straterra question

Both of these side effects are common and tend to go away after a few weeks. It will take up to 6 weeks before you see the full affect of Strattera.

If you need more info on Strattera go to www. ADHD.com Medication board. Lots of people there have experience with it. I am going to post you some info that has been compiled by Millermom from the experiences and input from the moms on that site.

quote:

This post is very similar to the first one we gathered info on. I did update with newer findings and experiences regarding dosing levels and comorbs, adult dosing, inhalation and overlapping stims.
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Our collaborated effort to collect experiences on
Strat has turned out some fantastic information even
our doctors aren’t giving. Thanks to everyone who took
the time to share thier experiences, I think it’s safe
to say, we wrote the book on this Med! Anyway, I
realized on some other boards that there were loads of
people planning on switching to Strattera over the
summer. I wanted to post the tips we have learned and
shared with each other, not just for the newer
members, but for the older members who don’t want to
wade through the dozens of posts. Of coarse I cannot
post it all but here are the biggies;
First; this isn’t a med you want to start in the
middle of improtant times in their lives. I highly
recommend starting in summer. You can have results in
4 days or up to 6 weeks. Usually it is 4 weeks to see
consistant full effects. It can, temporarily, make
kids hyper and emotional and angry if they are med
sensitive or coming off amphets. There are also side
effects in the beginning as the liver learns how to
handle this med, the first few weeks. If you don’t get
to 4 weeks, you haven’t tried this med and put your
child through an ordeal for nothing. Impulsiveness and
hyperness are sometimes the last symtoms this kicks in
for. So hang in there.
Second; The target dose should be at least 1.2mgs for
every 2.2 lbs of body weight. If you aren’t good with
formulas, you divide his weight by 2.2, then multiply
that # by 1.2. That will give you the mgs you need to
work up to. I am constantly shocked at how many
scaredycat doctors are perscribing doses too low, or
that they up it too high like stims to see better
results. You can read much of this in the script
insert. A low dose has almost no effect except
moodswings, a high dose can cause rage and is a
dangerous game to play with a childs blood pressure.
This is not like the other meds, there is only one
right dose and it is completely size dependant. There
are no increased effects over 1.8mgs per 2.2 and very
poor inconsistant effects on less than 1.2mgs. I do
not recommend going to the 1.8, the best results are
somewhere nicely in the middle of min and max.
Unfortunately, this med comes in limited mgs sizes
right now and a few mgs can make a big difference.
For some kids it can be tricky finding the perfect
dose where you get max theraputic bennies without any
mood changes. Hopefully the makers will catch on and
make the doses in more specific increments. I think
if they made them by the 5 mgs, a lot more people
would be successfull with this. If you are going to
resort to opening the capsules for any reason, PLEASE
BE CAREFUL, inhaling this powder can cause serious
repiratory problems!
In adults, and children over 70 pounds the dosing is a
little trickier and sometimes the formula won’t be
accurate. here is whats recommended for the over 70
pound crowd;
Dosing of children and adolescents over 70 kg body
weight and adults - STRATTERA should be initiated at a
total daily dose of 25mgs, and increased after a
minimum of 3 days to a target total daily dose of 40
mg to 80 mgs depending on thier weight. After 2 to 4
additional weeks, the dose may be increased to a
maximum of 100 mg in patients who have not achieved an
optimal response. There are no data that support
increased effectiveness at higher doses regardless of
weight(see CLINICAL STUDIES).
The maximum recommended total daily dose in children
and adolescents over 70 kg and adults is 100 mg.
Third; Children and adults as well need to start on
low doses. They recommend 4 days, at a starting dose,
I say 8 with kids, from my experience. I also
recommend the first two weeks be given at night,
before bedtime. In the beginnining most kids have
extreme lethargy and stomach aches a few hours after
taking this med, not things you want happening in the
middle of the day for two weeks. At night, they sleep
through this and any other side effects. Don’t beleive
that you can give this on an empty stomach. I
recommend a high Carb meal! Don’t let the side effects
deter you, they go away 95% of the time and only
return when they are sick and run down or very tired
from too little sleep or take a main dose on an empty
stomach. If they do not go away, unfortunatley, this
might be the wrong med for you.
Contrary to claim’s, you have to have to have to take
this on a full stomach. FULL! Another contrary, this
is not an all day med for many kids. It wears off the
important symptoms by 5-6 hours, mostly hyperactivity
and impulsiveness so don’t expect to see results until
you go to administering this in the morning. It does
seem to help focus most of the day, but its irrelevant
when you have some fast forward sitcom going on
everyday by 2:30. That brings me to my next tip.
Fourth; Once you are up and running on target dose and
seeing good results, if it seems to be wearing off a
little, ask the doctor for two smaller sized doses
instead of the one big one, one before school and one
after school. This not only prolongs the positive
effects until bedtime, but really gives a boost to the
day over all. I recommend the morning dose be the
larger. For example, my son is 58lbs he takes 25mgs in
the morning and 10 after school. The 10 mgs alone
would do nothing, but what a whallop it packs as an
addition! It almost seems to wake up or bring back
some of that morning dose. We were very happy with the
