How does Strattera Work?

By Dr. Kenny Handelman

I have recently started posting to this blog. I have really appreciated the great response to it, and I am watching the comments to find questions which may be worth answering on the blog. As my subscribers know, I have a database of thousands of questions on ADHD, and I will use these as well to draw for content. To become a subscriber, please go to: The ADHD Doctor.

Tim wrote a comment the other day with a question: “I’ve recently started taking Strattera (2 weeks ago). Would you please comment on its effectiveness, how long it may take (should I already be noticing a difference if it is right for me?), why its not prescribed for kids (or is it or when it might be acceptable to use it if it is effective), and what I should be looking for in regards to figuring out whether or not it’s working?”

Let’s answer this one.

Strattera is the first non-stimulant medication which has come out for ADHD. It is FDA (and Health Canada – for us Canadians ;-) ) approved for the treatment of ADHD from the age of 6 years old and up. It is approved for Childhood ADHD, Adolescent ADHD as well as Adult ADHD. As a Psychiatrist who deals predominantly with children and teens, I occassionally like to smile at the idea of there being ‘Geriatric ADHD’. While I cannot comment on that at length, I am aware of adults who have started Strattera in their sixties with good effect.

Stratter’s other name is: Atomoxetine.

How does Strattera work?

Strattera selectively blocks the reuptake of norepinephrine (or noradrenaline) in the brain. This, in and of itself, can increase the ability to pay attention and improve hyperactivity. The interesting thing is that Strattera gradually has a downstream effect on the dopamine in the brain, specifically in the frontal lobe. Now, I am throwing around a lot of medical terms very quickly here. Allow me to explain:

The frontal lobe is the ‘command center’ of the brain. This is the area that new brain imaging studies show is most affected in individuals with ADHD. This command center allows people to use their ‘executive functions’, which are the thinking skills which allow for: sustained concentration, impulse control, delayed gratification, etc.

Norepinephrine and Dopamine are called ‘neurotransmitters’. These are little brain chemicals which jump from one nerve cell to the next in the brain to carry a message through the brain.

In individuals with ADHD, research shows that they have ‘underactivity’ of the dopamine and norepinephrine in the frontal lobes.

ADHD medication generally increases the activity of the brain chemicals dopamine and norepinephrine in the frontal lobe, and in so doing, they increase the attention, and decrease hyperactivity and impulsivity (i.e. they increase these ‘executive functions’.

So, coming back to Strattera.

Strattera brought some very unique features to ADHD treatment which were not there prior to its release.

The benefits of strattera include:

  • 24 hour symptom control – although it takes the medication about 3-4 weeks to ‘kick in’, when it does, it works 24 hours per day, contrary to the stimulants which work up to 12 hours per day
  • No abuse potential at all: because there is no increase of dopamine in the part of the brain called the nucleus accumbens, Strattera cannot be abused to provide any pleasure
  • No increase in tics: because Strattera doesn’t increase dopamine in the part of the brain called the striatum, there is no increase in motor or vocal tics with its use. So, for people with ADHD and Tourette’s, this is likely the best ADHD medication
  • Good for ADHD + Depression or ADHD + Anxiety: A recent study showed that Strattera helped depression and anxiety (when they were present in combination with ADHD) and the ADHD. This can often mean that someone could take one medication for their condition – i.e. Strattera, instead of needing to take two medications – i.e. one for ADHD and one for the anxiety or depression
  • May help for nocturnal enuresis: Strattera causes some ‘urinary retention’. This means that for some children who wet themselves at night, this medicine may lead to more dry nights. This is not a main treatment use for strattera, but it can be a side benefit
  • May not cause ‘personality changes’: Some of my teenage patients complain that their stimulant medicine helps their concentration, but may take away their personality, or spontaneity. Strattera is a good option for this, as it does not clinically appear to cause these results

Strattera works for approximately 75% of people who take it. There are some data which suggest that if one takes it after having had treatment with a stimulant, that this may yield a slightly lower response rate. Why is this? It is my clinical impression that this does not relate to the fact that the stimulant has ‘changed the brain’, but rather the fact that as in many conditions in medicine, if something doesn’t respond completely to the first treatment used, it is much less likely to respond to the second treatment – i.e. it is ‘harder to treat’.

How can you tell if strattera is working?

Generally, one should notice an improvement in concentration, and a decrease in hyperactivity and impulsivity. The benefits should generally last for 24 hours -and be more ‘steady’ than they are with the stimulant medicines. As mentioned above, it takes about 3-4 weeks for Strattera to start working, so one needs a little patience.

The long acting nature of strattera means that the benefits of the medication last into the evening – meaning that if a teen has homework or a project to be done, they can still have the benefits of the medication to help them late at night.
Also, there are a lot of data that people with ADHD have many more troubles driving – increased tickets, motor vehicle accidents, etc. So, if a teen (or adult) is going to drive home late at night after a party -it is better if their ADHD medication is still working in their system.

The last part of your question, Tim, was why this medicine isn’t prescribed for kids. The answer is (as I am sure that you have gathered by now) that it is used for kids too.

