ADD Medication and Treatment Reviews

Strattera

Strattera is an effective alternative to the stimulant ADHD medications most commonly used to treat symptoms of attention deficit hyperactivity disorder in children ages 6-12, adolescents, and adults
Generic Name: Atomoxetine hydrochloride

What is Strattera?

Strattera (Generic Name: atomoxetine hydrochloride) is an effective and safe alternative to the stimulant ADHD medications most commonly used to treat symptoms of attention deficit hyperactivity disorder (ADHD or ADD) in children ages 6-12, adolescents, and adults. It is a selective norepinephrine reuptake inhibitor (SNRI) medicine. Strattera is a non-stimulant; it is not considered a controlled substance by the Drug Enforcement Agency (DEA). It has not been studied in children under the age of 6.

Strattera was the first non-stimulant medication approved for ADHD treatment in the United States by the Food and Drug Administration (FDA). Stimulant ADHD medications are often the first-recommended treatment, but Strattera is a good alternative for people who cannot tolerate, or don’t experience the desired effects of, stimulant medication.

The American Academy of Pediatrics recommends ADHD treatment with behavioral therapy before medication for children under the age of 6. For children ages 6 to 11, the AAP says “The primary care clinician should prescribe US Food and Drug Administration–approved medications for ADHD and/or evidence-based parent- and/or teacher-administered behavior therapy as treatment for ADHD, preferably both.” Likewise, the National Institute of Mental Health finds the most successful treatment plans use a combination of ADHD medication, like Adderall XR, and behavioral therapy.

How Do You Use Strattera to Treat ADHD?

Before starting or refilling an Strattera prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

What is the Typical Dosage for Strattera?

As with all medications, follow your Strattera prescription instructions exactly.  Strattera is taken orally, with or without food, once or twice daily. The first dose is typically taken first thing in the morning. If a second dose is prescribed, it is typically taken in the late afternoon or early evening. It should be taken at the same time each day for the best results.

Capsules should be swallowed whole with water or other liquids. Capsules should never be opened, crushed, or chewed. If your child is unable to swallow the capsule, discuss a different medication with your doctor.

Capsules are available in 10mg, 18mg, 25mg, 40mg, 80mg, and 100mg dosages. The time-release formulation is designed to maintain a steady level of medication in your body throughout the day.

The optimal dosage varies patient by patient. Your doctor may adjust your daily dosage after 3 days until you or your child experiences the best response — that is, the lowest dosage at which you experience the greatest improvement in symptoms without side effects. The maximum recommended dosage is 100mg/day.

During treatment, your doctor may periodically ask you to stop taking your Strattera so that he or she can monitor ADHD symptoms; check vital statistics including blood, heart, and blood pressure; or evaluate height and weight. If any problems are found, your doctor may recommend discontinuing treatment.

What Side Effects Are Associated with Strattera?

The most common side effects of Strattera are as follows:

Children and adolescents (ages 6 – 17): upset stomach, decreased appetite, nausea, and vomiting.

Adults: constipation, dry mouth, nausea, decreased appetite, dizziness, sexual side effects, and problems passing urine.

Other serious side effects include the following: severe allergic reaction, slowed growth in children, priapism, and difficulty urinating including trouble starting and emptying the bladder. Seek immediate medical attention if you have trouble breathing, see swelling or hives, or experience any other signs of an allergic reaction.

Taking Strattera may impair your or your teenager’s ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor. Most people taking this medication do not experience any of these side effects.

Disclose to your physician all mental health issues including any family history of suicide, bipolar illness, or depression. The FDA recommends evaluating patients for bipolar disorder prior to administration of Strattera to avoid inducing a manic episode. Strattera may create new or exacerbate existing behavior problems, bipolar disorder, or suicidal ideation. It can cause psychotic or manic symptoms in children and teenagers. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including anxiety, hearing voices, agitation, panic attacks, trouble sleeping, irritability, hostility, aggressiveness, or depression.

Discuss any existing liver problems with your doctor. Strattera can cause severe liver injury for some patients. Contact your doctor immediately if you or your child experiences these signs of liver problems: itching, right upper belly pain, dark urine, yellow skin or eyes, or inexplicable flu-like symptoms.

Report to your doctor any heart-related problems or a family history of heart and blood pressure problems. Patients with structural cardiac abnormalities and other serious heart problems have experienced sudden death, stroke, heart attack, and increased blood pressure while taking Strattera. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experiences warning signs such as chest pain, shortness of breath, or fainting while taking Strattera.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

What Precautions Are Associated with Strattera?

Store Strattera in a secure place out of the reach of children, and at room temperature. Do not share your Strattera prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

You should not take Strattera if you have:

  • taken, or plan to take an antidepressant monoamine oxidase inhibitor or MAOI within 14 days
  • narrow angle glaucoma
  • an allergy to any ingredients
  • a rare tumor called pheochromocytoma

If you’re thinking of becoming pregnant, discuss the use of Strattera with your doctor. Animal studies indicate a potential risk of fetal harm; infants may be born prematurely, with low birth weight, with spinal abnormalities, or experience withdrawal. Strattera is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

The effects of Strattera on children under 6 and on the elderly have not been studied.

What Interactions Are Associated with Strattera?

