Posted by ADHDdoc on April 12, 2006, at 11:15:42
In reply to Re: Lynne: (Re: Focalin XR vs Concerta » ADHDdoc, posted by SLS on April 10, 2006, at 21:18:05
> Hi.
>
> What place do you feel Strattera has in the treatment of pediatric ADD versus adult ADD?
>
> Thanks.
>
>
> - Scott
Strattera (atomoxetine) seems to be a good choice for those who need a non-stimulant. It doesn't seem to be quite as effective as the stimulants for treating ADHD. Therefore, most of the time, in a typical new patient who never has tried any medical treatment for their ADHD, I'd probably recommend a stimulant first, unless I had a good reason to do otherwise. The effect size in at least one of the adult double-blind studies was disappointingly low, but there are some methodological reasons why this alone may not tell the entire story. I certainly know of many physicians who treat both adults and children with Strattera.For those of us who have been treating patients with ADHD for a while, it certainly is nice to have Strattera as one of the options available as an alternative to patients who can't/shouldn't/don't wish to take stimulants. Prior to the arrival of Strattera, which has a pretty safe profile of common side-effects, our best non-stimulant option were ("off label," or non-FDA-approved) the tricyclic antidepressants. They have a much less favorable record of safety, particularly regarding cardiovascular problems, and they required periodic blood tests and EKGs for long-term monitoring.
I also have had some modest success using a combination of Strattera and a less-than-therapeutic dose of a stimulant, for those whose optimal response to stimulants occurs at a dose that also gives them too many side-effects.
So, I'm very glad that Strattera is available, but I use it selectively. I'd keep an open mind. Hope this helps.
poster:ADHDdoc
thread:620435
URL: http://www.dr-bob.org/babble/20060412/msgs/632146.html