Hi there,
My son has been on Strattera since kindergarten and he is now in third grade. He was born with mild cerebral palsy and hydrocephalus - two conditions that affect the brain. So we weren't suprised when in preschool he started having problems in daycare with behavior. But at that point he was still handleable. He was in a special ed pre-K and didn't seem to need medication, only behavior modifications. Then the summer before kinder, he developed epilepsy and it all went downhill after that.
By the spring of his kinder year, he was out of control and we sought out a psychiatrist because we just didn't know what to do. She put him on Prozac and in just a few days he went from just out of control to being in orbit around the sun. It was awful and scary.
So then he was put on Strattera. Unfortunately, my son has oral sensory issues and a feeding disorder. Since Strattera only comes in a pill, we could sort of hide the small doses in chocolate milk and were starting to see a difference. Then when the dose was upped over time, the bigger pills were so bitter we not only couldn't get them into him, but no food as well becuase he was suspicious of all foods because we tricked him.
I desperately surfed the Internet looking for alternatives and found a compounding pharmacy in our area who could put the Strattera medication into a transdermal gel. The doctor said it would take around 7-8 weeks for us to see the full effect if it was going to work on him. She also prescribed a mood stabilizer as well because even though Strattera helps with ADHD, it can cause agitation in some people.
So sure enough by the seventh week, Caleb calmed down and paid attention in class. We didn't tell the teacher what we were doing and she wanted to know why our son suddenly was much better at joining the class, paying attention and following directions. Then we told her about his meds.
However because of his feeding problems, we eventually couldn't get the mood stablizer in him in any food or drink. Again the compounding pharmacy helped us out. Couldn't do it in a transdermal gel, but could do it in a suppository. Not the most appealing way to get a daily med into your kid, but it took it out of the feeding arena and now he gets the full dose most of the time. (Occasionally he poops it out if he hasn't had a good BM prior to receiving it.)
Many doctors who aren't familiar with other delivery medication delivery methods, were skeptical about the dosage and affects of my son getting his meds this way. Well after experimenting with the timing of the meds, I can tell you he does get it into his system.
He currently gets his Strattera dose split between morning and night. We discovered through trial and error to do it this way. Typically Strattera is given in the morning. If we gave it all at night, then there wasn't enough of the fresh dose in his system for ADHD control during the day. If we gave in the morning, then he would sleep through most of the classes.
The first half of second grade, his grades began to fall because of his excess sleeping. So in December, we switched it back to night. By January of this year, we once again had a frustrated, out of control and aggressive child! He was suspended almost 10 times in a month! The school even threatened to call the police!!
His psychiatrist said he shouldn't be sleepy after being on it for several years, but I am here to tell you it does on him. He quit sleeping in class when he did not get the dose in the morning. But there wasn't enough fresh dose in his system to control his symptoms either.
Plus he had grown and his mood stabilizer was too low as well as his epilepsy drug needed upping because he was having more and more breakthough seizures.
So we had to add Risperdal to his medication schedule. (We get that compounded too.) So by mid February, the Risperdal had kicked in, but were still having bad days. So I decided on my own to try and split the dose. We found that sleeping was still almost eliminated in class, but good ADHD control was achieved. Along with the Risperdal, he was able to calm down and finish second grade on a good note. We tried wean him off Risperdal this summer during YMCA Day Camp, but the couselors were calling us at work becuase he was having emotional meltdowns. So we put him back on it.
The reason I am telling you much our dealings with all the meds is that if I had just tried the Strattera as the doctor and pharmaceutical company said it had to be given, we probably would stil be at square one. Strattera has worked for my son, but we have had much trial and error as to how to get it into him and how much and what times of the day works best with his current combination of medications.
Strattera is different as it takes along time to build up to the therapeutic dose and in that time, some early side effects can happen and/or enough time hasn't happened for a good trial run.
I understand that Strattera doesn't work for everyone. We like it that we can keep a constant amount in his system and we don't have daily medication rebound like the short acting ADHD drugs. As far as side affects, the weight gain is the only one I have seen. But then again all four of his meds have weight gain as a side affect.
And the times that he has missed doses or had to step it down becuase of surgical procedures, boy we could tell he was missing it. It isn't pretty!
We also have a typically developing younger son who is active, but it in no way resemble the older ones attention problems. The younger one responds well to standard behaviour modifications used on kids his age.
Anyway, good luck with whichever route you choose with your son. I know from experience the stress from daily phone calls from school and daycare. In fact, it got so bad that my son was eventually kicked out of daycare and now I am working part time so he doesn't have to be in daycare.
Kim Howell