Hello, I am wondering if anyone experienced what I am about to describe on this medication who stayed on it, and if so if this went away, and how long it took. My daughter started on Strattera about a week and a half ago. We have Tourrettes and bipolar in our family, so a stimulant was not an option for her. Anyhow, her doctor started her out on 18mg for four days, and then up to 25mg. Well, the first few days were truly, truly amazing! I saw a miracle performed! She was everything I always knew she could be, suddenly the other girls liked her, she was focused, motivated, amazing, truly! Then we started on the next dose. She also did well on that for a couple of days, and then blam, nothing. This was heartbreaking to say the least as I had gotten a taste of something so beautiful for her! The normal life I never had growing up. Well, she has not shown any positive results since, and it has been three days, and today her teacher told me she was her worse ever, and aggressive and mean to other children. I am scared to give it to her tomorrow, but have read enouph to know I may need to wait it out to see if it'll help her or not. I called the pediatrician, and he said he'll call in a prescript to start her back on the 18 mg tomorrow, so she'll start the new lowered dose Sat. I'm just wondering if I am doing the right thing. Did this happen to anyone else who didn't throw in the towel and stop taking this medication, and did this go away? If so how long did it take, and did anyone get relief from this particular side effect after lowering the dose. Also did anyone who saw amazing results the first couple days and then see the benefits dissapear stay on it long enouph to see if it came back after the eight week trial period, and did it? If not, did you raise the dose, and if so did that help and for how long. Was if brief again, or is there a point where the benefit actually lasts in a person who gets this initial great response and then back tracks? Thanks, Elli

Hello, I am wondering if anyone experienced what I am about to describe on this medication who stayed on it, and if so if this went away, and how long it took. My daughter started on Strattera about a week and a half ago. We have Tourrettes and bipolar in our family, so a stimulant was not an option for her. Anyhow, her doctor started her out on 18mg for four days, and then up to 25mg. Well, the first few days were truly, truly amazing! I saw a miracle performed! She was everything I always knew she could be, suddenly the other girls liked her, she was focused, motivated, amazing, truly! Then we started on the next dose. She also did well on that for a couple of days, and then blam, nothing. This was heartbreaking to say the least as I had gotten a taste of something so beautiful for her! The normal life I never had growing up. Well, she has not shown any positive results since, and it has been three days, and today her teacher told me she was her worse ever, and aggressive and mean to other children. I am scared to give it to her tomorrow, but have read enouph to know I may need to wait it out to see if it'll help her or not. I called the pediatrician, and he said he'll call in a prescript to start her back on the 18 mg tomorrow, so she'll start the new lowered dose Sat. I'm just wondering if I am doing the right thing. Did this happen to anyone else who didn't throw in the towel and stop taking this medication, and did this go away? If so how long did it take, and did anyone get relief from this particular side effect after lowering the dose. Also did anyone who saw amazing results the first couple days and then see the benefits dissapear stay on it long enouph to see if it came back after the eight week trial period, and did it? If not, did you raise the dose, and if so did that help and for how long. Was if brief again, or is there a point where the benefit actually lasts in a person who gets this initial great response and then back tracks? Thanks, ElliWelcome to the forums. Hopefully you will find this site as a useful resource for questions and support.

You have asked a lot of good question. I'm glad you got to experience something that works for your daughter. I think you are on the right track. Now it time to tweak the dosage, the time it's taken and possibly splitting the dose.

Your doctor did follow the dosage child guidelines from Lilly, which are .5mg/kg for 4 days and then increase to 1.2mg/kg (not to exceed 1.4mg/kg).

How much does your daughter weigh? Based on the 25mg dosage she should be around 66 lbs.

Aggression is one of the side effects reported. Maybe she needs to move back down to the 18mg dose or take two 10mg to equal 20mg. I was on 60mg all at one time and just recently split the dose 25mg AM and 25mg at noon. I do notice a difference in the afternoon with not being tired.

You are doing the right thing. Remember, you saw an improvement. You just need to start adjusting. It has been reported that once you reach the target dose it will take up to 4 weeks to see positive results. As long as your daughter is not experiencing really bad side effects, you should try ride it out.

Another thing, your daughter might be a poor metabolizer or PM. Here is information from the Strattera site on PM's:


Atomoxetine is well-absorbed after oral administration and is minimally affected by food. It is eliminated primarily by oxidative metabolism through the cytochrome P450 2D6 (CYP2D6) enzymatic pathway and subsequent glucuronidation. Atomoxetine has a half-life of about 5 hours. A fraction of the population (about 7% of Caucasians and 2% of African Americans) are poor metabolizers (PMs) of CYP2D6 metabolized drugs. These individuals have reduced activity in this pathway resulting in 10-fold higher AUCs, 5-fold higher peak plasma concentrations, and slower elimination (plasma half-life of about 24 hours) of atomoxetine compared with people with normal activity [extensive metabolizers (EMs)]. Drugs that inhibit CYP2D6, such as fluoxetine, paroxetine, and quinidine, cause similar increases in exposure.


This might explain why the dosage increase produced the aggression and loss in positive results. Remember this medicine is fairly new and a lot is still being learned. 25mg, at one time, may be too much. But 18mg in the AM and 18mg in the PM may be just right. The half-life is 5 hours for a normal metabolizer and up to 24hrs for a PM.

Overall, work closely with your doctor and follow their medical plan. Educate yourself and offer your suggestions. If they make sense, your doctor should take them into consideration. My doctor actually listens to me when I offer suggestions and allows me to adjust my medication. His view is "you know your body more than I do."

