Strattera : Is It For You ?
Strattera is the first FDA-approved treatment for ADHD that is not a stimulant and is not a controlled substance under the Controlled Substance Act. As a non-controlled substance, Strattera provides the convenience of physician samples and phone-in refills. Strattera has gathered a lot of publicity, and a lot of marketing money, which makes it seem like the best medication since antibiotics were developed. But its short history is filled with controversy.
There are a lot of serious questions to be answered about Strattera:
- Just how effective is Strattera?
- What are the short-term side effects of Strattera?
- What are the long-term side effects of Strattera?
- How does it compare to Stimulants in terms of effectiveness, or safety?
- How does Strattera compare to alternatives natural medicines like ATTEND in terms of effectiveness, or safety?
Strattera is a norepinephrine reuptake inhibitor, a class of ADHD treatment that works differently from the other ADHD medications available. Strattera works by selectively blocking the reuptake of norepinephrine, a chemical messenger, or neurotransmitter, by certain nerve cells in the brain. This action increases the availability of norepinephrine, which is thought to be essential in regulating impulse control, organization and attention.
See our discussion on norepinephrine here.
Taking Strattera Carefully
Take Strattera exactly as directed by your doctor. Strattera offers flexible dosing, once or twice daily. Discuss a convenient schedule for taking Strattera with your doctor. Do not take Strattera with any other medications, even over-the-counter medications! You must talk with your doctor first! Talk to the Pharmacist too!
- Our reports indicate that there can be serious problems taking anti-depressants with Strattera.
- Our reports indicate that there can be serious problems taking even Benedryl with Strattera.
- Our reports indicate that small doses of stimulants may be OK with Strattera, and may enhance treatment.
Lilly to Put Suicide Warning on Strattera Label
Thursday, September 29, 2005 from Reuters News - Foxnews.com
CHICAGO — Eli Lilly and Co. (LLY) Thursday said it will add strong warnings to its label for Strattera used to treat attention-deficit/hyperactivity disorder, including the risk of suicidal thoughts among children and adolescents.
Strattera will now carry a "black box" warning the strongest required by U.S. regulators. Such warnings typically hurt sales of products by raising concern among doctors and patients about the safety of a drug.
The Indianapolis drug maker said a review of clinical trials data identified a small but statistically significant increased risk of suicidal thoughts among Strattera-treated children and adolescents.
Risk of Suicidality in Children Treated w Strattera (Dec 05)
FDA recently alerted health care providers that treatment of children and adolescents with Strattera increases the risk of suicidal thinking. Strattera (atomoxetine) is approved to treat ADHD in patients 6 years and older. The increased risk of suici...
About Strattera (atomoxetine)
Our reports indicate that it takes 4 to 6 weeks for Strattera to work well (to reach therapeutic levels).
We believe that Lilly will experience the same problems that VAXA has in getting people to stick with Attend, which also takes 4 to 6 weeks to work well. The problem is that parents usually only give an intervention 2 weeks to work, and then they move on to something else.
Stimulants like Ritalin, when prescribed with the correct dose, work in about 20 minutes, so parents tend to go back to using them, even with the harsher side-effects. After all, the parents don't experience the unpleasant side-effects - the kids do. But the parents do enjoy the benefits of the medication around the home.
Our reports also indicate that Strattera, like Attend, has fewer "ups and downs" than stimulants.
There can be some stomach problems, but there is less of a "rebound" effect. By the way, for reducing the "rebound" effect of stimulants, try drinking a Mountain Dew at the 3 hour mark (for Ritalin). This seems to help a great deal to eliminate the "crashing" off a dose of Ritalin, and make a smooth landing.
In one of the Strattera studies the researchers reported the following adverse events occurring in some patients:
- Rhinitis (33.3%),
- Headache (20%),
- Anorexia (16.7%),
- Dizziness (16.7%).
No serious side effects were observed and no patients stopped medication or discontinued the study due to adverse events.
There have been reports of prostate problems in men with ADHD from Strattera.
Warning on Liver Injury from Strattera (March 2005)
FDA is advising health professionals about a new warning for the drug Strattera, used to treat attention deficit hyperactivity disorder in adults and children. The drug's labeling is being updated with a bolded warning about the potential for severe ...
In each of six clinical trials, Strattera was statistically superior to placebo in reducing the symptoms of ADHD in children, adolescents and adults. The positive effects of Strattera were seen for overall ADHD symptoms including hyperactive /impulsive symptoms and inattentive symptoms.
Ummm. Coffee is better than placebo.
Would you take a medication that was not better than a placebo?
Remember, Attend makes statistically significant improvements on the computerized TOVA CPT test in 70% of subjects, and 80% improvement on Parent Rating Scales; Ritalin makes statistically significant improvements on the computerized TOVA CPT test in 85% of subjects.
Is Strattera better than either of these?
One of the studies [Heiligenstein J, Kaplan S, Harder D, et al.: Atomoxetine: Clinical outcomes in pediatric ADHD with comorbid ODD.] reported the following:
"The results showed that ADHD RS, CGI and CPRS ADHD Index scores from baseline to endpoint were markedly improved in patients taking atomoxetine compared to the placebo group, with no significant difference attributable to the presence or absence of comorbid ODD.
"In the atomoxetine group, clinical response was 65.4 percent for those with ODD and 58.9 percent for those without the comorbid disorder versus 36.4 percent and 29.3 percent in the placebo group (all p values less than or equal to 0.007).
ATTEND had a statistically significant response from 70 percent of those without the comorbid disorder.
"The most commonly reported treatment-emergent adverse events were headache, rhinitis and abdominal pain. Diarrhea was the only statistically significant side effect that occurred more often in children with comorbid ODD when compared with those without ODD."
It looks on the surface like Strattera may be very helpful in treating children and teens with Oppositional Defiant Disorder and ADHD. However, the results may not be as good as either Attend combined with Extress, or stimulants.
In six placebo-controlled studies, two in children, two in children and adolescents, and two in adults, Strattera significantly reduced core symptoms of ADHD, and was well tolerated. In all studies, participants met Diagnostic and Statistical Manual, 4th Edition (DSM-IV-TR), criteria for ADHD.
Both Strattera and older treatments, like methylphenidate (the active ingredient in Ritalin and Concerta), are effective in treating ADHD.
ADHD News : Strattera
ADHD Drugs Not Linked To Heart Attacks In Kids - ThirdAge
USA TodayADHD Drugs Not Linked To Heart Attacks In KidsThirdAgeCooper and colleagues examined the medical records from four health plans involving 1.2 million patients taking ADHD drugs including Ritalin, Adderall, Concerta and Strattera from 1998 to ...
This book section: ADHD Medications
Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.
Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.
Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561