results of one dose and would have gladly settled, but
our neuro recommended this and what a difference it
made! This tip is the one I get the most thanks on as
it really makes a huge difference, both in length of
effectiveness and dimishment of side effects. If you
have an experienced doctor, he may even perscribe it
this way without you asking. It is becoming a very
common trend as people learn more about this.
Fifth; Just some warnings. If you miss a dose, give it
asap! My son isn’t very sensitive but gets emotional
if it’s even 3 or 4 hours late, especially that
morning dose. Remember it has antidepressant
properties. Also, if I give my son the second dose any
later than 4pm, he has nightmares all night long, I
mean all night! (this is common but not across the
board). My theory is that if it is still at an
effectual level in his system, what would normally be
a fleeting tangential series of dreams has the power
to develope into a nightmare. He never had nightmares
before (rarely). Lastly, if your child has been on
amphets for some time, watch the weight gain on the
Strat! Some kids are eating themselves right into
needing a higher dose and just as they reach 3-4 weeks
when they should be having results, parents are
mistakenly thinking the stuff doesn’t work. Keep an
eye on the weight. Adjust the dose accordingly.
Sixth; When things go wrong; For many kids, Strat
weakens when its up against the wall. By that I mean,
when kids are sick or tired or run down, or in a
new/overwhelming situation it can appear they aren’t
on meds at all. Maybe its a metabolism thing, I’m
unsure. But I have heard many tell of this and it has
been my own experience as well. Keep giving the dose
every day. Stoppoing will only let the levels in his
system drop and you will need to ramp up again. The
levels drop much quicker than they ramp up so its
important not to miss more than an occasional day.
Also, if your child shows signs of being too highly
dosed (angry, weepy, easily agitated) and there is no
significant weight loss that would require a dose
adjustment, there could be a build up in their system.
For whatever reason (usually metabolic) the med
levels are getting too high and they need a little
temporary lowering. I did this for 3 weeks over the
summer, dropped him down 10 mgs and he came around
nicely. I don’t know how or why he needed this but it
worked and I may have to do it regularly. If your
child has regular metabolizing problems, this med is
going to be hard to work as the levels in their system
need to be consistant.
Seventh; When to give up. If you child has a comorb
other than tics or mild depression, this med has a
higher failure rate (according to the polls we did).
This isn’t a fix all med. It might make other
disorders worse, just like stims do. At its best, its
not going to cover all your bases. I’m not saying if
this fails, your child has another disorder, I will
say it is a red flag that maybe there is something
else going on. I have seen Strat work nice with the
anxious child and even the bipolar child, but just as
often it doesn’t help these disorders and can even
exasperate them.
If you are still having trouble with activity levels,
I have met many people using very low doses of stims
along with it, just to pick up the slack. This med is
very mix friendly with the exception of some asthma
meds and MAO inhibitors. Over lapping stims is a nice
way to ramp up as well, having less negative effect on
school work and behavior, especially for the child
with a heavey side of Hyper.
If you see any positive effects in the first week or
two, that is a good sign. Stick it out. If you don’t
get to 4 weeks on the target dose (6 for very hyper
kids), you never really tried this med, and you could
be cheating your child out of a very nice, side effect
free treatment. My most favorite thing about this med
is that it changed nothing about his core. He is now
the boy who has been stuck inside himself all his life
and he is very very happy to be out and about and in
control of his brain. It has helped in all areas,
academics, sports, family, friends, self esteme,
everything. Still it doesn’t overpower him, he still
has good days and bad days, happy days and sad days.
It doesn’t define him like the other meds we have
tried, it just sort of released him. I have only
stopped crying about a month ago. If your child takes
Strat and is not happy and has negative personality
changes, again, this may be bad news.
Thats all I got, I think. I am not a doctor, nor am
crusading against Stims, I know they help many many
kids, I must admit they helped my son concentraite
great at school, but there was a stranger living in
our house and he was miserable, we all were. Plus they
really worsened his tics. I think there are a lot of
kids out there like mine, and this is a great
alternative. For a long time, we have been stuck
envying the kids who were helped by stims. Now there
is something for us, too. Plus they eat and sleep and
grow on this stuff. I can’t think of three more
important things my kids need to do. We also had an
unexpected perk. DS’s tics, which began at 2yo,
(beleived PANDAS induced) have near completely
stopped. When he misses a dose of Strat they come
right back within a few hours. I have read of a few
cases where it worsened or brought on tics, but
overwhelmingly I read it stops or deminishes tics more
than the meds perscribed to help with tics. Truth be
told, if Strat stopped working on my sons ADD, we’d
keep him on it for its tic bennies. We have tried
everything and this is the only thing that has stopped
his tics. Well, there are mild ones but only a mom
would notice. For all intensive purposes, the tics
are gone.
Good luck, I hope there were people interested in what
we have learned, this was one heck of a long post.
Thanks again to everyone who shared their tricks and
everyone else who tried them and gave them a thumbs
up. I hope our combined efforts help some parents find
that this is the a great alternative for their child.

