difficult child 3 - violent rage. Strattera?


Active Member
We've been to a Christmas party at difficult child 1's in-laws. We of course took difficult child 3, he's been maybe slightly edgy but it's easy to put this down to the season, shopping and changes in routine. However, several times in the last couple of days he's been particularly resistant to changes in routine.

This afternoon (Saturday) we had a choir rehearsal for Sunday night's community carols program. I wanted difficult child 3 to sing in the choir, he had agreed to, but when I said it was time to go he was resistant. Earlier in the day he was compliant with his daily study routine so I was surprised at this resistance. I reminded him of our plans, he was annoyed that we wouldn't be spending all afternoon and all evening at home where he could play game on the computer.

But he came with me anyway. He did stay for the rehearsal bits where the choir was needed but didn't really try to sing. He also spent every minute he could playing outside with a cap rocket. I tried to engage him more inside, but he was sullen at times. Obstinate.

When it was time to go I had trouble getting him moving, then a friend stopped to chat and difficult child 3, by now in the car, got very impatient and rude, banging loudly on the side of the car and telling me to hurry up.

A little bit of occasional rude behaviour, I will tolerate. A lot of the time it's just difficult child 3 being socially inept, trying to be over-familiar in a joking way. But today it didn't seem like it.

We got home form rehearsal, difficult child 3 wanted to go straight to the Wii but husband was trying to work on a problem with our TV (fairly urgent) so difficult child 3 had to wait (very frustrated). difficult child 3's attitude was very annoying - he was rude, officious, impatient and loudly objecting to our lack of consideration for him. naturally, neither husband nor I will stand for much of this. As I said, occasionally we'll ignore it if it seems to be anxiety-driven, because he generally does stop and self-correct. But not this evening. So we began to chip him about it, to correct hi and tell him to stop being rude to us, it was not getting him anywhere.

difficult child 3 began to get even more belligerent. husband & I tried to handle it by making him change the subject, when the subject was getting nowhere. difficult child 3 kept saying the same arguments over and over, we would answer the arguments ten difficult child 3 would make the same complaint. We finally had to say, "We have spoken, drop the subject."
Again, we only do this under extreme pressure and after our patience has been thoroughly exhausted. Usually it works. Not tonight. Not well, anyway.

Almost at the party. difficult child 3 says loudly, "I'm hungry." Again, tone of voice was insolent, whiny and demanding. husband & I both reacted (not aggressively). I said, "I'm glad you didn't say that at the party. That would have been very impolite."
difficult child 3 said, "I was only trying to be funny."
husband & I both said, "We're not laughing. And jokes like that are definitely not funny in someone else's home; it implies they're bad hosts. And even if you think they are, it's impolite to say so. If you're still hungry after the party, we'll stop and buy you some food."
Again, this is our usual strategy, and usually it's effective.

The gist of all this - the pattern was there (with hindsight) that difficult child 3 was touch in the extreme, belligerent and aggressively loud. Normally we can rein him in, but any attempts to do so were not only not working, they seemed to be making him worse.

At the party difficult child 3 introduced himself to a teenage girl. He was a bit hamfisted about it, but otherwise it came off OK. We left him in that room and were mostly in the next room. In the room with difficult child 3 were difficult child 1, daughter in law and a few of their friends. The party had subdivided into teens/early 20s (one room) and the parents of that group (the next room). The kids watched a movie which happened to be a favourite of difficult child 3's. When I looked in occasionally he seemed to be happily watching it with the others.

This family has a custom at these parties of opening gifts. So as we had brought gifts also (only $3 max value) we participated. It meant that the movie was turned off (I think it had finished) and everybody moved into the room where the kids had been. difficult child 3 at this point was being mildly annoying to difficult child 1 so I intervened and moved difficult child 3. Soon we were all sitting - I was next to difficult child 3, husband was sitting on the floor in front of us.

