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| Thursday, August 7, 2008 | |||||||||||||
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You are here: Alumbo! Self-Help Supersite > Item Detail Page 
Strattera (Part 1)This is the new drug for the treatment of ADHD.
A feature article by Anthony Kane, May 20, 2004 
What is Strattera?Strattera is a norepinephrine reuptake inhibitor. This makes Strattera inherently different from all other medications used for 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:
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. (Continued in Part 2) Anthony Kane, MD ADD ADHD Advances
Next: Strattera (Part 2)
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