There are some safety issues with Strattera, and these will be addressed in an upcoming blog post.

Thanks for the great question Tim, and I encourage other readers of the blog to comment on this or any other post. Please remember, that I cannot comment on every question, or every post, but I will try.


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Comments

  1. Jon burton says:

    I have ADHD and used to take strattera a long time ago and it worked but now I am in Collage and the symptoms of ADHD are for some reason more prevalent now. I can’t really live in the moment if you know what I mean. I try but for some reason my mind always stays busy. It’s like there is a constant inter monologue or threw line going on in my head and I can’t just relax. If I take Strattera again would this possibly go away?

  2. Cheryl says:

    in addtion to my last note my son still is ADHD today and age 28 but deals with it in other ways besides taking meds. Yes it can be done.

  3. Michele says:

    I have an 8 year old son with ADHD. We have tried most of the stimulant drugs but it seems each one has a side effect. He has been on the Daytana patch which I love, its been great but I’ve noticed an eye blinking tic recently so his neurologist suggested switching to Strattera. I’m nervous to start it but I have no choice since the stimulants bring out tics for him. Do you find this happens a lot?

    • Wendy says:

      my daughter is 10yrs old and was diagnosed with ADD(no hyperactivity) at age 5. We have tried 7 different meds between then and now and found that strattera has been the best fit. She went off the meds over the summer and is now starting them again and I just had a question about it. She complains about being very tired at school and I wanted to know if giving it to her at night would still be helpful at school the next morning? I was afraid that she will lose the benefits of it during the night.

    • amanda reese says:

      I had my son also on daytrana patch its seemed to work but he had the eye blinkink tics n also started to stutter in that case it means its too much for them (he is 5) he a 5 mg then to 10 n then 15 but we did not noticed any help just tics. So we r now taking strattera n I’m on day 4 n noticed it causes him to be very sleepy we take it at night before bed n so far we are doin good but the doctor told me to give it a week to notice any changes but no tics with this he dont stutter no more like he did on the patch n it also burned his poor butt n dried him out so give it a try I was nervous to but it seems to be a good choice

  4. Pip says:

    Found this blog after talking to my doctor about trying to medicate what I believe is a life long battle with add/adhd.

    Every thing I have read about ADD/ADHD fits me to a T. Even though I was a bright child and got very high marks in tests my inability to focus and do homework made me a failing student. I’m messy and could never keep a clean home or workspace which is a point of shame for me. My lack of a degree has effected my ability to take care of my family because at the job I currently work I do not make enough to support them to the extent I am capable of. I also feel I have various addiction issues. I have been a marijuana abuser since I was 18 years old in reference I am now 35. I realize now that I probably do self medicate my issues with marijuana. I also have unhealthy addictions to video games and sex. Relationships have never been easy for me. I never had a problem finding love but after time I would start to feel restless and would find reasons to alienate that person until the relationship was over. I used to abuse alchohol but I was thankfully able to keep that under control. I am a diabetic and my lack of focus and impulse control issues makes it hard to control my blood sugar in a consistant manner. Plus my smoking pot contributes to the health issues I am already dealing with. I am a father now with two beautiful daughters and a woman who loves me. It’s because of her that I am seeking treatment for this because she works in the mental health field and she’s seen the symptoms and is raising a daughter from her previous marriage who was diagnosed with ADHD and we are very similer in behavior. I talked to my doctor and am currently trying strattera to hopefully get a hold on this. Having read others issues with this condition makes me very sad because I feel with more education and guidance I could have maybe faced this fully at a younger age. As it stands now I feel like I have lived a life wasted dealing with something I couldn’t understand. I do feel better reading others stories and also want to thank you for having this place for discussion of these issues.

    • Sarah says:

      Thank you for what you wrote. I have a wonderful 9 yr old son who in the last 2 weeks has tried two different stimulants. Unfortunately the side affects were bad so today I was literally in tears not knowing if I should keep “chancing” it or call it quits and “deal” with it. I am going to keep trying because I do not want him to have to feel what you do. I don’t want him to struggle and self medicate himself as he gets older. Thank you for your honesty. It helped me,if nobody else.

  5. A student on Strattera says:

    I found this blog and I think it may provide the step in the right direction in terms of advice. I am a 23 year old college student who has been diagnosed with bipolar disorder, chemical dependency, and ADHD. I have been clean (no drugs, including alcohol) for almost 2 years. Both of my manic episodes in life have been drug-related or drug-induced, so I lately have been questioning the bipolar diagnosis. Before I got clean and began a strict medication regimen, I was on Lexapro for depression. I began buying Adderall from others students and of course, with no direction from an MD, used it incorrectly. It led to no sleep and a manic episode.

    Now, I am on Strattera and Lamotrigine for mood regulation. I found Strattera worked in the very beginning. I was so cloudy from just getting clean and finally being free from all the chaos of mania that I noticed an increase in concentration. That was May of 2009. Now, in November 2011, I feel like Strattera’s efficacy has declined, for me. I’ve been on a string of antidepressants, most recently Wellbutrin, and recently my doctor took me off all antidepressants because Strattera has antidepressant benefits and “sometimes, depression just goes away on its own,” as she put it. I would say my mood has been slightly better.

