Strattera



Posted: Wednesday, December 29, 2004

by Anthony Kane MD
ADD ADHD Child Behavior Treatment and Medication



Strattera



What is Strattera?


Strattera is a norepinephrine reuptake inhibitor. This makes Strattera inherently
different from all other medications used for ADD ADHD.


Norepinephrine is one of the main neurotransmitters used by the nervous system.
Neurotransmitters are chemicals the body uses to communicate between nerve
cells. Although there are many neurotransmitters, the main ones involved in
ADHD are dopamine, norepinephrine, and serotonin. Ritalin and Dexedrine, the
two paradigm stimulant drugs used to treat ADHD both increase the level of
dopamine and norepinephrine in the brain. That seems to be how they work.
Strattera very selectively affects only the norepinephrine pathways. It does not
influence the function of other neurotransmitters.


How does Strattera Help ADHD?


The short answer to this question is that no one really knows, which is the same
answer that we have to the question of how Ritalin and Dexedrine work.
Although the neurotransmitter pathways seem to be involved in ADHD, we
don't completely understand the connection.


For those of you who are not satisfied with that answer, here is the currently
theory. First, you need to have an understanding of how the body regulates
brain function using neurotransmitters.


Nerve cells communicate with each other through chemical messengers, or
neurotransmitters. There is a tiny space between two communicating nerve cells
called a synapse. When a nerve cell communicates with its neighboring cell,
either to stimulate it or inhibit it, the cell does so by emitting a small amount of
chemical, a neurotransmitter, into the synapse. The neurotransmitter comes in
contact with the recipient cell and either stimulates or inhibits the cell. As long
as the neurotransmitter is floating around, it can affect the recipient cell.

To
limit the duration of this affect, the body clears the neurotransmitter from the
synaptic space as quickly as possible. It does this in one of two ways. It may
release an enzyme to break down the neurotransmitter. A more efficient way is
that the nerve cell that sent out the neurotransmitter reabsorbs it and stores the
chemical for later use.


Thus, it comes out that the body can regulate the effects of neurotransmitters in
four ways:

  1. It can control the amount of neurotransmitter released.
  2. It can control the rate of the absorption of the neurotransmitter.
  3. It can control the amount of enzymes available to breakdown the neurotransmitter.
  4. It can control the sensitivity of the recipient cell to the neurotransmitter.

Whatever path the body chooses to regulate neurotransmitter function, there is
one basic principle the longer the chemical sits in the synaptic junction between
cells, the greater the effect that neurotransmitter has. With this we can begin to
understand what Strattera does.


Strattera is a selective norepinephrine reuptake inhibitor. That means that when
a cell releases norepinephrine to stimulate its neighboring nerve cell, Strattera
gets involved by inhibiting the first cell from reabsorbing the norepinephrine in
the synaptic junction. The net effect is that there is more norepinephrine around
to stimulate the nerve cells.


Norepinephrine helps to regulate attention and arousal levels. Increasing
norepinephrine in the frontal lobes of the brain seems to enhance attention,
concentration, and organization. This is the current theory of how Strattera
works.


How was Strattera tested?


The safety and effectiveness of Strattera in the treatment of ADHD was
established in six randomized, double-blind, placebo-controlled studies in
children, adolescents, and adults. Over 4,000 children, adolescent and adults
were included in these studies. Over 1,000 of them were treated with the
medication for one year or longer in systematic investigations.


Strattera has not been tested in children less than six years of age or in geriatric
patients.

What are the Side Effects of Strattera?


The most common side effects in children and adolescents in medical studies
were upset stomach, decreased appetite, nausea and vomiting, dizziness,
tiredness, and mood swings. In adults, the most common side effects were
constipation, dry mouth, nausea, decreased appetite, dizziness, problems
sleeping, sexual side effects, problems urinating, and menstrual cramps. Most
people in clinical studies who experienced side effects were not bothered enough
to stop using the drug.

What is Special about Strattera?


So why is everybody so excited about Strattera? Well, Lilly is excited because
in less than a year, they have already grabbed 12% of the ADHD market away
from the stimulants. But why should you be excited, or should you be?


Lilly claims that Strattera has four advantages over the other available
medications.


To Page 2

 


Anthony Kane, MD



ADD ADHD Advances


Anthony Kane, MD is a physician and international lecturer.
Get ADD ADHD Child Behavior and Treatment Help for your ADHD child, including child behavior advice and information on the latest ADHD treatment. Sign up for the  free ADD ADHD Advances online journal

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