And now, with a roomful of people, difficult child 3 began to be really annoying. He was tired so he yawned. fair enough, but he vocalised the yawn (a way of attention-seeking and announcing boredom). As the hostess was explaining how we would open presents, difficult child 3 began to say to me, more loudly each time I did nothing, that he thought it was stupid and he didn't like those rules. Then came more loud yawns, then he began to say, "I'm tired."
I hushed him, so he said it louder. I biffed him on the shoulder (like kicking your bridge partner under the table) to try to warn him to shut up, but he got very offended with me. I wasn't doing it hard enough to hurt, just to try to send a message of, "Please pay attention to me, you're doing something wrong."
Then husband rapped him on the leg (the only big husband could reach). difficult child 3 was getting quite loud and objectionable, I had warned him he would have to go outside to sit in the car if he kept this up; so I finally sent him out of the room. I realised too late that I couldn't send him to the car, I didn't have the keys. So we sat in another room with a couch, it was far enough away from the party for it to be a quiet space.

That's when difficult child 3 really lost it. He started punching things (a mattress leaning against the wall), he threw his glasses to the ground (they didn't break), he punched me, he grabbed me by the arm and squeezed hard, he was raging, crying, shouting at me (the party was loud, I doubt they heard much) and at one point difficult child 3 said, "I'm going to kill you and dad." He continued to say he hated us, he wanted us both dead, and so on. He was really angry, his hair was stuck to his forehead and when I touched his forehead he was hot.
At about this point I began to think, "This is NOT normal for difficult child 3 at all. Yes, he is angry because to his mind we've been nitpicking all afternoon and evening, but we've been nitpicking because his behaviour has been uncharacteristically aggressive and rude. And maybe 'uncharacteristic' is relevant here."

Now to put in a possible cause - difficult child 3's medication dosage has been increased a fair bit this year. He takes a sustained release form of dexamphetamine and over this year, the dose has doubled from 20 mg/day to 40. Early in the year we were trying Concerta, and found that not only was it not helping him focus well enough, he also had rebound on it. The doctor increased the Concerta dose and he concentration was better, but the rebound was much worse. Then one weekend we were away and difficult child 3 had forgotten to pack his Concerta, so I had to give him some spare dex tablets I had in my bag. The behaviour improvement was amazing. So after talking to the doctor, Concerta was dropped and we upped his dex to 30 mg/day, with the option of a 5 mg short-acting top-up.

Then later in the year the higher dose wasn't enough for him to be able to complete some especially complex topics. He was having difficulty word-finding, there were other signs that it was attention-related, so the doctor authorised another medication increase.

About tis time difficult child 3 saw the autism psychiatrist for the first time. That doctor expressed concern at the high dex dose coupled with difficult child 3's known history of anxiety. There is another medication the doctor wants to try, but not at such a high dose of dex as well. He wanted difficult child 3 cut back to 20 mg/day at the most. And I know he can't function academically at that level.

So last Tuesday, we saw the prescribing pediatrician. He reluctantly put difficult child 3 on Strattera, with a view to getting him stable on that and then lager on cutting out the dex once the Strattera is on board.

So difficult child 3 has been taking Strattera since Tuesday night. That's 4 doses difficult child 3 has had to date. He's also been taking his daily dose of 30 mg/day of dex (not the extra 10, because he's working on Maths right now and not English, so I took the opportunity to cut back the dose a little). I did use the 5 mg top-up dose on Wednesday and Thursday.

So to tonight's behaviour - when we got home (after a difficult trip home in the car, difficult child 3 still trying to argue and using the same aggressive, belligerent tone) husband looked up Strattera online (he has access to government medical info). And it says in big print, precautions - monitor for any behavioural change and also adverse reactions include hostility eg aggression, oppositional behaviour, anger. Other things mentioned are mood swings and suicidal ideation. The leaflet says to watch for thoughts or talk of self-harm or harm to others (he threatened to kill me and husband; I know it's just talk, but he still said it); feeling very agitated or restless (yep, I'd say so); new or worse irritability; an extreme increase in activity and talking (maybe) and other unusual changes in behaviour.

The advice is to get him seen to ASAP.

