Sunday, June 15, 2008

Strattera Update

After a brief period off of Strattera, Gus has been back on for a little while now. He started at 10 mg and then increased to 15. I took him to the doctor last week, it had been almost a month. The word she used to describe him was 'loopy.' He was not running all around the room like he usually would, but he wasn't exactly what you could call focused either. Instead of his body buzzing, his brain and mouth were motorized. He went on and on about Who Framed Roger Rabbit, very perseverative and going a mile a minute. Our pediatrician wasn't sure what to make of Gus's behavior, so she consulted with the specialist.

The specialist felt that Gus was not on a high enough dosage to see any result. He wanted to go for 36 mg a day, but the dosing guidelines limit his size/age at 25. So he started on that level this weekend.

The only real difference I see is that the meds are making him subdued and sleepy, but I don't know if that equates to focused. He's less responsive when I call him and still needs lots of reminders to complete tasks like getting dressed, maybe not as many as before, but not a huge improvement there. On the other hand, he is having some sleep issues (waking up before 5 am randomly, getting out of bed several times at bed time, sometimes waking in the middle of the night). He's not eating normally. Several times I've had to feed him. He's still anxious and has been getting grumpy on & off, but he's expressing himself more clearly.

This morning, about an hour after taking the meds, he started complaining of feeling sick, tired and of a headache, which is very out of character for him. Even when he's sick, he rarely complains, which told me that he had to be feeling pretty bad, at least for a while.

So I don't know. The side effects haven't been earth-shattering, but neither have the positive results. I'm thinking this medication may help a bit, but ultimately is probably not worth it. We'll have to let him adjust to this new dosage, but it seems more pessimistic by the day.


  1. Hey there! I was doing a google search and found your blog. We just started our daughter on Strattera last week. She's to take 10 mg the first week, 18 the next two and then up to 25 mg after that. She is six and a half years old and has Aesperger's too. Just thought it was interesting to read your comments about it. She's only been on it a week now and I've noticed her being tired alot and thus very cranky at times. Still a little hyper but there are times when she is better focused. Just thought I'd share.

  2. Welcome! I'd be curious to know how your daughter does. I can't say if Gus is more focused or just quieter. I know one thing for sure - his sleep is being effected. He's gotten out of bed about 6 times already tonight. He used to fall right asleep. And he's saying things like, "my mind can't fall asleep," and that he's confused. This could be a problem, but I hope it wears off.

  3. Hi. I just came across this through a google search. My 6 yr old son (Aspie) started 10 mg Strattera this morning. This will be the 5th med we're trying. Neither my husband or me are sold on the whole idea. I am glad I found this blog and can read and compare.

    How do you get Gus to take this med? This morning was a nightmare trying to get him to take it in ice cream or jelly. He can't swallow pills yet.


  4. Hi Debbi! I mix the medicine into applesauce. It's a struggle and we have to go through a whole ritual of putting a towel across his lap and making sure he has orange juice to chase it. He spit it back at mne once, not on purpose, but because he gagged. It's got to taste awful, but I haven't found a better way yet. When we have our follow up, I'm going to probably take him off it. He's no more focused and no less impulsive to me.

  5. Hi there. My son is 12 and the Dr. used to think he had ADD, but it never seemed right to me or the teachers at the school. The teachers kept saying Aspergers and PPD-NOS was diagnosed by the school psychologist. I took him to a specialist and he says Aspergers and ADD tendencies, but that nothing seems to fit 100%. We've tried Concerta, Adderal, and most recently Strattera. The teachers seemed to think it helped and I wonder if it just made him quiet? By the time he would get home he would show sympotms that I'd never see in him when off medications - defiant, cranky, lack-of sleeping, and oppositional. All summer I left him off medication and he has been great. He gets "superfocused" as I like to call it on either outside or inside stimuli, and is hard to contact. That really is his major issue. I don't know what to do. They had him on 40mg of Strattera and I worry about putting him back on it. He seemed so irratable and sad when he was on it last. I hate medications, and my husband is even less interested in things like Ritalin as he was put on it for his issues in high school. He says the meds made him feel "stupid" and not "himself". I don't know. I know the school system will be pushing me to medicate him again. I hate this.

