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    Old 04-01-2003, 06:07 PM   #1
    DawnP
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    Question Is it safe to combine?

    Does anyone know whether it is safe to use Strattera and Concerta together? I am going to be trying my son on Strattera. Based on everything I've read, I do not want to just drop the stimulant med (Concerta) he's taking and send him off to school with only the beginning dose of Strattera. I am going to start him on a Saturday but he will have to go on the school on Monday. I am wondering whether he can take both until the Strattera gets into his system. Or, can he take the Strattera at night before bed and the Concerta in the morning before school until we get through the first few weeks of getting it into his system? My Pediatrician said that some Drs. even use it at night for some patients as it helps them sleep!

    If anyone knows, please advise!

    Thanks

     
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    Old 04-01-2003, 06:23 PM   #2
    momory
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    I have a 9 yo son who has been on Adderall for about 2 years now...He started Strattera 40 mg almost 3 weeks ago. I was advised by his neurologist to keep him on the Adderall for 2 weeks, as it took at least that long for the Strattera to work. I was told that because these were totally different classifications of drugs that they could safely be combined. My son did very well on the combination of the 2 meds and when we stopped his Adderall last thurs., he had a very difficult time the following day with impulse control, mood swings and major hyperactivity...all of these symptoms much worse that my son on no meds at all...I was ready to stop the Strattera but after reading comments from other parents have decided to wait it out another 2 weeks...He has not had another really bad day like last friday but still having difficulty staying focussed in school. We have noted a certain calmness in him, however that I have to attribute to the Strattera...not like a drug induced state but a genuine calmness...Will keep reading and posting...Have found this site to be extremely useful.

     
    Old 04-01-2003, 06:26 PM   #3
    DawnP
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    Thank you Momory, you answered my question perfectly! I think I will try both for awhile and then see how he does when we stop the Concerta. This board is really helpful. Thank you for taking the time to help.

    Dawn

     
    Old 04-02-2003, 05:32 AM   #4
    RhondaBradshaw
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    DawnP - Whew it's good to see this post. Now I have someone to communicate with. March 11th, my son takes Concerta 54mg every morning. We started him on 25mg Strattera for 4 days and then increased to 40mg and that's where he is now. It's almost been 3 weeks. We give the Strattera at night after dinner/before bed and his concerta at 6:30am. I'm here for ya. What questions do you have. All children are different but if there are any major concerns you have lets compare notes.
    Good Luck
    RhondaBradshaw

     
    Old 04-02-2003, 01:04 PM   #5
    DawnP
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    Hi Rhonda and thanks for replying so quickly!

    i am interested in hearing about your son and his personality before meds etc.

    I actually have two boys with ADHD but the younger one who is 7 is the issue right now. My older son takes Ritalin and it works for him and for us.

    The 7 year old has been taking Concerta for l year. Prior to medication he was not learning adequately in school, ws sent to the principal's office repeated for being out of control and was a generally frustrated child. The poor guy told us that his brain told him to do bad things. We had him thoroughly tested by a Psychologist and opted to put him on Concerta after his ADHD diagnosis. He also has ODD (Oppositional Defiant Disorder). The Concerta has been a godsend as he has dramatically improved his behavior and learning at school. He's also much more agreeable when on the meds. The problem is that we give it to him early in the a.m. like you so it ends up wearing off before dinner or any evening activities which make things much more stressful at home. We can't give it to him later because he already can't get to sleep at night. As a result, I was hoping the new med - Strattera might work. I will give it to him at night for a few weeks and then try it without the concerta or a lower dose of concerta and see how it works out. I definitely don't want to just drop the Concerta cold turkey without getting the Strattera into his system. From what I have read on this board, many parents haven't been too thrilled with the Strattera. It sounds like it's more of an antidepressant type drug.

    I am wondering whether your son had trouble sleeping when he was just taking the Concerta. Also, does the Strattera help him sleep? My pediatrician said some Docs prescribe it at night so the kids will sleep as opposed to taking it in the morning.

    I really don't like medicating my child but his life has improved so much with the medication and he's happier with himself. Behavior modifiation definitely does not work at this time for him.

    I will look forward to hearing your story and thank you again!

    Dawn

     
    Old 04-04-2003, 06:52 AM   #6
    RhondaBradshaw
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    Hi DawnP - Trevelyan has been on medicine for ADHD since 3 years old. He was in the finest pre-schools and was expelled because he could not control his temper and did not take well to authority (any type). I was raised by getting a spanking when I acted out. This was not and still is not the resolution for my son. It only drives his anger. I've just recently begin to learn to parent w/positive energy, leaving the negative behind because that only makes his behavior worse. Afer spending thousands in tests, psychiatrists/psychologists and them finding nothing wrong (keep in mind he was 3),our pediatrician said that Trevelyan was prime ADHD. There were NO learing disabilities and he has a very HIGH IQ. They started him on Ritalin, 3x 10mg a day and no med on weekends. It was wonderful during the week, but the weekends were so bad, as parents we could discipline his the whole weekend but it was getting him no where. He was miserable. The doc said to give him the med on the weekend. So we did. This helped all of us tremendously. By the time he was in 2nd grade, he was having trouble in school again and we increased the dosage to 40mg a day. In the beginning of his fourth grade year, he started Concerta 54mg a day because the children picked on him about having to go take medicine every 2 hours. Children can be vicious and his self-esteem was being ruined. This worked well through the 4th grade. November of this year he was having trouble getting homework done, he had a serious lack of motivation (and we tried every reward system there is) but the ability to get along with others was not the issue anymore, it was staying on task and not daydreaming that caused him problems. The doctor suggested that we changed his ADHD med completely stating that he had been on the methalphenadate (sp?) so long that his body may be immuned to it. We changed to Adderrall XR 30mg and Oh' my stars, it was the worst thing I've ever done. He would have rages (to the point where he would bang his head in the wall, or throw things), fought w/his brother (still does), tell lies about anything and literally, he didn't care about life while on this med. He could not vent his frustration in anyway but fury. We went back to the doc March 11th, and the doc put him back on the Concerta 54mg w/Strattera and suggested we get him some counseling. He has been taking the Strattera for 3 1/2 weeks now and had complained about headaches and stomach aches. He's typically not one to complain about anything. He's a pretty healthy child. Everynight this week he has had a headache and his pupils seem slightly dilated when he's complaining. I'm calling the doc today because it's not fair to give him this medicine and him have headaches. I'd rather deal w/his rages than see him in pain. He goes to a psychologist on the 15th and I'm hoping that cousneling along w/a psychiatrist for med mgmt we'll get him on the right track. This has been going on for 8 years now. I'm tired and I know he has to be. I'm ready to have a normal relationship w/my sweetheart. Some of his actions are intentional and he is disciplined for that but somethings...He can't help.
    There is our story in a nutshell. I'm re-grouping on this Strattera because I've really not seen a major difference in him. They say to give it 4-6 weeks to see a difference but I'll be damn if I'm going to watch my baby suffer from a headache every evening. Ya know...Anyway - I'll keep you posted and you keep me posted. Take care of U and those you love!

    Rhonda

     
    Old 04-04-2003, 12:08 PM   #7
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    Here is another thing you might try. It worked on the angry and stubborn children both my own and others'.

    I have copied and pasted, to save typing~
    I am a mother and a grandma.
    I feel bad for parents of unresponsive kids with undesirable behaviors. My first born daughter was hell on wheels. We just do the best we can, and trust in the "experts".

    THIS WAS ABOUT 23 YEARS AGO~
    Different doctors had told me all sorts of (in my opinion, rather abusive) ways to alter my daughter's out of control behavior and none worked. Then, in desperation, from the example in a video where a psychiatrist tried to reach an unresponsive child, I tried holding her still. It took all my strength, but I held that toddler while she kicked and screamed at me to put her down. All the while, I told her I love her and was not going to let her be out of control. Around two hours later, she went from a maniac, to sobbing, to crying, to resting quietly in my arms. Both of us were covered in sweat.

    She only went wild one more time. She pulled all the clothes out of her dresser drawers, out of her closet, tore down the window drapes, pulled the bedding and mattress off the bed, and pulled her dresser over on its side. I told her, "now you can clean it up!" She was two and a half years old. (previously said she was four, but I did the math)

    Of course, she could not clean it up; she was no longer in a rage. I let her struggle with the mattress that, of course, she could not get onto the boxsprings. I let her clean up what she could, and then I finished putting her room in order.

    That was her last full blown tantrum. She was responsive to me after that. Now, I have used this method at different times, with parental permission, on several kids labeled ADHD, which I had been asked to babysit, in past years. One was 10 years old, and it was rather easy, since he did not know me or what I would do, so he submitted rather quickly. I think he desparately wanted to be controlled. This kid was wierd seeming. He was depressed, sullen, and antisocial, failing school, seemed almost retarded in his thinking processes, and would not allow anyone to touch him. He fidgeted all of the time, and was spaced out. He had a rather dead look in his eyes.