We thought about it - the only medical help we can get at this time of night (2.30 am now) is to take him to the hospital. It would take us 40 minutes to get there at this time of night (easier driving this late) but arriving in the middle of the night on a Saturday night,let along one this close to Christmas, they will be too busy dealing with drunks, car accidents and idiots who have been doing stupid things at the beginning of their holidays. difficult child 3 said he's tied and he does function better after sleep.

So I know we took a chance but I think it's the right choice for now, to have him in his own bed getting some much-needed sleep. Maybe in the morning when his dex is back on board, he will behave for us.

I did ring the hospital - the nurse I spoke to had to look Strattera up on the database. She strongly suggested getting him seen, but agreed with the wisdom of letting him sleep vs driving for ages and then sitting for hours in a hospital waiting room to see someone who also was unfamiliar with this medication or this kind of case. The nurse said to contact difficult child 3's doctor ASAP.

The trouble is, the GP started her annual leave on Friday. The pediatrician will be available (I hope) on Monday but not before, and difficult child 3 had his next dose of Strattera due tonight (he's already missed it by a few hours).

So a few questions - has anyone else had an experience like this with Strattera? If so, how did you handle it?

And should I have weaned him off it? I can't cut capsules in half and he was in the first week of treatment, which (for us in Australia, anyway) is a half dose.

Any suggestions?

I'm going to head for bed in a few minutes, but either I or husband will be up in a few hours so we'll be watching for any answers.



New Member

I am so sorry you and husband and difficult child had this experience, when things have been going so well. Wow, he was def. raging. difficult child was on that particular medication several years ago, she went manic on it and I did not wean her off as per the doctor, we just stopped it. She was up at 3 a.m. pulling food out of cabinets, ripping toys out of room, screaming, jumping total insanity.

I dont want to steer you the wrong way, yet if it were me and the medication had only been administered for less than a week and that happened to me i'd just pull it. So, from what you wrote you'll be able to get to the doctor by Monday??

Sorry you went through that, you and husband handled it very well.

((((hugs)))) I hope you all get some much needed sleep


Active Member
Wow- you really had your hands full and patience tried! It sounds anxiety driven to me- at least some- when I was young, if I couldn't get to a way to release anxiety or nervous energy, I became angry and irritable- but I guess raging can be caused by a lot of things. Anyway- I can't help you much on this but wanted to send support.

I'd be afraid to suggest something pertaining to medications. However, my son's psychiatrist always starts him on 1/2 or even 1/4 does (usually 1/2) and the first two doese are going to be really low ones for difficult child anyway, so psychiatrist tells me that if the new medication isn't working well or causing an advers reaction, to just stop it cold. He says when the doses are really low, it won't cause a problem not to titrate him off of it. But, difficult child has never tried strattera and I'm not a dr, so I don't want to advise you here. Can you find any psychiatrist on call to answer that question before Monday?


New Member

Marg, you problem already have this info....... yet i found this stuff on side effects. Often what I do if i cant' reach my doctor and there's a bad side effect just to be on safe side I contact my pharmacist, I dont' know if your able to do that there. Just to double check pulling him off the medication with-o weaning off.


I support the decision to let him sleep. I have no experience so bear that in mind, but I would just pull it too since he's only been on it such a short time.

My goodness difficult child 3 sounds so much like manster when he gets frustrated. Please give us an update when you have time.




Active Member
Thanks, guys. Jen, thanks for that link. I've had a look through it, it definitely looks like we've done the right thing. I'm a bit anxious about not being able to see anybody until Monday, unless we go to the hospital. I don't have a lot of faith in the accuracy of the medical care at the ER, given the fairly specialist nature of the problem. We're unlikely to see anyone above the level of GP if we go in when he wakes (Sunday).

What I will consider doing - I think I'll show difficult child 3 that page you sent, Jen. We've already mentioned to him that we think it's the new medications. I had told him I would do some digging while he slept. Of course, it could trigger him to read the information leaflet in ALL his medications, in meticulous detail, for ever more. But maybe that's not such a bad thing!