    A few weeks ago my doctor said she was thinking about trying Adderall with me, but worried because of the abuse potential, and because I had abused it in the past. As she said, “It worked for you but you abused it.” As a person with a history of substance abuse issues (otherwise known as addict), I expressed a slight worry about Adderall. A few minutes later I realized she had made a mistake. Yes, I obtained Adderall without a prescription but I never took out-of-this-world doses, never snorted it, never used it for anything but trying to complete my homework. I left that meeting discouraged because I wanted to revisit the idea of trying Adderall but we ran out of time. A meeting a few weeks later, I brought up Adderall. She said she would need to think about it. I should mention that about a month prior to her even suggesting Adderall, she increased my Strattera. I had lost the Rx and so I officially began taking the new dose at this time. I take 60 mg at night because it makes me sleepy, and 18 mg in the morning. I have also begun taking a supplement called L-Tyrosine on my own (my doctor doesn’t comment on amino acids.) I notice no change. If anything, I notice that now, I am more distracted than EVER. I actually cannot do a task for more than 5 min unless it is enjoyable. On my browser, if I come across a word I don’t know, I Google it. Then I open more and more tabs as things pop into my head. These are usually websites that have nothing to do with what I am currently trying to achieve, ie, schoolwork. Currently I have an exam at 9:00 and I have 7 tabs open; only 1 is related to studying for the exam.

    I am desperate for help because as soon as I graduate in December, I have to hold down a real job and/or possibly apply and go to graduate school. I know I have great potential but I think I need something that works better for me than Strattera. I want to try an extremely low XR dose of Adderall. I truly feel good to be off antidepressants for now. Lamotrigine is necessary for mood control. But Adderall, I feel, could be an savior because increased concentration = better outcomes, decision making, goals getting accomplished, etc. This leads to feeling better, ie, better mood.

    It’s hard explaning this all to my doctor especially because our meetings consist of a 5 minute chat, renewal of prescription, and her cutting me off anytime I say anything personal that does not relate specifically to my mood and attention. Not that that’s bad, but it is not a very conducive environment to feeling heard.

    Sorry this is so long but I tried to be as concise as possible. If you could offer anything, even a sentence or resource to look at, I would be immensely grateful. I have 6 weeks left in my final semester at a very tough college and I would like to go out on a note a bit higher than the dismal one I’m currently on. Thank you.

  6. A SHORT version of "A student on Strattera" says:

    Oops… I just realized my previous comment is so long!

    Here is a concise version of my dilemma: I used to buy Adderall from classmates two years ago. Now I am on Strattera prescribed by an MD. I don’t feel like Strattera is working AT ALL for me. I am super distracted and find it hard to get motivated to do even the smallest task. Now I am considering trying Adderall but my doctor is reluctant because of my past history. She keeps increasing Strattera though my symptoms don’t approve. I don’t know what to do, and I don’t want to seem like the stereotypical college student begging for Adderall.

    Any advice would be greatly apperciated!

    • Krissy says:

      Hi, I am currently on Adderall XR 20mg in the morning for ADD, also pristiq 100mg for depression, and 25mg Lamictal for my so-called bipolar. BTW, antidepressants were the only reason i had one or two manic episodes.

      Anyhow, I have been on the Adderall for 2-3 weeks. It definately helps with getting motivated to complete tasks/chores. However, if I’m not moving around and I sit down to read, get on the internet or my cell phone, I get extremely hyperfocused on what I’m reading. It’s very annoying when I should really be exercising, completing chores, paying attention to my son, etc. Hours will pass without accomplishing anything besides reading blogs. Guess I need to let my mind get used to the dose or decrease it. I guess I’m having the same problem as you do with Strattera and hyperfocusing. Sorry, just wanted to let you know that u may want to try Adderall, but it may have the same issue as Strattera. We just need to stay away from our phones and internet!

  7. Laura says:

    Dear Dr. Handelman,

    My son was Diagnosed with ADHD, just under 1 year ago, he turn 5 just this summer. The doctor that he is seeing is a pediatric neurologist. He has been reluctant to put him on medication due to the fact that he has had a very difficult time gaining wieght but eats a very large amount through out the day. I have recently been working with a children’s mental health centre, he is now in the centers milleu program which is having good benifits as i am not the only one seeing the behavioural difficulties that he has including opposition, impulsivity, and temper control. I just had a meeting with the whole team that over sees the benifits and such for my son both phycologist on the team are recomending that my son go onto strattera and think that if there are no side effects that hinder it’s usage with him it would be a good match. I was wondering if this would be true considering that all the research that i have been doing is suggesting that it is for children 6+?

    • Laura says:

      There is also a history of bi-polar illness and depression in the family as i myself have bi-polar and my mother has clinical depression.

  8. Erica Forman says:

    For anyone who has a child that seems to be suffering with ADD or ADHD symptoms or for anyone who has a child that has been diagnosed, I strongly urge you to read Last Child in the Woods by Richard Louv
    http://www.youtube.com/watch?v=ejyMJWh2qFw&feature=related

    This book is absolutely amazing and definitely an eye opener for parents, teachers, and child care providers of all kinds. I am a parent and a preschool teacher. I am not making money on the book, its just the only book like it of its kind, and I try to tell as many people as I can about it. You can get used sometimes at used book stores, but it is also very inexpensive on amazon or sites alike.

  9. mykstor says:

    I’ve taken Strattera as well as other ‘selective reuptake inhibitors’, as this class of medications is called. None of them are 100% targeted to only norepinephrine, dopamine or seratonin; i.e. none of them are exactly and ingeniously ‘selective’. What’s more, to detect these three main classes of neurotransmitters*, cells have numerous ‘flavors’ of receptors and these meds still don’t constitute the perfect match as far as usurping the exact combination of subclasses of receptors goes. Scientists still need to learn much more and beyond that, create meds that not only do the job without also targeting other wrong receptors, but molecules that are not overly toxic to totally unrelated parts of our bodies, such as the liver and furthermore easy to metabolize without creating toxic byproducts in the process.

    All of them have caused me periodic itchiness, which varied in intensity from time to time. Often this would affect the back of my hands and I’d find myself scratching them until I noticed I was bleeding. Why the variance? It’s doubtful anybody really knows. And remember these meds are all about nerves and the way they behave. It might be connected to many things, perhaps connected to something one has recently eaten, which in turn changes amount of many other chemicals circulating in our bodies at various times, like trace metals, hormones, hundreds of different enzymes, amino acids, levels of vitamins.

    *there’s another major neurotransmitter only recently discovered, nitric oxide, (Molecule of the Year for 1992), which earned three researchers a Nobel Prize in 1998. Their discovery led directly to the invention of Viagra and its subsequent cousins, all of which, too, are not yet perfectly targeted to just the right subset of receptors nor totally without breakdown byproducts which play some havoc. Hence headaches, backaches, bluish vision, etc. as side-effects. Nitroglycerin had been in use as a source of this neurotransmitter for well over a hundred years, but nobody knew that one of its breakdown products, nitric oxide, was a true neurotransmitter. We’re learning it has many functions, but is most famous as a vasodialator, meaning it relaxes blood vessels allowing increased blood flow.

    I’ve had ADHD since I was a tyke back in the ’50′s well before it had a name. I was simply an odd, boisterous, stubborn child, an enigma to my folks.

    I’ve learned over many years that I’ve always been quite bright. At age 4 I could never accept the inevitable answer to my obsessive questioning “Why?” about everything I was told to do.
    My exasperated and often face-slapping mother insisted that I make do with: “Because I SAID SO!” I already understood at that age that this was tyrannical and totally unacceptable. I took every kind of punishment, but I never shut down and quit asking ‘why.’
    I suggest to any of you parents who respond in this way:
    Consider that just maybe your AHAD child might be exceptionally bright, perhaps brighter than yourself, and like any adult is insulted by intimidation when he/she intuits the parent actually has no answer, is too proud to admit it or believes the child isn’t ready for the honest truth. Increasingly, scientists suspect that ADHD is a portion of a ‘cluster’ or ‘spectrum’ of related abnormalities. Severe autism at one end, going towards Aspberger’s then less ‘abnormal’ to AHAD. With increasing knowledge comes the discovery that often such children posess a spike or more of genius in some areas beyond their parents’ and that far more of the problem is a communication wall than previously thought. iPads are working miracles opening up surprisingly bright brains to a populous which had naively perceived only subnormal IQ. Google the ground-breaking Aspergers woman, Temple Grandin, who sees both sides and has done so much to help enlighten the formerly ignorant about the degree of intelligence and emotional capabilities of many who lack the capacity to be heard and understood.
    One astounding example: It was long thought autistic children didn’t want to be held or touched because they didn’t have the emotional wherewithal to crave it. Turns out that probably ALL autistic children love touch and holding, but at the first encounter with it at birth became phobic because touch was always so spontaneous, often leading to head petting, getting dragged somewhere, picked up, kissed.. just roulette. This suggests that the moment autism is detected, touch needs to be so predicable that the child doesn’t immediately associate it with “all hell will break loose” and henceforth fear it for life.
    Is there anyone still reading? I told you I was a problem child. My folks tried to beat me down, but I still suck up knowledge at 63 like a sponge am obsessive about my interests and am proud of it;-)

    • slackermom says:

      As a mother of a daughter with ADHD/OCD, I totally agree with you that my child is of above average intelligence. She hasn’t proven it on an IQ test but I believe that is only because she can not pay attention to the instructions. I have always been told by everyone who meets her that she is very smart and they can not believe the stuff she comes up with. She is highly imaginative and creative, and I wonder sometimes if that is why her brain gets locked with intrusive thoughts. I am on a forum with other parents of kids with OCD and 90% of them talk about how highly intelligent their children are, but because of their conditions they don’t perform to the standards of mainstream society. I absolutely without a doubt know that my daughter is brilliant. I have tried my best to not “beat that out of her” as you called it. I am not going to lie…sometimes I lose my patience and I am not as supportive as I should be. When she was a really little kid and she gave me those non-stop questions about things I couldn’t answer, sometimes I would make things up just to give her an answer. Lately though, I will say “I don’t know” or sometimes I just say, “google it’. I know your mom couldn’t do that 50 years ago. :)

    • s from pdx says:

      ADD/ADHD is distinct from the autism spectrum. A kid with ADD has trouble focusing, but ASD(autism spectrum disorder) is about not understanding social cues. ADD is treatable with meds and also helped with CBT. Autism is only proven to be treatable with ABA and CBT. We did much better coming off meds with our ASD kid. I have personally dealt with both in my immediate family and have tried everything from diets to meds to neurofeedback to OT and countless others.

  10. christina miller says:

    Hi, I just started taking strattera today but in the genetic form of atmoxetine. I have ADHD but as well as many effects of depression and anxiety, which one of the main reasons why i choose this medication to help all three, but to my surprise i read the box and it said it can INCREASE my symptoms of depression anxiety and my mood. I know it says in young children and teenagers, but im only 20, and im wondering what are the chances of suicidal thoughts and a increase? I dont want to take a ton of meds to help with each of my problems. but i can not take the pressure anymore

    • Rob says:

      Hello Christa,

      Like yourself, I had those same concerns. It is not easy taking any kind of medication. Especially once you read the “pro’s and Con’s” of the drug. When we embark on such a mission to rescue ourselves from our issues, we have such high hopes to get better. The chances of suicidal thoughts and anxiety very from person to person. Remember, your treatment provider knows your history and would not knowingly prescribe a medication to you if you demonstrated suicidal tendencies. When I started taking it, like you, I had those same concerns. The fact that you are addressing them shows you are mature and are arming yourself with knowledge. Good for you! That’s important. Another suggestion I would give you is to have someone you trust check on you from time to time and make notes of any changes in moods, speech or general activity. After about 6 or 7 months, ask that person to share with you what they observed and be sure to give them a free pass to be open and honest. You will find this a BIG benefit to you. If you have any questions or need any support, drop me an email. azsumday@yahoo.com. Take Care Christa.

  11. Eric Frederic says:

    My daughter is 9 years old. She had ADHD and MERLD (miced expressive receptive language disorder) She is constantly asking questions about the human body. She will obsess on the brain for days at a time. What does it do? When color is it. What does it feel like etc etc etc. Then she will move on to another part of the body. I check her interrnet websites and she look at dozens of sites for answers. I try to give her answers but I’ve finally resorted to “Google it?” She is a bright child. Has an unbelievable memory and as a child always assigned people she meets a color. I’ve always been “Black” and Mom has always been “Red.”
    Her fine motor skills like drawing, writing clearly and coloring are still very unrefined and she has a hard time making “small talk” with other kids her age. I guess I am wondering if you ever had a connection between lack fine motor skills and obsessive questioning? Any insights would be appreciated. Thanks!

    • Mike Storer says:

      More and more studies are discovering a very blurry line between a “cluster” of disorders, perhaps starting from the hardest to communicate with or relate to cases of autism to milder cases, to Aspberger’s syndrome, where individuals are more able to ‘fit in’, to more severe cases of AHAD or ADD and / ODD to milder cases of hard-to-control attention, to any degree of ‘quirky’ tendency to preoccupation with subjects that the majority considers outside the norm, to people who blend in quite adequately, but are in some way an eccentric, in other words “outside the circle” or “off center”. It’s frankly quite a mess right now as more and more variations on a general theme are able to be spotted, are reported much more than before and clinically identified, while at the same time this growing stack of somehow related degrees of “misplaced” attention or ‘atypical behaviors’ has not given away its secrets and avenues of connection with one another.
      And it somehow leads a thinker to the conclusion that each and every one of us balances on this tightrope somewhere or another and none of is unaffected by some kind of quirkiness, some ‘oddball’ quality we’d be too ashamed to tell even our closest friend. We can’t stop buying lotto tickets, we overeat, we’re sexaholics or else phobic about sex -or germs, stuffy air, have a silly predilection to collect some odd thing we don’t talk about, or simply can’t resist watching yet another game on TV.

      What can one do? I’m 63 and now know I’ve had a form of this syndrome all of my life. I’ve had quirky, unusual interests all of my life. I drove my folks nuts because I wanted a chimney for Christmas, (actually, one of those metal vents on roofs for furnaces, drains, etc, and that are to be seen in all shapes and kinds). Another year I desperately wanted a stop light, you know, a regular red-yellow-green automatic traffic signal. I never got any of these things (yes, there were others). I look back now and feel my folks mishandled so many things. Often it would have been only a matter of acceptance and less embarrassment, sense of failure or angst about what I’d become as an adult if they’d given in. Of course my folks’ motives were good; they loved me, wanted me to be well-liked, not laughed at in school, to be have a successful life as an adult with a family and three kids. In the ’50′s as a child, parents had nowhere to turned and dealt with ‘problem’ or ‘odd’ children such as myself the best way they could and unfortunately often corporal punishment such as slapping, ridicule, to throwing one’s arms in the air to indicate to the child how really ‘weird’ or what an ‘oddball’ he or she was. I recall overhearing my grand folks in the next room telling my parents in a somewhat low voice how the child of some acquaintances of theirs had been such a problem, “Well, It was a miracle, they took him to a clinic and this surgeon operated on his brain, just a tiny snip. You wouldn’t believe the miracle, he’s now the nicest kid and so sweet.”
      I was seven when I heard this. I was also very, very smart. Actually, the problem was, I was too smart for my parents’ egos. I say that with love. But it was true. They’d rather I shut up than put them to the task of dealing with boundless curiosity. That was surely the root of many a slap across the face by my mom for refusing to not be told ‘why?’ Unfortunately, this is a very human foible and perhaps I’d be tempted to resort to the same if it were relentless. For instance, I doubt very much that my mother understood that that boy had been lobotomized, but it wasn’t lost on me!
      To the point:
      ADHD is a curse, but also a blessing. Don’t ridicule your child into submission or ‘normalcy’ Don’t make him/her fear and loathe himself for being ‘different’. It can take years and years to undo such damage. Teach your child that each of us is unique and a wonder. Give him tools to live with himself lifelong with self-love. Show him how to set one, two even three alarms on a calendar to give himself time to shift from one subject he’s hyper-attentive about to the next. ADDers have a hard time ‘shifting gears’ from one subject to another when deeply involved. My mother would bark at me from my bedroom door to go do something else. Man, I’d be so far away, she’d frighten the daylights out of me. I spent years feeling like I was walking on eggshells with nowhere to hide.
      ADDers are stubborn as mules. This gets tempered with age, but remains a trait and can lead to excellence by stick-to-itiveness with learning foreign languages, calculus, getting a sculpture just right without giving up.
      I’ve learned so much about so many topics, traveled everywhere, managed to work on my own without dealing with a boss everyday. There’s a life for your child out there. With all you see as drawbacks, there is equal brilliance, excellence. Don’t over-worry it. Teach tolerance for others instead. Come up with inventive tools, clocks and timers, allow extra time to change subject matter. Where your child lingers ‘too long’ on something, he’s learning right in that moment more profoundly than you perhaps ever dreamed of doing. Whether you deem it of value or not is not for you to know. LOVE AND ACCEPT. PRACTICE TOLERANCE. Towards yourself and all souls.

      • Jen Jesso says:

        Mike,
        Your post was so inspiring for me! I have a six year old son who has a diagnosis of PDD and is going to be evaluated for Aspergers. He also has ADHD. Like you as a child, he rarely asks for toys for Christmas. He wants water-towers, cell phone towers, furnace fans. All i want is for him to be liked and fit in. I’m always worried about him and his future. Will he have one? Will he be happy? Reading your story reminded me that I need to be patient and support his quirkiness…embrace it and love him for who he is. I’m happy to hear you have grown and had a successful life and relationships.
        God Bless you.

        • Mike Storer says:

          Thank you Jen. It means a LOT to me to hear that even one person read and, better yet, got some good out of what I wrote.
          Yes, yes, your son sounds so much like me at that age! I would draw how I imagined the insides of a refrigerated drinking fountain or air conditioner must work, etc. I wanted a “real” ream of paper!! Very odd wish before everyone had a home printer. I got laughed at, but after much pleading, it was one of the most memorable gifts once I got it. I was a jumper. I’d jump for .. hard to guess.. maybe fifteen minutes standing in one spot. I became ashamed of jumping as I got older, but it felt so good and helped my mind re-design and invent all kinds of cool things. Or perhaps I’d fantasize about some exotic land I wanted to go to and what it would be like. It was really just the same as many who get a strong urge to pace or take a walk when absorbed in thought. My folks finally got me a Pogo Stick.. one of their smarter solutions; I’ve always had these huge legs of a quarterback. I became good with my hands and learned to make art with all kinds of mixed media. I’ve made tons of art I’m really proud of and sold some beautiful things that display nicely in palatial homes far richer than my blood.
          Just one more thing and PLEASE don’t anybody fret, as I have absolutely no reason to know or if this is related:

          Already at the age of 4, 5 or 6 I began to suspect there was something “different” about me sexually, too. Of course I was still far too young to understand what that meant, but it was enough to make me fearful and worry as I was figuring out more each year what I’d best not ever talk about. I wasn’t ever very effeminate, but I was near the last pick for sports, dreaded that shame, but I did care about re-designing my folk’s home and dragging them around to show them some house our’s should be. That was suspicious enough. And I learned quickly how I must behave to cope with living in a household, brother, sister and society very backward and negative towards homosexuality (imagine the 50′s and 60′s and my dad a big narcotics officer who went off to work with his .33 Special and chromed handcuffs every morning). I’ve often wondered if a few of the things I was interested in as a child were sexual sublimation, as I was certainly trying to figure out many, many mysteries.

