I have struggled with is that taking him off for weekends, esp extended weekends ,means starting over with the sleeplessness. Less use over the past summer meant we were almost back to day 1 in the fall
I am trying to insist he take it every day-I even bought a pillbox so I can be sure. Two drs have said it is better for an inattentive kid to be on all the time anyway as they are missing so much that is happening around them otherwise-they hear less, pick up less vocabulary. I do believe I am finally accepting that.
He is not a behavior problem and it is so easy not to worry about the meds on weekends and breaks. But Ive learned the hard way and honestly think I already see a better ‘social awareness’
So, give it time-at least 3 full weeks. And think about 365 days/yr when you do find the med that works.
He is rail thin but always has been-being off meds on vacations and even the summer made no significant difference in weight gain for him.(others have had different experiences-you will have to see)
So glad that you’ve seen improvement and pluses w/ Strat.
We unfort didn’t…after 2 wks I had to pull my DD off of Strat…she was totally awful in sch and there was no way I could let her go another 2 wks like that being as disruptive as she was…to make a 30 day Strat “test”.
Good luck and keep us informed on his progress! My DD is 8 yrs.
Loves,
S