Catatonic, Are You Out There?

[swmom]

Catatonic -

We recently upped the amount of the calc/mag supplement we're giving our daughter, but we still have not reached
the amount that would be 6x her body weight for the magnesium and ok for the calcium. We also day before yesterday upped the amount of Strattera we're giving her from 40 mg to 45mg, which is now the midpoint of her range. Well, this morning was just
HORRIBLE. She was super agitated, easily frustrated,
just uncomfortable in her own skin. Most of our mornings are pretty rough but today was particularly so. I'm trying to figure out what the problem is. Could it be the supplements? We're also giving her the omega 3. Any thoughts? Someone mentioned that it's possible one of the supplements is increasing the rate of absorption of the Strattera? Do you know?

[AustinsMom]

I'm not Catatonic, but am curious how much your child weighs? Speaking from experience, Strattera can definitely cause agitation, irrational anger, rage, so be aware of that also.

[swmom]

Sorry, Austinsmom, didn't mean that no one else can respond! Catatonic was the last one I spoke to re: the amounts of the supps I was using and whether it was working.

My daughter weighs 68 lbs. 45mg is the midpoint in her range.

[dfp]

One possibility is that the cal/mag is interfering with the absorption of the Strat. Apparently, because cal/mag is kind of an antacid it can block the absorption of certain medications. I know it played havoc with my son when we tried him on Adderall XR.

Only AFTER we had given up the Adderall did I read that you're not supposed to take it at the same time as Adderall. Not that it would hurt you, but it would just mess things up.

So maybe that's the case? Since I know that you have to be sooo precise with the Strat, I would think that anything that interferes with that could be a problem.

[swmom]

dfp -

When you say you're not supposed to give the meds and the calc/mag at the same time, do you mean if you're on meds you shouldn't be taking cal/mag at all or do you mean that you need to give the meds for example in the morning and give the calc/mag at some other point during the day?

[catatonic]

Okay, this can be a complicated issue and I'm not particularly well-versed in pharmacology, but here's my understanding of how it works:

There does appear to be an interaction between magnesium/calcium and methylphenidate (Ritalin, Adderall, Concerta, etc) but the interaction appears to be one where the medication interferes with the body's metabolism of magnesium (not the magnesium affecting the med). Perhaps this is one reason that Ritalin contains magnesium stearate? See www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7761553&dopt=Abstract

Strattera is not methylphenidate, it is atomoxetine. I realize this, but there is no research literature dealing specifically with atomoxetine and magnesium.

I know that I would be extremely to give up magnesium supplementation. Not only is it absolutely essential for general brain and heart function. but for children with ADHD it's got other benefits. There is research evidence that 95% of ADHD children suffer from magnesium deficiency and that remedying this deficiency will help address attentiveness problems. (See www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9368235&dopt=Abstract )

These behaviors you are seeing could definitely be side-effects of the medication. Perhaps they'll recede as she adjusts to the higher dosage?

To maximize the benefits of the magnesium, try giving it at bedtime. (I'm assuming you give the Strattera in the morning.) Giving the magnesium in the evening has a couple of benefits. One, it won't cross-digest with the Strattera. Two, it may have a beneficial effect on sleep, particularly by giving it when she's coming off the meds.

By the way, I'm really sorry you're having a hard time of it. I know stressful that can be and I'm glad you're here looking for some help (instead of hiding in the bathroom crying, which is my trick). Hang in there.

[swmom]

I appreciate all these responses. Helps me understand what might be going on. The management of the meds and the supplements, not to mention HER, has literally become a full-time job. I suppose we'll just take this one day at a time. Thank you again, for all your support.

We had a good afternoon and evening yesterday, which makes me a little more hopeful than I was yesterday morning. This morning also was good, so PERHAPS she's getting use to the higher dose and the higher dose is working. I did not give her the calc/mag this morning as I usually do nor did I give her the multivitamin. I'm going to try giving the calc/mag in the afternoon and evening and see how that goes.