  6. A couple of thoughts...At 12, your son should really be given the choice of whether or not he's going to be medicated. Also, as the parent, you have the final say about whether or not he will be medicated and the school can't force you to do it. However, I understand the kind of pressure they can exert, so I can empathize with your anxiety about it. Maybe you can have a sit-down with your son and explain the behaviors that are causing the school to want him on medication. If he doesn't want to take it, maybe that will motivate him to work with you & his teachers to stay off it.

  7. My son is 7 and was diagnosed w/ Asperger's last year. Like many w/ Aspergers and Autism Spectrum Disorders, he also has ADHD. In the past year, we've tried Adderall, Vyvanse, and Concerta. The side effects of each of these meds have been undesirable, to say the least. My son becomes irritable, hypersensitive, rigid, bossy, and sometimes aggressive. Normally, he is a happy, gentle, carefee and playful child. The meds seem to have a Jeckyll and Hyde effect. I attended an Aperger's support group meeting tonight. The guest speaker, a neuropsychologist, explained how kids on the autism spectrum respond physiologically to stress. She cited a recent study that has proven that the cortisol levels in Autistic children begin at higher levels and remain at higher levels for much longer during periods of stress than in typical children. Given our family's ongoing issues w/ stimulant medications, I questioned why physicans prescribe stimulants to kids w/ ASD. She conceded that it doesn't make sense to further stimulate a child whose limbic system is already overstimulated. She said that the therapeutic dosage of the meds is intended for typical kids and is usually too high for ASD kids...ASD kids usually do better on lower doses due to the difference in limbic system function. This is actually the only explanation that has ever made sense as to why I was seeing such an extreme change in my son's personality and behavior. She also noted that good sleep and diet are vital in proper brain function. Our experience is that stimulant meds couldn't be more disruptive to sleep and diet, as my son completely loses his appetite and usually can't fall asleep until midnight or 2 a.m. when taking the meds. I have been wanting to try Strattera because it is a "non-stimulant," but it sounds like everyone is experiencing the same side effects as with the stimulant type meds. It has been such an emotionally trying ordeal to get this medication and dosage right, and I'm feeling so hopeless and exhausted. Right now we are trying Adderall again, but only 5mg, whereas before we began at 20mg. Do the side effects eventually improve? I admit that we usually only last about a week on the meds and give up. Is it even worth it to try the Strattera?

  8. Hi Kim,
    Part of our big problem with the stimulant meds was that since Gus is already very thin, we couldn't risk the appetite suppression side-effect, so we never even got around to trying the others. With Strattera (which I heard from a neurologist is actually a stimulant, it just stimulates the production of different hormones than the other Ritalin-family stimulants) I'm not sure I can advise whether it is worth it or not. I was never fully behind putting Gus on meds to begin with, so I'm a little biased. What I can tell you is that we had him on it for over a month at 3 different dosages and I was never happy with the results. I hear that it takes several weeks for the side effects to peter out, but I didn't see that happen. At this point we've been told that our only options are antipsychotics - Risperdal or Abilify - and we're not willing to go there at this point in time.

    Thanks for sharing the info about ASDs and high levels of sensitivity. I'd always read/heard that ADHD meds rarely work well for kids on the spectrum and now it makes sense. I've heard tales of sensory issues becoming worse with stimulant medication.

    We chose to try Gus with no meds last year because he was getting a new teacher. The new class made a huge difference for him and we're starting this year without meds as well. He's matured a great deal, so I've raised the level of expectation in terms of his behavior and being able to control the ADHD symptoms on his own. We'll see how it works out. I wish you lots of luck with your son!

    Please check out my other blog for more up-to-date postings on Gus's progress.


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