Strattera working at a lower-than-target dose?

[AC]

Based on my 14-year-old son's weight, he should probably be on about 60 mg of Strattera. Because he is doing well on his 40 mg dose, his ped has opted to leave it as is.

I am wondering if anyone has had success at a lower dose than recommended but had even better results at a target dose.

PS- Hi Anne

[AnneM]

Hi AC !! It is really good to see you here

I am going to boot this up on the hope that someone has some help here!! ....

[Millermom]

Hi, AC
You don't say his weight?
My son can do very well on lower than target dose, in fact, I find sometimes I have to titrate the dose down as it seems to have some build up over the course of a few months. If I see him getting oppositional and petty, I lower about 1/3 for a week or two and he does very well. Once he starts to get "Fuzzy" I raise it back up and he goes on his merry way.

There is also his metabolism to consider, if he has a slow one, he might not need the target. Most of the parents I have read from have effectiveness on lower doses but only temporarily. So enjoy it now, when you start to see "Fuzzy" or "Weepy-Emotional" you can feel good knowing you can go higher iand it will porabaly clear it up.

Meds can be very mysterious, can't they?

[HooDunnit]

Hi Millermom and welcome to Veronika's website. Good luck with your own website. I'm sure you are helping many people!!

[AC]

Hi Millermom

Happy to see you here, and thanks for your reply.

My son weighs about 110 lbs.

If I am understanding your reply, you notice your son becomes a bit "oppositional" and "petty" on a too-high dose? Do you know why that is? I ask because I am noticing that my son seems to occasionally get a bit on the mouthy, raised-voice side later in the afternoon lately.

I haven't attributed this behaviour to the Strattera since it isn't a stimulant, but I wonder now after reading your post if it could be (or it could just be typical obnoxious 14-year-old behavior).

My son has always been extremely sensitive to stiumlants yet he has a very fast metabolism (eats like a horse but stays slim and trim) so I can't imagine that at his weight the 40 mg. could be too HIGH a dose.

What do you think?

Thanks again for all your help.

[Millermom]

Hi Hoo, Thanks for the welcome!

AC,
"Mouthy" is a pretty accurate word for too high a dose in my son. But, he gets "weepy" easily on too low of a dose. Still, I can imagine this might manifest itself as "Mouthy" during puberty ! Not looking forward to those years! Not uncommon for depression to be expressed with anger at this age. Isn't that what puberty is all about? Heh! I bet its a combo of his age and the low dose. Remember it has anti depressent properties and low doses will have negative effects on most kids. Too High of a dose is aggitating to the whole system. It can cause mild hypertension, most kids will react with very negative behavior. In extreme cases kids have gotten violent, I don't recommend going over 1.5mgs/2.2lbs. Besides the weepiness, lower than target doses have inconsistant results for my son.

There is indeed a sweet spot for this med and it's completely weight dependant, ever changing with growth. So for 110lbs 60mg would be the manuf. rec. minimal dose. 75mg Would be the max. Somewhere in btwn is the just right dose with max bennies and min side effects to "Attitude". The bad thing about Strat is that it takes a bit more observing and managing and tweaking than the other meds. But I'd walk a thousand miles for the results we've had these last 10 months.