I'm going to have to head for bed soon - it's now after 3 am and I'm really tired! But I had to do this before I went to bed, so my brain could process the information more effectively. I WAS hoping to get to church in the morning; I'm afraid I may be too tired.



Mom? What's a difficult child?
Sorry about this Marg. No matter what the reason it is always scary when our kids become aggressive and threaten us.
K has been on Strattera at least 2 times. For some reason her psychiatrist at the time kept wanting to revisit it.
It was not a good fit for her.
She bacome much more violent, had thoughts of wanting to die, kill us. Agitation over the top... Very similar things you are seeing.
K is very violent and has had suicidal ideations in the past.
But the she had been fairly stable prior to the Strattera and it put her over the edge.

I kind of hope it is the Strattera so you know what is causing this and can eliminate the cause.
Poor guy.. and hopefully you are not hurt from the grabbing and punching either.


Well-Known Member
I have heard nothing good about Straterra from anyone, and most of it is about moodswings and rages. I'm sure I don't know everyone...lol...and it works for some kids. But I would never give it to one of my kids or take it myself. I've gotten too much extremely negative feedback.


Marg, you may already know this, but Strattera is an antidepressant, not a stimulant. It can have the same side effects as any other AD, including anger, mood swings and aggression. Furthermore, the reaction could have been from combining the two medications. by the way, our docs have repeatedly told us that clinical studies show Strattera only works for 40 percent of kids with ADHD. Not a great track record.

If he's sleeping, don't wake him (you know the adage, "Let a sleeping baby lie.") Obviously, I'm not a doctor, but in your shoes, I wouldn't give him another dose until you are able to talk to or have a doctor evaluate difficult child 3. Since he's only taken it for 4 days, it hasn't had a chance to build up significantly in his blood stream, which means he is not at great risk for AD withdrawal syndrome.

Please update us when you can.


Hi, I am sorry I am so late to this thread, I haven't been on all day or last night. I am so sorry you are going through all of this.

My nephew was on Strattera for 2 months and had horrible mood swings. He was absolutely miserable, very nasty and mean. His fuse was shorter than usual, he snapped at everyone for everything. He didn't get violent with anyone but he would slam things and punch walls and things of that nature. I have also heard of this happening to other kids on it as well. My nephew now takes Vyvanse and it works really well for him. He is doing very well in school and his mood has actually improved. His fuse got much longer and he seems much happier. He actually likes taking it!!!

Hang in there and God bless. :)


Well-Known Member
Hubby had a similar reaction to Strattera, even after he was at the proper dosage for his weight. His doctor wanted him to try it for a month...I was dead set against it, wanted him to go on Ritalin, but I was outvoted. He had horrible mood swings, would go from crying to agitated pacing, wanting to punch something, and back to being upset and tearfully apologizing.

At the next appointment (I went along), I handed the doctor a spreadsheet tracking doses, moods, and behaviors, and requested, "Ritalin. Now."

Miss KT did better in school on Strattera, but her attitude and behavior went slightly downhill. She stayed on it for about two years, mainly because she wasn't eating on the stims.


Well-Known Member
Marg, I hope by now you've all gotten some badly needed sleep.

That really tried your patience!

You've gotten some great ideas and experienced views here, unfortunately, many after you went to bed. I hope they help you when you're back to the bb.

I wish I could help; I have no experience with-Strattera but just from reading these comments, I am leery of it. Good luck!


New Member

I hope you guys are getting some much needed sleep. by the way, when I pulled it difficult child wasn't on it that long either, he said it builds up in the system so we'd be on the safe side. I know what you mean about being uncomfortable until Monday comes.

Poor baby, yes I too explained to my difficult child when that had occured and she was so jittery and shaken, couldn't stay still was screaming at me that it was the medications as well. She was kinda lost in it all. Give him a hug when he wakes. I hate when the medications can do that stuff. My difficult child cant' handle any anti depressants, we came to learn as well.

Update us when you can.



