Strattera can treat ADHD in some young children
The study shows that the non-stimulant drug is effective for some children 6 years and younger
In a new eight-week study of 101 children aged 5 to 6 years with ADHD, the drug was safe and reduced some symptoms of ADHD in children, according to reports from parents and teachers.
That said, only 40% of children treated with Strattera were “much” or “greatly improved” on a clinical assessment scale, compared with 22% of children taking placebo. Because the study was small, the percentage of children in the “much improved” or “greatly improved” category was not statistically significant.
The new findings, which appear online in Pediatrics, are similar to what has been seen in older children taking this medication for ADHD.
About 3% to 5% of children and adults in the US Have ADHD, which means attention deficit hyperactivity disorder. It is a behavioral disorder marked by impulsivity, hyperactivity and inattention.
Unlike many other medications used to treat ADHD, Straterra is not a stimulant. Instead, it works by increasing norepinephrine levels of the brain’s chemical, which helps reduce impulsive behavior and hyperactivity and increases attention.
Some Symptoms of ADHD Remain
“Overall, the medication significantly reduced the symptoms of ADHD in children and was generally safe, but these children still had some symptoms,” says study investigator Christopher Kratochvil, MD, a child and adolescent psychiatrist at the University Medical Center Of Nebraska in Omaha.
“It is important to have appropriate expectations about medication to treat ADHD,” he says. “Medication alone is generally insufficient and should be combined with behavioral therapy and parent training.”
The new study “gives us some information on how safe and effective it is in treating this population,” he says. “It would be good to have long-term treatment studies and comparative trials with stimulants.”
“Strattera is the first non-stimulant drug approved for ADHD, and overall, compared to stimulants, it does not have as striking an effect or as rapid a effect or as consistent a stimulant as effect,” says Andrew Adesman , Maryland. Adesman is the head of developmental and behavioral pediatrics at the Steven and Alexandra Cohen Children’s Medical Center in New York at New Hyde Park, New York.
According to Adesman, there may be other problems with using this medication in children under 6 years – primarily the swallowing pill. “Five-year-olds can not swallow the pills and these pills are supposed to be taken as a whole,” he says. Dust in the capsules can irritate the eyes, and cleavage of Strattera pills is not advisable.
That does not mean there is not a role for Strattera in children, he says. For example, children who did not respond to stimulants and those who can not take them due to medical problems or substance abuse at home can benefit, he says. “There are times to think about non-stimulants, but for most children with ADHD, clinicians should start with stimulants.”
Jon Shaw, MD, a professor of psychiatry at the University of Miami School of Medicine, agrees. “Strattera is best for children with ADHD plus anxiety symptoms and for teens who have problems with substance abuse or addiction because they are not as potentially addictive as stimulants.”
There are some drawbacks, he says. Strattera takes several weeks to work, while the stimulants start up correctly.
“You also can not take a vacation drug with Strattera because certain blood levels of medication are needed to be effective,” he says. Some people stop taking stimulants over a weekend or several days to minimize side effects like appetite suppression and weight loss.
“We have to be judicious before jumping to use any medication to treat ADHD and treat behavioral approaches first,” says Shaw.