          So you can see, I was this child who was wonderfully creative and bright on the one hand and on the other a worry, frustration and I’m sure at times an embarrassment for my folks and older siblings. And all of this through an era that was the epitome of Conformity with the Joneses.
          Keep in mind that in those Dark Ages, “gayness” (nobody knew that word) was scorned with complete self-righteousness. It was classified as a horrid disease by the same industry and perhaps the very university Dr. Handelman attended.
          Even today more than a few alcoholic husbands, for instance my decades later re-found playmate from second grade and I suspect even my own grandfather– ended up on the bottle because of taking the only known, or at least acceptable, path to a premature marriage with kids that should never ended up in such a mess. Yes. We are all too judgmental of others. The biggest part of the problem is stupidity, not whether your children are “different” or not. Don’t ever let them be the brunt of any small thinking you may still harbor. Just teach them to have courage to be who they innately are.
          The huge cultural tsunami of the later 60′s and 70′s happened just in the nick of time for me. I was just old enough to flee to a much more liberal and enlightened Europe in that era and really begin my own life. I’ve been happily espoused for twenty years now. Although the U.S. still denies us a legal document, we have a good life and are as happily married as any reader here.
          In closing let me say that I don’t believe ADHD has anything to do with which gender one ends up being attracted to, but in my case, I believe it was a blessing in that it gave me the stubbornness and will to push through and not be beat down by others’ stupidity.
          Anyone who believes this much harder path is a “choice” and the chooser is a “sinner” has his/her head up… yeah, up there.
          Teach your kids self-pride for their own individuality and acceptance of others.

          • slackermom says:

            Wow! Almosts speechless….my daughter who has ADHD/OCD is an artist. She can draw with amazing ability.

            But something you said triggered something with me. The part about being sexually aware at an early age. My daughters OCD started in 3rd grade and as intrusive thoughts. Her biggest fear was “people having babies”. That’s exactly how she would say it and I could never get her to explain what she meant. She is 12 now and we are still working through her anxiety. The other day she told me she was having “bad thoughts’ which is what she calls her intrusive thoughts. Sometimes she will tell me what they are though often she will not be detailed about it if she does tell me. She told me that day that she had the thought that she was gay but she knew she wasn’t. But she thinks she thought that because my nephew is gay and we always compare her to him. I just told her that no matter what…whether she was straight/gay I would love her. And that everyone has probably thought about it at least once. I also agree that it is not a “choice”. I could recognize it in my nephew when he was 7 or 8 years old. I just don’t think he would choose it. After you telling me about your grandfather though, I am wondering about my own dad who is now 73. He is an alcoholic. He always had a lot of homosexual friends. One of his best friends growing up lived in his family’s home and was gay. Hmmm…I wonder.

  12. Olga says:

    My son is 6 and has text book features of ADHD/ODD. He was always a very bright, active boy who never sat still, but it wasn’t until he was 4 in pre-K that he started having significant problems both at home and at school. We tried a year of behavior therapy and I cut back on my work to give him more attention/structure (my husband and I are both physicians). Despite our efforts, he continued to get worse. I was very hesitant to start him on medications, but after a year of trying other techniques, we opted for the medication route. It was trial and error, but we finally found the perfect combination of Intuniv 2mg and Concerta 18 mg. It was a dramatic change and he got great reports every day in kindergarten and I was finally seeing the light at the end of the tunnel. The real treat for me is that his ODD symptoms seemed to go away almost completely. Then, the tics started (strange eye movements with head turns). We had him evaluated by a neurologist and neuro-ophthalmologist who both agree they are tics most likely brought on by the Concerta. So we stopped this 3 weeks ago and his behavior in school has deteriorated to the point that we may have to change schools (and his teacher at the current one is excellent with years of experience so this did not come up lightly). Unfortunately, the tics haven’t gone away completely (which is a bit unexpected after stopping the Concerta), but I still think the association between the Concerta and the tics is there as they did get dramatically better after stopping it and the tics developed less than 2 months after starting the medicine. Now, I’m not quite sure what to do as I’m worried about starting him on another stimulant. I’m particularly worried about him developing Tourette’s syndrome. I’ve come across Strattera, but his psychiatrist isn’t a big fan (she participated in the study that showed it wasn’t so helpful in 5 & 6 year olds). Any thoughts?

  13. Ryan says:

    I’m 21 years old and have gone thru many stimulants and also had neuro feedback brain training. None of these have worked. I am willing to try strattera, but here’s the catch. I’m about to have my baby boy here in a week or so and want to be myself. Should inbe concerned about irritability or anything such as that, that could conflict with me being as happy as I should? Is right now the best time to get on strattera?

  14. Julianna says:

    I have been a nurse for 13 years and personally also have struggled horribly with ADHD since atleast the second grade in school. I have taken Strattera since 2007 and it has 100% changed the quality of my life. I personally don’t feel that any pill is a “miracle” drug that will take care of each and every problem or symptom we experience in life, as I still personally struggle with anxiety at times, But overall the ADHD symptoms and depression that can be present with ADHD are pretty much non existent while I am taking Strattera. I personally notice a difference the first and every time I take this medication and that is no lie. One of the immediate affects of this drug for me is I notice much more attentiveness while I am driving that I had no idea was even missing (Scary).I cannot imagine not being on this medication and plan to remain on it the rest of my adult life unless there is any indication that it would be known as harmful to the body. My son who is almost 8 years old is also being looked into as being ADHD and I am planning to ask about him being put on Strattera. I feel that people with ADD or ADHD need to do what is best for them and what they decide, not necessarily either medicate or not medicate. However I am telling you all that I personally am now medicated and only wish that I had been sooner in my life.

  15. will says:

    I was prescribed straterra, up till this point i haven’t taken it yet. i was just prescribed last week. The problem i have is, i am 36 years old, i haven’t had regular doctors checkup or appointment probably in 20 years. I am overweight.. meaning 5’7 230 pounds, but i am unsure if i have any heart conditions, as far as i know i do not. What if i were to take it and have sudden death? Is there really any risk? My regular doctors appointment is march 19th, he sure isn’t going to give me an ekg etc.. etc.. so it’s not like i’ll ever know for sure until something bad happens! Am i paranoid or?

  16. slackermom says:

    Thank you so much for this article. My daughters psych recommended that her peds change her from Vyvanse to Straterra for her ADHD/OCD. I was worried about changing. We are going for the visit to change tomorrow. Your article was very informative and I am truly hopeful that my daughter will find it helpful.

  17. I have an 11 year son which is so frightened of life,I was told he has ADD.He plays soccer and I just feel he give 50% of himself. Will this help him as there is so much side effects.The doctor has recommened Straterra.

  18. Mike Storer says:

    Hello Teresa..
    So you have a sixth-grader? Although eons ago, I vividly remember my classmates and teachers in those years. I don’t know how the system works where you are, but we kids moved to middle school –junior high– the next year for 7th grade. What a tumultuous change! Those are really rough years for all kids. Hitting puberty, growing an inch a month. Personalities start to become more defined, everyone’s clamoring to fit into one clique or another and fears abound about being left out or not being considered “cool”. Boys start locking horns and girls start competing for attention and comparing their looks. If you think back, we bordered on being savage, hormonal animals. I guess that’s why they put those 2 or 3 years in a separate school almost like a separate cage.. I say this half jokingly. But only half..

    In light of the above, I wonder if you have all the information about what’s going on in your son’s world and in his head.
    On what do you base your statement, “he’s so afraid of life”?
    Being a fearful person, child or adult, certainly doesn’t come to my mind as a major hallmark of ADHD.
    However, I can see how repeatedly suffering surprise attacks, frequent physical accidents, forgetting what one is supposed to be doing, then becoming startled out of one’s wits by sudden yelling.. all because of poor attentiveness to one’s surroundings –or more aptly put, hyper-attention on something fascinating far off elsewhere– could condition anybody to be a constant state of anxiety and fearful of taking any action at all.
    Similarly, who told you he has ADD? Your family doctor? If so, based on what, exactly? I hope more than just your observation about fearfulness or his telling him that.
    I think for the time being, Straterra or not and whether Straterra works or not is not even the issue. If I were your physician and heard what you told everyone here, I’d be more interested in gathering more knowledge about your son’s exact fears and finding out if there’s a reason for it, if something or someone has traumatized him –just finding out exactly what’s going on there. maybe even enlisting the help of a therapist to get him to open up.
    Has he always given “only 50%”? From where do you have this notion? Maybe he’s trying 110% but it’s still not good enough for you? I’m not saying this is the case, but you know there are parents who are like this. Their children can never do or be good enough for them. Such a child, dependent on parents for survival, has no choice but to become resigned to never being quite up to snuff, becomes withdrawn and gives up to a certain degree before he even gets started. Does he have a dad around? If so, is his dad rarely or never satisfied with things your son does? For if so, that could certainly make him feel worthless and apathetic about trying.
    I was in 2nd through 9th grade with a neighborhood pal who did poorly all through school while I did very well. At age 60, we found each other after all these years and began corresponding. Boy, the things I’ve learned by patiently asking and listening! He’s every bit as bright as I am and loves to learn. But he one of those kids who just fell through the cracks. Come to find out, his dad was a full-blown alcoholic and his mom perhaps, too. He told me our fourth grade teacher was the only one who encouraged him. She told his parent he needed help at home with reading. Chris just told me this recently, “But my folks never lifted a finger to help me.” They had other interests. They even joked that he wasn’t a real bright bulb. Once I reminisced with him about making papier mâché dinosaurs in 5th grade. He confessed to me that he never made his because he didn’t understand what we were supposed to do, but was too afraid to ask any more questions! With these two pieces of information, the needless tragedy of it all dawned on me: My friend’s only fault was being in the wrong grade. He should have been held back a year to give his little neurons the time they needed to catch up. This was such a stigma for parents, the thought of having a “slow” child, so naturally we kids believed this ignorance, too. So it never happened.
    Had he been given the time his natural genetic makeup required to mature, I suspect he would have gotten much better marks, a bit of praise, and his self-esteem wouldn’t have been half as battered all through school and later in life.

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