Before taking Strattera, discuss all other active prescription medications with your doctor. Strattera can have a dangerous interaction with antidepressants including MAOIs, asthma medicines, blood pressure medicines, and cold or allergy medicines that contain decongestants.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Strattera before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Sources:

http://pi.lilly.com/us/strattera-ppi.pdf
http://www.fda.gov/downloads/drugs/drugsafety/ucm089138.pdf
http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021411s035lbl.pdf

More Information on Strattera and Other ADHD Medications:

Free Download: The Complete Guide to ADHD Medications
A Parent’s Guide to Psychiatric Medications for Children with ADHD
How Does ADHD Medication Work? Your First Questions Answered.

26 Strattera Related Links

  1. I was not diagnosed with ADD until I was in early 70’s. I had been diagnosed with depression and was on Paxil for maybe 20 years. It seemed to have helped some, but I really never believed I was depressed. My doctor tested me for ADD, put me on Straterra. After just a few weeks, I noticed improvement in my moods and focus. I have been on 60 mg for roughly a year. I have no discenable side effects. One thing I like, is that I don’t get the feeling that I have changed from being me. After all, I survived fairly well for 70 years. I don’t want to become totally efficient or give up my creative and daydreaming ways. I just want to have a bit more control. Others have commented that there seems to be a noticeable difference in my behavior.

  2. I have Strattera for 3 year. First I took it in the morning and didn’t realize different for concentration, so by the time I tried another part of day and end up in the evening, because I realized, that I am not exhausted after night, like I used to be all my life, before Strattera. First time in my life I can feel I was realy sleeping.

  3. My 9 year old son was diagnosed with ADD a little over 2 years ago. Concerta was basically ineffective, and he couldn’t maintain his weight. He tried Vynase last for 3 months; his focus was great, but he dropped 2 pound a month. By last July, he was extremely underweight and our developmental pediatrician recommended we try Strattera. We started at 10 mg, and over a period of 6 months his dose has been increased to 60 mg in a single dose. He has gained 12 pounds during this time, which puts him on the lower end of a normal weight range. His attention and focus has never been better. He initially complained he’d get sleepy when he took the pill in the morning; we switched to giving him his medication at night, and he now has no complaints or side effects. On stimulants he was developing borderline eating disorders due in part to his suppressed appetite; he was only eating 4-5 different things. Now he is relaxing his self imposed food restrictions and adding foods back into his diet. He is able to do all of his schoolwork without loosing focus. It definitely took patience to wait for it to become effective. Overall, Strattera has been a real game changer for my sweet bright boy.

  4. My 11-year-old son has been on Strattera for 3 years. At low doses it works very well for him, but about three months ago because of a growth spurt the doctor raised him from 25 mg to 40 mg. His behavior began to escalate a couple weeks later with more aggression. He will suddenly go into a mood where he is not himself at all. He is normally sweet, funny, and friendly. When he flips into this mode he is extremely disrespectful, defiant, angry, and aggressive swearing and hitting parents and teachers, pulling his light switch off his wall, kicking his door, and throwing things. I took him back to his doctor last week because he was so bad at school that the teachers and principal couldn’t handle him and he was physically violent at school. His doctor raised the dose of Strattera to 60 mg. Within two days he had an even worse incident at school where he was threatening suicide as well as destroying property. The next day at school was the same. The next evening instead of giving him the 60 mg dose I had some of the 25 mg pills left so I gave him that. He had one of his best days ever at school that day and it has been several more days and he has been back to the sweet boy he normally is. Strattera can be great, but be careful about raising the dose. Everybody is different.

  5. I was self-diagnosed with ADD at age 59, after reading Dr. Hallowell’s book “Delivered from Distraction” which I discovered through researching modafinil, the only medication which ever helped me to function better. I received the prescription for modafinil for wakefulness problems after being diagnosed with obstructive sleep apnea 10 years earlier.
    My self-diagnosis of ADD was confirmed by a leading physician/clinician at Harvard Medical School, and together with the insightful content of Dr. Hallowell’s book, brought enlightenment and awareness to issues I have struggled with all my life, despite high academic and professional achievement.

    Further research brought me to the YouTube video series generously posted by Dr. Russell Barkley, who is the most accomplished and preeminent clinician/researcher in the field of ADD/ADHD. Dr. Barkley is of the opinion that atomoxetine combined with a stimulant (I ultimately settled on Mydayis as the best option) is an ideal treatment option for the predominantly selectively inattentive form of ADD which I have. The combination of both agents provide complete relief from symptoms that neither agent offers independently, and allows lower dosage of both agents in combination to achieve effective relief of major symptoms. Unfortunately, combination therapy is not FDA approved and patients will need to find and work with a specialist who is not averse to off-label treatment protocols. If you can find such a provider, and suffer from predominantly selectively inattentive ADD, you will likely find this combination therapy to be highly effective.

  6. I was diagnosed with ADD at 24 and prescribed Ritalin and did relatively well on it. I stopped taking any medications about a year later, partly due to feeling uncomfortable taking a stimulant daily. I’m 30 now, and within the last few months decided to pursue ADD medication again. I was still wary of stimulants so my doctor and I decided to try a low dose of Strattera for my ADD symptoms along with Prozac for my depression and anxiety. I really wanted it to be right for me because I was so much more comfortable with taking a non-stimulant. However, I experienced TERRIBLE side effects. I felt as if I was in a daze, I had tingling and numbness throughout my body, and was just generally confused and not feeling like myself. I tried it for a month thinking that possibly the side effects would wear off over time but they got worse and my doctor switched me to Vyvanse. I felt better the very first day I didn’t take the Strattera. My doctor told me some people like myself just can’t tolerate Strattera.

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