Need advice on medications...

[mattsmum]

Background: Prior to Bipolar diagnosis, difficult child was on Straterra and Concerta for ADHD. Post Bipolar, he was on just Depakote. The ADHD symptoms were bad so the Concerta was reintroduced. As time went on, I requested that we try the Straterra instead of the Concerta, since the Concerta is a stimulant. So, he is on...


250mg Depakote and 40mg Strattera (added August 10th) in AM
1000mg Depakote in PM

I know that Strattera builds up in your system over time. However he seems to be fine in the morning...and gets more irritable, defiant, angry after taking AM doses. Could it be the Strattera???

On the other hand...
His dr. gave us 10mg Methylin to give him as an afternoon "boost" dose because Concerta seemed to be wearing off. The methylin has worked beautifully. I haven't tried it though since switching to Strattera. I may try it today.

Questions....
1. Could Strattera be aggrivating his anger?

2. Is Methylin a good option...only lasts 3-4 hours?

3. Any other options for ADHD symptoms for a child with-Bipolar as well??

4. Is 40mg Strattera too low of a dose. He used to be on 60mg.

Thanks for your insight!! :smile:

Linda

 

[crazymama30]

I think I remember something about stratterra having some negative effects on mood, someone who knows more hopefully will post soon. It does sound like it is the Straterra, especially if you see this behaviour often.

 

[Janna]

We have had no luck with any ADHD medication with Dylan. They either overstimulate or cause increased anger/aggression.

We had very good luck with the atypical antipsychotic, Abilify, with him. That helped alot with hyperactivity and impulsivity.

So, what we did was, we agreed he just can't take ADHD medications, and put him into an Emotional Support classroom in school. There, they have a teacher and an aide in a smaller, more structured environment, and they can give him more time for tests, spend time teaching him focus, etc. It's been pretty good.

 

[mrscatinthehat]

Strattera was a nightmare for us. difficult child 2 was on it for a while until I could not take it any longer (this was before Residential Treatment Center (RTC)).

Beth

 

[smallworld]

Strattera is dosed by weight. How much does he weigh?

Strattera is an antidepressant. Like any antidepressant, it can cause irritability and mood swings in kids with BiPolar (BP). In fact, these symptoms have been reported in kids without BiPolar (BP) who take Strattera. So yes, the problems could be related to Strattera.

 

[mattsmum]

He weighs about 70 lbs.

I gave him 10mg Methylin and it totally calmed and quieted him down. BIG difference. Does anyone use just that for ADHD?

I know the problem is that he would need frequent doses...but if it helps I don't mind.

Any good alternatives for Methylin that are longer acting?

 

[totoro]

Someone just posted this BLOG about ADHD and Strattera. I thought it was interesting. Here it is again.
http://addadhdblog.com/how-does-strattera-work/

K is on 35mg and she weighs 55#'s at the moment. psychiatrist says we can take it up to 45mg. It seems to be fine for her??? But I was watching it closely and worried like you.
She has actually been playing by herself in the am, something she never did before, ever! Afternoon's are still a struggle.
Good luck.

 

[busywend]

1.) Yes for sure
4.) I imagine that is a starting dose and if it does not work do not be surprised if psychiatrist tries to increase it before giving up to try something else.

As far as the other drug you asked about - call your loval pharmacist for advice - I am sure they will know which ingredients are helping his attentiveness.

 

[TrishaBC]

Early last summer difficult child tried Strattera and had horrible results. He was angry, aggresive, emotional, and totally unhappy. This was only after three weeks, he hadn't even worked up to a full dosage yet. We contacted the P-doctor and he was put back on Concerta, and we tapered off the Strattera.

 

[huntersmom2002]

they have my 5 yr old son now on focalin, abilify, and depakote. When you get into medications that have the Methylin in it, ask your doctor cause i read up on it, and the information stated that the methylin can cause stunted growth. Before these he was on Respridol and Metadate(Neither really worked for him),and they tried the adhd patch(forgot the name-did not owrk made him more angry & agressive), plus he was also put on clonidine{it's a high blood pressure medicine they are using on kids with ADHD}(did not work at all), concerta(did not work).

 

[smallworld]

Methylin is a form of methylphenidate. So is Metadate. So is the Daytrana patch. So is Concerta. Focalin is refined methylphenidate. They all have the same side effects.

 

[mattsmum]

I spoke with the Psychiatrist and we took him off of the Strattera beginning today. I know it takes time to get out of his system, but he was not aggressive are argumentative at all today. However, he was HYPER! LOL

Beginning on Monday, we are going to give him 5mg of Methylin 2x/day to see how it goes. He is very big for his age, so I am not immediately concerned about stunted growth, but I will definitely look into it. Thanks!! :smile: