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Attention Deficit Hyperactivity Disorder

Options for Improving ADHD

08/25/2003

Question:

We have a 8 year old boy that has ADHD, he was on Adderal now takes Stratta 20mg. a day. He can go to sleep okay now and he can get ready for the day without us saying his name over and over, so that is a big deal to us. His teacher complains now that he wants to make the kids laugh and won`t stop he is worst at this in the afternoon. This medication has really controlled his need to be the boss and we have seen some improvement in yelling at us when he doesn`t get his own way. What I was wondering if he needs a stonger pill or if being the center of attention and the rest of what I talked about is just him. He also can lie to get his way. I would just like to have two opinions.

Answer:

Atomoxetine (Strattera) is the new non-stimulant medication for ADHD. It appears to, at this point (on the market for about 8 months), work extremely well in 1/3 of the patients put on it, work "OK" in another 1/3, and not work well at all (or have very problematic side effects) in 1/3. Many ADHD specialists are continuing to give stimulants along with the atomoxetine, usually at a much lower dose than before the atomoxetine was started. Atomoxetine is dosed by weight. The dose is done based in kilograms (1.2 mg per kilogram) but would usually be about 0.5mg per lb. So, if he weighs 40 lbs he is probably on about the right dose (although some patients need to go a little higher. Talk with his physician about the specific concerns to see what s/he can suggest.

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Response by:

Susan Louisa Montauk, MD
Formerly Professor of Family Medicine
University of Cincinnati