Good luck and keep us updated. Thanks for posting.

elli,

How old is your daughter and how much did she understand about the medication before she started taking it? I'm wondering if some of the initial benefit was, to some degree, a placebo effect. Most comments I've read from people who have had success with Strattera have said that it took a while to get going and the change was gradual.

With my daughter, the changes I noticed started two or three days in and they were very subtle. So subtle, in fact, that my husband didn't notice until I pointed them out. Little by little, however, it became very apparent that the medication was working. Today (after 2+ months), we're having great success.

My other question is about her weight and her target dosage. Em was 90 pounds when she started at 25mg per day. We upped the dosage slowly until she reached 50mg a month later. Now we're trying 60mg even though that's a little higher than the recommended dose because she was still having concentration/motivation problems. It's only been a week at the higher dose, but I'm definitely seeing more improvement.

Is 25mg your daughter's target dose or it higher? If it's her target dose, then maybe the "relapse" was the result of too much medication too quickly.

Don't give up yet, you're still early in the process. Strattera's benefits (not a controlled substance, 24 hour coverage) are worth some patience during the early phase.

Good luck!

Thank you both for your quick responses. This site is very helpfull! Let me see if I can remember the questions so I can answer them and I'll update things a little. My daughter has no idea at all what she is taking, I just give them to her in the morning with her vitamen and flouride, and she doesn't ask, she is six, so I don't think it was her knowledge of anything affecting her behavior. I also don't think it was me imagining things because I didn't tell her teacher, and she called at ten Am the very first morning asking why my daughter was so quiet and calm, she thought she was sick! Then at soccer practice that afternnoon, she was the star player! She was focused, driven, and the other kids all started talking to her that day as well, where as they are usually totally annoyed with her. Then her soccer coach came up afterward and commented on how amazing she had played that day, and he never said a work to me before, I don't even know his name. So to me the people who didn't know and commented on the change were pretty objective. OK, yes she is about sixty pounds. I don't think she is a poor metabolizer, if anything maybe the opposite problem, she was effected by it pretty much immediately! My nine year old son who is also trying it out is slowly but surely started showing minimal improvements, but I can definately see that he metabolizes it slower. It hits him slower and wears off slower. I kind of think it'll work better for him though, because he doesn't seem to have the side effects. She has almost all of them. He started out on 25 mg, and is now on 40 after four day on the initial dose, and we just started seeing a minor minor difference after almost two weeks. I've noticed in all the previous threads I've read that there seem to be two types of reactions, the people that have the initial immediate extremely positive results for a few days, and then nothing, or worsening of add, and aggression or anxiety. Then there seem to be the people who don't feel anything, wait it out, and either give up, or start slowly getting gradual positive results, and end up loving it. The problem is you don't really hear the end results of the people who seem to have experienced what my daughter is experiencing, with it working so wonderfully for a few days and then not working, and then the aggression/anxiety, because either they stop taking it and switch to something else, or they seem to never be heard from again. I clicked on the names of people with similar threads and read all their other postings to follow up on what happened next. So I am wondering wether it works for one type and not the other, or if maybe those people gave up to soon, or if the ones you didn't hear from were so successfully treated they never looked backward to post anything. I suppose if I or my children were totally symptom free, I might inevadably move on, too! I'm sure that's why we hear more negative then positive things. I'm just theorizing because I so badly want this to work for my children. My daughter especially, with boys, it's somewhat more acceptable as "boys will be boys" but my poor precious little girl is somewhat of a social outcast to her peers, and having been exactly like her as a hyperactive little girl, I hurt for her! For a little girl, it's a very lonely walk! I know we learn to live with it, I went on to be very successfull, and think outside the box, hyperfocus and be very creative, OK, here I sit digressing again! Sorry, LOL. Anyways, I just really want this to work for her. I do have to update a little though and say she actually got a good report from school today, and seemed her normal self, if improved it wasn't noticeable, or if so, only in that she didn't get in trouble at school today, and it was even a substitute teacher. Also, she didn't fight with her brother, although, we were pretty busy, so if she was aggressive at all, it slipped under the radar. I'll have to watch her over the next few days and see what happens. We didn't lower the dose yet as the lower script wasn't filled till today after she'd taken it, and since today was good, I figure we'll give it another go and see how she does. Just dying for that miraculous somebody to say, hey, I went through exactly what your daughter went through, and I stuck it out, and it worked for me,and now I'm great! I'm also looking into that play attention thing. Can't afford it at the moment, but maybe can save over next several months.....Thanks, Elli

Elli,

Thanks for the answering our questions. Just a quick thing about posting. Please try to break a post into paragraphs. :D It helps those with ADHD stay focused and get through the thread.

You are doing all of the right things. Now that you have some 18mg and 25mg, you can play with the dosing. Do you think you'll go back down to the 18mg?
That's great feedback you received from the teacher and coach. We told our son that he is going to take some medicine that will help him concentrate and not have the urge to get up and run around. We call it his "concentration medicine".

If I remember correctly, I think I had some aggression/irritation symptoms when I first started. I remember a time when people at work would just irritate me to the point of just wanting to walk away during a converstion. I would become very defensive. I don't have this feeling any more.

Keep up the great work.

Hey, I posted a second ago, and it disappeared, so may appear twice, sorry. Anyways, I wanted to thank you for the input and to say, I will definately break up my posts! I tend to ramble! :faint: