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Stratera v Concerta (methylphenidate)

(16 Posts)
HisMum4 Tue 25-Feb-14 12:53:41

DS has ASD and ADHD. The school keeps raising concerns about inability to concentrate in lessons without an adult continually prompting him.

Did anyone changed from Concerta/Ritalin/ methylphenidate to anything else and seen significant improvement?

sweetteamum Tue 25-Feb-14 13:08:57

I'm sorry I don't have any advice but I'm going to watch with interest as I'm in the same position.

HisMum4 Tue 25-Feb-14 22:24:08

Anyone changed medicine?

streakybacon Wed 26-Feb-14 07:38:21

My son takes both. The aim is to reduce the methylphenidate and let the atomoxetine (Strattera) take over at some point. Hormones are in the way at the moment though.

HisMum4 Wed 26-Feb-14 20:24:33

streaky, could you explain about the hormones? Do you mean they interfere with the medication? What happens?

Why do they need to phase out methylphenidate?

ouryve Wed 26-Feb-14 21:27:43

Strattera takes a while to build up in the system - it takes several weeks to be fully effective, which means that stopping methylphenidate immediately could cause problems.

HisMum4 Wed 26-Feb-14 21:32:13

Oh, yes, it was developed as an antidepressant.

Is it working better than methylphenidate?

What about those hormones?

streakybacon Thu 27-Feb-14 07:07:36

It's just that it can be hard to determine what causes some of his issues - ADHD/Autism, teenage hormones, or personality. That means it's difficult to work out whether change in medication is working or not.

It was always a long-term aim to have a round the clock treatment. Ds has a rubbish memory and frequently forgets his three doses a day of methylphenidate. Management would be much easier if he only had one dose of atomoxetine daily so that's what we're working towards.

ThreeBeeOneGee Thu 27-Feb-14 07:11:07

You can get methylphenidate in various slow-release formulations so that only one dose a day is needed.

HisMum4 Thu 27-Feb-14 07:24:12

DS also foregets to take his Concerta from time to time it causes PR problems with the school. However, the main problem is that he is not very focussed even when he takes it. I think we should try Strattera.

Is it OK Streaky if I watch this space? Could you share your experience from time to time?

streakybacon Thu 27-Feb-14 08:08:48

HisMum Tbh I don't post much about ds's situation but feel free to ask from time to time and if I've anything to report I'll do so. We just kind of get on with it smile.

Suffice to say, ADHD and puberty is not a jolly mix.

Three unfortunately slow release methylphenidate didn't suit ds, hence the combo of immediate release with atomoxetine, which seems to work well for him (though obvs not a magic bullet wink.

wasuup3000 Thu 27-Feb-14 14:58:20

My DS is a nightmare when his slow release wears of usually at home time from school, so am interested in hearing about other medications.

ThreeBeeOneGee Thu 27-Feb-14 15:18:06

streakybacon: I'm glad you have found something that works. We have found a slow-release methylphenidate that suits DS2 but only on the third formulation we tried.

Suffice to say, ADHD and puberty is not a jolly mix.

Twelfth birthday approaching fast. Transition to secondary has gone much better than expected, but I am not looking forward to the hormones kicking in.

streakybacon Thu 27-Feb-14 15:40:36

It's taken several years to find a combination that suits ds. It's helped that we have an excellent psychiatrist who is willing to consider a range of options. The NHS were dreadful in ds's case but hey-ho, swings and roundabouts.

Good luck with the hormones. Ds is starting to settle now (15), but the last couple of years were rough.

HisMum4 Fri 28-Feb-14 00:42:50

streaky, could you expand a little about the formulation? What difference did it make? Which formulation?

streakybacon Fri 28-Feb-14 07:12:52

Not much to tell really. He was diagnosed at 10 and we left it a year before trialling medication. Started on 5mg immediate release methylphenidate morning and lunch time, then iirc up to 10mg morning and 5mg lunch. In time this increased to 10mg both doses.

We needed ds to be calm and functioning in the evenings as well as during the day so we trialled slow-release methylphenidate but it was awful, as though he wasn't medicated at all, so we returned to immediate release. We added a third dose of 5mg around 4pm.

Like I said earlier, it was always difficult to work out which of his behaviours were ADHD/autism presentation, which were drug reactions, and which were just 'him'. Add puberty in to the mix and it got even more confusing. Ds was still quite susceptible to stress in those early days too and that impacted on his presentation.

In time we started looking at longer lasting medication so we considered atomoxetine. Introduced a low dose in the mornings (I think 18mg), as well as the methylphenidate he was already taking. The aim was to establish him on atomoxetine and gradually wean him from the methylphenidate. We haven't started doing that yet - there have been times when it has looked like we could begin and have missed a couple of late afternoon doses but it's not something we can manage regularly. The hormones make him quite lively at times so we're waiting till he settles in that respect before cutting back that dose altogether.

At present he takes 15mg methylphenidate morning and lunch, plus 5mg late afternoon, and 40mg atomoxetine in the morning. That's a blend that suits him for now but we'll be reducing soon, under psychiatric guidance.

All this has been over a period of five years. It takes time to step back and analyse the effects of each drug, so it can't be rushed. Maturity plays a big part too.

Does that help?

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