Relentless Warrior Mom
My son was diagnosis ADHD in the mid 90's, never could get the right medications. In 2005, he had his first hospitalization and was diagnosis BP1 and taken off all stimulants until the moods swing could be stabilized.

It took two years to get the right cocktail and it was an experience I would not wish on anyone! Then in July of 07, they thought we had him stabilized so they added the stimulant back, I wont go into the details but the end result is even though his ADHD is severe as his BiPolar (BP), HE CAN NOT take a stimulant for his ADHD!

I have found several articles online in regards to this but it is a new discovery. He went through every possible stimulant in 13 yrs of TX with a minimum of ten to a maximum of 20 office referrals in each school year! I would suggest talking to your doctor about the incident. Alot of symptoms of BiPolar (BP) and ADHD are co-existent in each diagnosis.

Best wishes with your current situation!


Active Member
difficult child 3 slept in this morning until 10 am - unheard of, for him. He was only three hours late to bed (less, when you consider how often he's not in bed until 11 pm) but he slept in for a lot longer.

We had warned him we wouldn't have time for our thorough talk this morning because we wanted to go to church, but we promised we'd talk when we got back.

When we left he was playing games on the Wii. He didn't want to come with us and we didn't want to push it, not after last night. So we got back form church and I asked how he is. "What do you mean?" he asked, again a bit surly.

I explained I wanted to know how he felt, was he rested, was he feeling comfortable. And that it was time for our talk.
He was quiet for a minute and said, "I've decided to just let it go."
"Well, we haven't made tat choice, we feel we need to work out why things happened so we can prevent it happening again."

I talked to him, made sure that he realised I was NOT criticising him (so he didn't need to jump in and defend himself) I was merely describing events as I had seen them. I pointed out that if we had realised sooner that his deteriorating behaviour had been possibly linked to medications, we would have done things differently. But his manner had become increasingly surly, belligerent and out of character. I said that sometimes he does say the wrong thing but will respond to us correcting him; yesterday/last night our correcting him only got him angrier, until he exploded. Again, not like him.

So I said in summary, we're accepting that it's likely that he can't tolerate Strattera and I will wing the pediatrician in the morning to talk to him about what to do next.

In the meantime, we still have our daily assessment to do - 15 minutes of maths, 15 minutes (minimum) of gaming, to assess how well he can function with both. He did not sound happy. Then I said there were three other things we have to do today - have a swim at the beach, preferably now, then move Grandma's Christmas tree and get ready to decorate it; then take the camera out in the last hour of daylight and get some good photos of some local flowers, a very unusual tree at the school, and so on. These are all things he loves to do. He didn't sound enthusiastic. However, he has gone to the clothes line to fetch his swimsuit, I'm typing this while I wait for him to say he's ready.

Tonight we have our village carols night, difficult child 3 was supposed to be singing with us. I'm not sure whether to make him do this now. We'll have to decide later on, depending on how he's feeling.

He told us he had read this thread. I had left it up on the computer for husband to read before we left for church, while we were away difficult child 3 read it. He said, "I almost wish I hadn't, now." He didn't like what he read. However, I think it persuaded him to not keep insisting how hard done by he was. I think it finally gave him a bit of perspective, which is good.

What is really making me angry - according to the literature, only 1; of the trial had problems with aggression or suicidal ideation. So how come I keep hearing so many similar stories? I'm seriously thinking of writing to TGA (Therapeutic Goods Administration - the Aussie FDA) about it, to complain about the high risk our kids are being put to, by what I believe are artificially low (fudged?) figures. I'm sure there must be enough data out there now to send a questionnaire to every prescribing pediatrician, to list the number of patients on Strattera now and in the past, and to list how many in that lot were taken off it because of problems.

I might even do my own survey (because it's easy for it to be confidential) and send the results straight to the AMA journals. CC to TGA, CC to Eli Lilly.

I hadn't realised that Strattera was an antidepressant. difficult child 3 has reacted badly before to antidepressants. I suspect he's like me - has problems with them. A pity, I think they would help if only he could tolerate them without going psychotic.

I have similar problems with them (it varies from going really weird, to being ridiculously sedated) so I can sympathise with the poor lad.