    After I first held him, he began to look me in the eyes, and to do as I asked. I held him only once more, against his will, and that kid literally melted.
    From then on, when he saw me, he ran for my arms. He settled down in school and got good grades. His face was happy and bright. His mother cried with joy.

    After that, I taught several parents how to help their children with their "grumpies". That is what I called the acting out. I saw kids change like a miracle before my eyes. I taught one mom to stop being angry with her son, and to stop calling him a "bad boy", and to focus on that she loves him. She began calling him her "good little boy", and the child opened up, became responsive and bloomed.

    I could tell you story after story, about teaching parents to stop reacting to their children, and to control themselves, and the children always respond. This includes not allowing themselves or their children to load up on sugary refined junk food, or to refuse to eat healthy foods.

    One mom reported to me that her child took her aside one day and offered to hold her while she got HER grumpies out! (They learn their behavior from somewhere!)

    My daughter’s child was born with her angry resistence tendencies. I taught her to hold the infant, and we both held the child. This child relaxed and is one of the most responsive children you can imagine. I do not mean compliant. The child used to be given a choice to behave or to sit in the corner on a little chair. The child said, "I will sit in the chair!". The child excels in math and reading, and everyone is astounded how the way the child is mostly pleasant and well-behaved. He still can get into a fit, when over tired or sick, but now he has different consequences, and has been taught that his attitude is up to him.

    For myself, I saw that I had expected my children to
    behave a certain way, so that I then would not lose control. More often than not, I reacted to them out of frustration. When I turned that around, and expected myself to behave a certain way and allowed my children to just be kids, not little regimented adults, it was amazing how happy and generally responsive they became!

    I am just telling my own experience. This is another way to handle these children, if we just take the time to do it.

    My oldest now grown child has told me several times that he wishes I had known to hold him before he was an out of control person, experiencing the school of hard knocks. I did not know how to be a help to him, and I know how I did handle him exacerbated his personal issues.

    I did my best at the time, and was not a bad mother, but looking back, I don't pretend that I gave him what he needed, either. It sure wasn't drugs that he needed, though I am sure his teachers would have preferred it. He didn't respond to anyone back then. He did fail some classes, and graduated from high school barely, by remedial classes. Then he went into the military, came out and on his own, he went to college and got a high degree in physics. He settled down, got a great job, and is married to a great young woman. He still is spacey, somewhat, because he is a dreamer and a researcher. He tests as genious, loves to think, and is learning Greek just because he wants to.

    I would hate to think what he would be like now if I had forced him into the school or psychiatric mold, or had drugged him to force him to conform. I can't wait to meet his future children. He is positive they will be like he was while they are immature, which was very hard to deal with for anyone that doesn't understand. His wife already knows that she will likely home-school, as the public schools would not deal with it.

    Don't think you have to drug your children or force them to deal with the side-effects. You don't. Get some quality family counseling and some of the fine books out there about how to handle strong-willed children.


     
    Old 04-05-2003, 07:57 AM   #8
    DawnP
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    Mikimac-

    I really appreciate you sharing your experiences with us. I think your information is accurate and can help many!

    I, too am doing my best to parent my son in a positive way. I love him dearly and truly have compassion for his frustration. I really find that when he's hysterical I just look at him and say "are you having a bad day?" and he just melts. He really just wants to be heard.

    The problem with my child/these children is that they always want their way and tend to be inflexible when they don't get it. That's when I see him get the most frustrated. I take the time to listen but real life isn't always like that. Everyone can't always stop to listen to what he wants - as an example - a teacher with 20 kids in the class. I am wondering how to teach him to be more flexible and understanding that others cannot always make everything perfect the way thay my son wants them.

    The Concerta has really helped him as I said before. He is very intelligent but was tested as only being in the 20th percentile of other lst graders. He is now way ahead where he was. He can listen and concentrate to learn. He gets along better with other children. He truly is happier on the medication.

    I will use your advice and hold him when he is upset.

    I read a great book - "The Defiant child". I'd recommend it to others with these issues.

    Thank you again for your compassionate and wonderful information.

