Expert: Dr Billy Levin - 5/24/2006

Question
HELLO DR. AND THANKYOU FOR THE FAST RESPONSE.  MY HUSBAND STOPPED TAKING RITALIN AFTER COLLEGE.  WE STRUGGLED HEAVILY IN OUR RELATIONSHIP AT FIRST.  WE WERE FRIENDS FOR ABOUT A YEAR, THEN WE STARTED DATING.  WE BECAME PREGNAT 3 MONTHS LATER.  WE DID EVERYTHING BACKWARDS.  WE HAD OUR SON AND THEN MARRIED TWO 1/2 YEARS LATER.  IT WASN'T UNTIL MY SON WAS DIAGNOSED, AND I STARTED RESEARCHING ADHD, THAT I LEARNED SO MUCH ABOUT MY HUSBAND.  I ALWAYS THOUGHT HE WAS INTENTIONALY TRYING TO PISS ME OF BY BEING LAZY!  HE NEVER REMEMBERS ANYTHING.  HE CAN'T FIND ANYTHING!  HE BLAMES ME FOR EVERYTHING.  HE SAYS THAT HE DOESN'T LIKE HAVING TO TAKE A PILL TO BE NORMAL.  MY SON IS A TYPE 1 DIABETIC, I TRUST HIM HERE IN MEXICO WITH NO ONE.  THE TWO OF THEM ARE DRIVING ME CRAZY.  THE LAST TIME WE WERE HOME,(MICHIGAN) IN APRIL, AFTER MANY PLEAS, MY HUSBAND FINALLY CONSULTED WITH HIS DOCTOR.  HE WAS PUT ON BOTH CONCERTA 18MG AND STRATERA.  IN HOPES AFTER A MONTH THE STRATERA WOULD BE KICKED IN AND WOULD DO THE JOB, ELIMINATING THE CONCERTA.  MY HUSBAND CAME HOME A WEEK AFTER ME, AND GO FIGURE, BECAUSE I WAS NOT THERE PACKING HIM UP AND MAKING SURE HE HAD EVERYTHING, HE FORGOT HIS MEDS.  I FEEL MORE LIKE THE MOTHER OF TWO, AS TO ONE.  I AGREE THE CONCERTA SHOULD BE HIGHER, BUT WHAT HAPPENS AFTER 12 HOURS.  MY SON IS NOT A HUGE SLEEPER!  I LOVE HIM TO DEATH.  I ALSO HATE THAT HE HAS TO TAKE THIS TO BE NORMAL.  I DEAL WITH THAT STRUGGLE ALOT.  I JUST FEAR FOR HIS SAFETY.  HE IS QUITE THE DAREDEVIL.  IF THE DOSE OF CONCERTA IS INCREASED.  WHAT HAPPENS AFTER THE 12 HOUR MARKER?  THANK YOU SO MUCH.

Answer
Strattera is not very effetive on it's own. Concerta 18mg is a very small dose and will not work! If both are increased to an optimal dose there is a very good chance for success provided they get taken regularly. To obtain an optimal dose the doctor should use rating scales.Using the combination will give a full days cover.