Strattera plus stimulant

[akafred]

Any experience?

[auntie]

I've heard of it being done on occasion.

Not sure it is a route I would take for my child. In talking with people I know who have used Strattera, it's not exactly a miracle worker-

it has a well documented tendency for it's efficacy to tank over time

it has a considerable list of side effects- I would be concerned about GI and menstruation issues given that you have a girl

it is indicated as effective for both attention and anxiety, and yet it isn't as effective at either as other medications that are readily available.

Not to trash Strattera, it fills a void for situations where a patient can't tolerate a stimulant because of cardiac issues or where a parent refuses to consider more than one medication or stimulants in general.

I would be more inclined to do a combination of a stimulant and SSRI or a stimulant and a minute dose of an atypical antipsychotic. Normally, I would go with a SSRI first, but given that you don't have access to Char's complete family medical history, a teeny dose of an antipsychotic might be safer for her.

[akafred]

In Char's case, Strattera has been the best drug we have tried. We have only tried the one SSRI (Prozac), but it was not very effective for anxiety and made ADHD much worse, the side effects were intenable, and the weaning process was terrible, so I am not really eager to try another. On the other hand, she has tried Strattera twice and both times it has been extremely effective for DD's anxiety symptoms, not perfect but much improvement, with some improvement to impulsivity but not much improvement of focus. But as you said, the efficacy wanes rather quickly. I'm tempted to talk to the doc about adding a little stimulant, assuming it doesn't make her anxiety significantly worse, to help fill that loss of efficacy. I am absolutely not ready to try anti-psychotics. She has a family history of obesity among other things. The only thing I know about her family history and meds is her brother takes a combo of Strattera, Prozac, and clonidine and does well on it, but he has ADHD-I and no oppositional symptoms where DD has ADHD-C and her anxiety is oppositional.

[agedsubaru]

DD's dev pedi won't touch it. At the time was looking for something to add on to her current stimulant regimen. She was concerned about liver issues.

[akafred]

Jan 11, 2018 10:21:52 GMT -5 agedsubaru said:

DD's dev pedi won't touch it. At the time was looking for something to add on to her current stimulant regimen. She was concerned about liver issues.

Won't touch Strattera or won't touch the combo with stimulants?

[auntie]

Jan 11, 2018 10:21:52 GMT -5 agedsubaru said:

DD's dev pedi won't touch it. At the time was looking for something to add on to her current stimulant regimen. She was concerned about liver issues.

That could be a concern.

I know DS's psychiatrist does yearly bloodwork that includes a liver panel. DS was there yesterday and came home with an order for an EKG as well. He hasn't had one in about 12 years.

[akafred]

I understand it is a concern. It (Strattera) is literally the only med that has had any kind of real lasting benefit and no unbearable side effects. We've been trailing meds for 2.5 years. I am exhausted of the ups and downs. She does well with Strattera, I just think she could benefit from a little extra boost, especially as we are seeing the efficacy wane somewhat.