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May 2003 - Strattera - Part One
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In January 2003, after five years of research, the
medication Strattera became generally available. Experts are now beginning to
gather additional clinical experience as to its effectiveness. This month I will
discuss Strattera and my experience in its use with children. Next month I’ll
talk about adults.
Strattera is used for the treatment of Attention Deficit
Disorder, and quite different from any other medication currently in use. Since
January I have been gaining personal experience in the use of Strattera for ADD,
and I would like to review the medication and my results to this point.
The aim of any medication for the treatment of ADD is to
reduce the significant symptoms. These include, among others: distractibility,
short attention span, hyperactivity and restlessness. The goals with Strattera
are no different than those we have with stimulants, but there are many
differences in how it functions.
Strattera is taken once a day and works for 24 hours. It
has less impact on sleep and appetite than do the stimulants. It is also
different because it takes two or three weeks to become effective. The initial
dose is related to weight, with increases possible at a later date.
Following is a discussion of my findings to date. These
results are to be understood as a work in progress and designed to give the
reader an idea of what I am seeing with my patients.
Eighteen children from 7 to 17 have tried the medication. A
good result means that the major symptoms of concern were well controlled so
that they were no longer considered a significant problem.
Seven did very well. The results were comparable to the
stimulants they had been on, but without any of the problems such as reduced
appetite or trouble falling asleep.
Four did not respond at all. This number is not out of
keeping with the failure rate discussed by the pharmaceutical company that
developed the drug.
There were three who, according to their parents, did well
at home. But the school called saying they were off the wall and all their
symptoms had returned. Why this occurred I don’t know. However, time did not
permit changing doses and they were again started on stimulants.
The jury is out on the remaining cases. I am observing some
and increasing the dose with others. I’ll know more in a month.
In summary, there are many good results and many reasons
that Strattera might be the drug of choice. It is not more effective than the
stimulants, but different and a new treatment approach for ADD.
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