Unquote

Goodluck

my almost 12 yr old son is on day 8 of the 25/40mg starter package and this is the first day he has not been horribly tired. I visited the other board recommended and posted a tiredness question a few days back.

It is pretty overwhelming and we homeschool-its hard to imagine this with a full day of school-Im sure he would fall asleep.

I see why summer is the best time for this med

Everything I read says you have to give it the full 4-6 weeks unless, of course, you are seeing something that indicates danger for your child. I didnt notice any difference when he started the 40mg so it seems more like a ramp up symptom than a dose issue.

He did not have any stomach issues-we take it at night before bed and his stomach is probably pretty empty by then. Im surprised that part went so smoothly

Otherwise, things seem the same here. Impulsiveness definitely not improving yet but Im determined to go the distance . He was a bag of bones on the Adderall.

Our ped told us that Stratterra would cause the tiredness…so she told us to give it to him at night, after dinner, before bed. She said that it is a 24 hour medication, and unlike Adderall it will not wear off in 8 hours (which was happening with my stepson).

Our ped told us that Stratterra would cause the tiredness…so she told us to give it to him at night, after dinner, before bed. She said that it is a 24 hour medication, and unlike Adderall it will not wear off in 8 hours (which was happening with my stepson).

Sorry I am new here…I posted the previous guest response!

Just wanted to put my two cents worth in here regarding this new medicine. Many of you oldies will remember me ( I Hope :lol: ) It has been quite awhile since I have posted as my son has been stablized quite well on his “cocktail” of med’s He is bipolar and ADHD w/anxiiety This new med I have found is a medical WONDER for Adhd for him of course. as some might remember my boy is med resistant and the “typical” add meds like ritilan and adderall were disasters for us. He was on concerta before the strattera came out and his doc told us about it and over this summer we made a change and it went so smooth that I was impressed. No weaning, no withdrawles just switch. I have found there is not the excessive ups and downs or the rebounds or even the excessive weight loss. Now this is our case,others may be affected differently as I am so justified to point out this is “our”case or opinion never would I presume to give medical advice I am the first to say see your doc and talk it over with a GOOD psychopharmachologist cuz “I” believe that a good doc and drug doc are half your battle with this multifacited disease.
Peace
Ladyspider