OK, must be off - there is a summer's day out there, clear blue sky and a gentle beach. Good therapy for difficult child 3 and for me.



New Member
Hi just a quick note one thing i came to learn was that when they do those trials they want the "best" result possible to get their medication off the ground and on the market. So, they from what I was told take the canidates most likely to respond well and who are in need and give it to them. Than they also weed down the group initially started with, so if it's 30 ppl they weed it down to 20 and so forth till they get the averages or percentages they want, if you know what i mean.

Now, no one would ever admit that this is what they do in reality. I'm not saying it's correct, just saying it's what i heard. So, when I read those supposed trials i'm always a bit leary of how they came to be.

I hope your day is good. :)


Marg said:
What is really making me angry - according to the literature, only 1% of the trial had problems with aggression or suicidal ideation. So how come I keep hearing so many similar stories?

The number of people drugs are studied on is small. Sometimes just a couple thousand. They have specific criteria and they are tested on adults. It's not until drugs have been used off-label in the general population that they become FDA approved for children. At least that's my understanding. How many years was Prozac out before it became approved for use in children? To my knowledge it's the only AD approved by the FDA for use in children, yet we see here the vast range of AD's our kids are on or have been on in the past. And we already know that medications used for adults do not work the same with children.

Further, they test these drugs on people with the specific disorder. IOW, only on people with ADHD. The drug is not going to be studied on people with comorbid disorders, such as autism, bipolar, anxiety, etc.

In addition, too many doctors are too quick to medicate symptoms. ADHD is also over-diagnosed, in my opinion. That means more kids are going to be on Straterra when they shouldn't be and you're going to see more negative results.

I feel that too many doctors just throw medications at things and see what works. They don't take the time to fully read the studies, nor do they take the time to understand the pharmacology. I honestly believe that many of us parents - lay people - know better what our kids should be on and what they shouldn't because we have a vested interest and take the time to do the research and talk to other parents. That's one of the reasons I like my doctor so much; she knows I research and know what I'm talking about and prescribes accordingly.

Some doctors also have a medication or combination of medications that they automatically prescribe for a given diagnosis. Across the board. If that doesn't work for you, they tend to increase the dose rather than try something else. If it still doesn't work they tend to add to it rather than try something altogether different.

Some of this is from my research, some of this is first hand experience and some of this is my bias. Regardless, medication studies, approval and prescribing practices need to change.

The one example I like to use is Nexium. I think everyone has heard of the purple pill. Nexium is almost the exact same thing as Prilosec (which can now be purchased OTC). The patent for Prilosec was set to expire and the drug company came out with Nexium. They spent tons and tons of money marketing it, stating it was significantly better than Prilosec. Doctors bought into it (shame on them - they should know better) and started prescribing it like crazy. What was discovered was that there was only a 3% difference in the side effect profile between Nexium and Prilosec. But by then, millions of prescriptions had been written for an expensive brand name drug, driving up our health care costs.

Pristiq is another one. It's the new version of Effexor. Supposedly it metabolizes differently. Effexor's patent runs out in 2010, I think. The side effect of Pristiq is supposed to be better. From what I've read, I've heard both sides. However, there is only a 2 point difference on the depression scale between Pristiq and the placebo. Not enough to make me take it.


I wanted to add that it is good to have these alternate drugs for the small percentage of people that it works better for than the other.

Another example is Celexa and Lexapro. Lexapro is almost the same as Celexa with some marginal differences in effectiveness and side effect profile. Insurance companies typically require a person to take Celexa because there is a generic for it. And for a lot of people - if not most - it works just fine.

Celexa worked well for me. For a time; then it quit working. Lexapro, however, works wonders. So, I'm one of the ones that benefits from that marginal difference.

My problem is with the way studies are done, they way they are presented, marketing strategies and prescribing practices.


Relentless Warrior Mom
Yes I agree, with my son and me, it is just what each individual body chemistry requires. I take Celexa and so does him and it works fine but Lexapro did not for me.