    Dawn



     
    Old 04-08-2003, 11:23 AM   #9
    webedes
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    RhondaBradshaw-and who ever else maybe helpful.
    i am new to the board and sure could use some help.
    My story is long and very exhausting. My son was dianosed at 4 with ADHD.He is now 12. We have tried every avenue. Meds., Couseling,Diet etc.He has been on ritalin Adderall, Concerta,strattera and now on Concera and strattera combined.His last dose of concerta alone was 108mg. He has been through all the test that you can give a ADHD child. He has a High IQ,but has no attention span at all. just when i think i have him figured out , he throws me. He is a very good kid. Without meds. he climbs the walls and hurts his little sister. Not intentionally though.I am now presently home schooling him, with the hope of sending him back to school next year. Ritalin doesn't stay in his system but for about 2 1\2 hours and doesn't usually start acting for about an hour. Before we started concerta he was taking meds, all day long.Then we started him on concerta first on 54mg until it ended up at 108mg. It worked ok, but he still had problems being distracted. I just feel like i can not find a happy medium. When he went to school , he was never a discipline problem, except for the fact that he never did any work. he just took up space in a chair.He would take the test and past them ,but for seat work, forget it.He has trouble with writing. He has dysgraphyia. He did ok until he had to change classes and could not get it together before it was time to move to the next class.that is when i decided to home school him. It has been a challenge. I recently went back to the dr. and they suggested that i try the strattera. that has been a complete nightmare.First they told me that it would take 2 weeks to build up in their systems. HA! At three weeks i called , they wanted me to wait, to be patient. I tried. I called back and they up it to 60mg form 40mg. It was ok at first in the mornings but the evenings were while. i tried to call and the nurse told me to be patient again. I told her that she just didn't understand, we were having to keep an eye on him 24\7. Then for one split instance, my son burn his leg,with 3rd degree burns. NOW the dr. has put him on combine concerta and stratterra. He doesn't sleep, doesn't eat ,his stomach hurts,more frustrated, nervous,fearful(which that was even before)has lost 5 pounds. He just doesn't look good. I chose not to give him the strattera today, He seems better. My son is a wonderful child ,who has been through enough. Please if anyone has any suggestions, please reply. He is an extreme. Thank God , He is very loving.

     
    Old 04-08-2003, 06:52 PM   #10
    TTrem
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    RhondaBradshaw: Our 13 year-old daughter has been on 50mg Strattera for more than 8 weeks and she did complain of headaches early on which caused us to consider stopping the Strattera but we didn't because initially the Dr thought it may be sinus headache (which turned out not to be true after several tests). After week 4 or 5 she stopped complaining and now she is doing fine while still on Strattera. After 8 weeks we are very happy with Strattera. There is no doubt in my mind that it has calmed her down remarkably and has helped her "slow down" with great impact on her impulsivity and ability to deal with frustrations. The Strattera on the other hand does not seem to be helping out as far as "concentration" and "focus" (ie schoolwork). She has high IQ and when she was on Concerta it was the REVERSE issues: the Concerta was helping focus but she was still impulsive , operating at a "high CPU speed" and had a volatile mood particularly in the evenings. We are eager to hear from others, however, about the idea of putting her on both Concerta in addition to the Strattera with the hope that the Strattera would help with impulsiveness and frustration management, while Concerta helps with focus. The final thing I would love to hear from others is that Strattera seems to have robbed her of a bit of her "spunky" and creative personality. She had a great sense of humor, with a quick mind and a funny comeback. Now with the Strattera, the slow-down in pace seems to have also flattened her personality and she senses that, which makes her a bit unhappy (in our mind it's a small price to pay compared to the troubles she got herself into at home and school before Strattera). PLEASE let me know how the Strattera/Concerta combination is working for you. Many thanks. TTrem

     
    Old 05-09-2003, 04:58 AM   #11
    DawnP
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    I am the person who originally posted this topic.

    I gave my 7 year old son Strattera at night for 4 weeks and continued to give him his Concerta during the day. I actually think that the Strattera might have decreased the effectiveness of the Concerta. We had an anger outburst at school last week after having a great school year prior to this.

    I did see that he got to sleep easier at night but also seemed to wake up much earlier. I think he did not sleep as well.

    I am going to take him off the Strattera for now and just continue with the Concerta. I am going to try again again the summer when I can be with him all day to measure the results.

     
    Old 05-09-2003, 11:12 AM   #12
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    Webedes,
    I can't tell you what all those years of psychiatric drugs have really done to your child's developing brain..age 4 was really such a young age to start all that. But since you mentioned the Ritalin is so short-lasting in him that seems to be a type of tolerance. It could be he has built up alot of tolerance to the large amounts of drugs over the years. There is a Dr. Peter Breggin who has written about this sort of thing.

    There are alot of books about alternate ways to deal with ADHD. Maybe you could try some of those. I have also heard that supplements like calcium and magnesium, B-vitamins, and fish oil....along with good diet, have helped alot of children. Tutoring helps on the school end for some.

    But if you decide to take him off all meds, taper them down very slowly over a few months as he could suffer withdrawals, or rebound hyperactivity, for quite awhile afterwards. Tapering may or may not avoid that but will at any rate reduce it.

     
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