Straterra or Concerta for ADHD??

Updated on March 05, 2013
J.S. asks from Chandler, AZ
10 answers

My son is 8.5 and has been on Concerta for about 2 years now. He seems to be doing better in school but I have to say I am at my wits ends. Since Concerta takes an hour or so to work, mornings are a nightmare. He is just so hyper. Every morning I dread waking up and dealing with getting him ready for school and me ready for work. We have a large family and it's hard enough simply because of that, but add a very hyper child, and it's even worse. Then by the time he gets home from school, the meds seem to be wearing off and evenings are just as bad as mornings. I feel like I don't see any of the benefit of Concerta because it's only helping at school. Has anyone used Straterra for the 24 hour effect? Are you happy with Straterra? My pediatrician doesn't prescribe Straterra and we would need to see someone else to get it. I just don't know what to do and I am so worn out. I end up yelling at him and I am afraid I am going to damage his self esteem. I feel like I need to be more supportive but I just don't know how when I am so fed up. Help!

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answers from St. Louis on

Straterra doesn't work very well if at all.

If I had a real problem in the morning I would wake them up with cup and meds in hand. When I was going to college a few years ago I used to set my alarm 30 minutes before I had to get up, I would roll over and take my adderall and go back to sleep. When the alarm went off again I was ready to get up because the stimulant kicked in.

Win win, no dragging out of bed, no fighting in the morning. :)

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answers from Philadelphia on

My 15yr old son takes Intuniv. It's the extended release form of Tenex, which he was on for many years before Intuniv. He has absolutely no side-effects from the Intuniv. He started on Adderall XR when he was first diagnosed at 5, but that turned him into a was really awful. He also developed tics soon after he started on Adderall and now has Tourettes.

A couple of years ago we tried Strattera on the recommendation of his psychiatrist. She said he was needing a bit more help with attention (although *I* thought he was doing just fine) and she was pushing the Strattera. So we tried it. He became, quite quickly, like within days, super aggressive, super angry, like a grumpy old man on steroids. Just mean and ornery. Add his Tourettes and our mornings went something like this: "Good morning, sweetie!" "EFF! SH!T Leave me the eff alone!" He became unbearable to live with and I didn't see that it did anything to help his attention. But, boy oh boy, was he awful to be around for those weeks. We took him off and he returned to his regular self, thank goodness.

But I've heard of kids who do well on Strattera. It's so hard finding that perfect medication/combination that works specifically for that one kid. The only way you'll know how YOUR son will do on Strattera is for HIM to try it. It's one of the hardest things I find about ADHD...finding that magic pill. For us, for now, it's Intuniv.

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answers from Columbia on

We tried Strattera with both of my boys before going to a different med.

With child 1 (highly inattentive, highly hyperactive), it just didn't work for us. We went with a stimulant medication (Vyvanse), and also added a non-stimulant to help with the time he wasn't on it (Intuniv). Intuniv works 24 hours, but it's not a stimulant....NOTHING out there works for hyperactive ADD kids like stimulants do. BUT, it does certainly make a huge difference in the morning and in the evening when he's not on the Vyvanse.

With child 2 (ADD, inattantive type, not overtly hyperactive): We stayed with Strattera longer...but found that my normally happy, funny, bouncy child, was actually becoming DEPRESSED on this medication. He actually had crying bouts for no particular reason! So we also switched him to Intuniv. It has been WONDERFUL for him and we're very happy with it.

My point is, you might have to try a few things out, in a few different combinations, to see how they work. With child 1, we switched him from Vyvanse to Adderall XR for a while, just to see if it would work well for him (because, honestly, the copays were much cheaper). But it didn't, and he noticed a difference in school. So communicate with him and ask how he's feeling. Keep an honest, running dialogue going with him, his teachers, and his doctors. If something's not working out, see what you can do to fix it without breaking something else.


C. Lee

ETA: The only side effect we've noticed with Intuniv: It made child 2 sleepy. He was tired during the day. So we started giving it to him at dinnertime. Problem solved...AND he gets a great night of sleep. :-)

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answers from Hartford on

There's an extended release Concerta. My [edit] eldest daughter uses that with great success. She's on the lowest dose for her height and weight, but as she grows the dosage gets adjusted.

Has your son's dosage been adjusted at all? You need to get your son to a Pediatric Neurologist that specializes in ADHD/ADD and is familiar with these medications, and is willing to meet with you frequently (every 3 months or more as needed) in order to make sure that the dosages are appropriate. There should be very close monitoring going on. Our pediatric neurologist is very thorough and does a basic physical at every single appointment every three months or so. We go over sleep issues, habits, diet, school reports, appetite, behaviors, and any other issues.

EDIT: I forgot to mention that we are thrilled with Concerta. My daughter likes how she feels on it, and it doesn't have any negative side effects for her. The "poor appetite" to start thing evens out as dosages are adjusted.

Also, I edited the first paragraph because I was thinking about my middle daughter on Intuniv for ADD. SHE gets Intuniv in the evening since it's not a stimulant and SHE won't take meds in the morning. My eldest daughter will, although she hates taking meds at all and occasionally has trouble swallowing. But she prefers how she feels and is able to do her schoolwork and homework and focus when on the medication versus what she feels like when she doesn't take it.

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answers from Jacksonville on

ADHD meds work different on each child so there's really no way of telling how it will affect yours. We got lucky- our daughter was put on Aderall first and other than going from IR to ER its worked amazingly for her, so I don't have any experience with any other meds.

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answers from Denver on

After trying just about every medicine conceivable over 5 years for my son's ADHD, we are currently using Concerta. Other than taking so long to kick in, we are pretty happy with how long it lasts for him. So many other meds, including many time release formulas, would cut out around 3 pm. Maddening.

Our doctor prescibed a very low dose quick acting ritalin for occasions where we need an immediate effect. We can also use it on nights we are going to be out late and need a little extra to get him through, or on weekends when we may not need him medicated for 12 hours but do have a short outing where he'd benefit from medication.

We have used the Daytrana patch - our only complaint with that was that he could take it off. If we put it on him before he awoke, he'd often take it off thinking it was left on from the night before. Even though we'd take it off at 5 pm each day! It also irritated his skin pretty badly after using it for 6 months.

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answers from Phoenix on

It took us a straight year trying different meds and different doses to find something that worked for my son. What works for some people, doesn't work for others. You won't know until you try it. Currently my son is on Strattera and it works while he is in school, which is the point of us putting him on meds to begin with. He is FAR from being "zombie-like" like someone else said. But it is pretty much worn off by the time he gets home from school. We just keep him very busy until he goes to bed and we can manage it. You need to just keep trying different meds and doses until you find the right one for your son. Good luck.

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answers from Sacramento on

Our son is currently on both, so I can share our experience.

I'm with you on loving Concerta when it's active and pulling my hair out when it's not. One option to consider is adding in a booster dosage of Ritalin in the afternoon. That gets our son through homework and softens the drop-off with Concerta with him. Mornings are still a nightmare.

He's currently taking Straterra with his Concerta because he was having emotional outbursts. It was a first step before considering mood stabilizers. So far, so good with Straterra. It hasn't solved the problem completely, but he's doing better. However, I can't say it's doing anything at all for his ADHD. Our son's ADHD is an extreme case, though.

Has your doctor mentioned the patch, Daytrana, at all? You can put that on your son before he wakes and it's supposed to be active much quicker than Ritalin in pill form, like Concerta. It also lasts longer in the day. Might be something to ask about, if your doctor hasn't already mentioned it. A friend of mine uses it with her son and likes it. It's a different delivery method, though, and you may not see the same benefits as Concerta.

Hang in there! Many of us know just what you're going through with the daily struggles.



answers from Seattle on

Meds work differently for everyone.

Straterra is one of my favorites, others hate it, others see no change in themselves.

Dosing is different for everyone, as well.

I have pretty raging ADHD, so my team (always work with a psychiatrist/ neurologist/ developmental Ped AND a counselor as a 2 pro team) usually works me up to double the standard dose, then back down to the min just in the TRIAL phase (3 months). Straterra is one that I worked up to 160, then back down to either 5 or 10 (lowest), and did best at the lowest dose.

On other meds Im at choke a horse doses, and on others I'm at a middling dose.

There's a LOT of trial & error with meds, as everyone's neurochemistry is different.

My nephew takes 2 doses of concerta... One before school, and one AT school. Same reasons, he burns through it in half a day... My niece is on a single dose.


answers from Chicago on

I'm speaking as an outsider here, but my nephew has been on Straterra for about 4 years now. While it seems to have helped with his hyperactivity, he also seems almost zombie-like most of the time. He's withdrawn and depressed. He was prescribed Prozac about a year ago to take in addition to the Straterra and I don't see much difference. Again, I don't live with him, but I wish they would try something different.

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