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Dr. Bob is Robert Hsiung, MD,
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Posted by teacherkris on April 16, 2003, at 11:30:40
In reply to Atomoxetine (Straterra) dsage » Lexxey, posted by paulk on April 16, 2003, at 10:44:45
I see what you're saying about poor metabolizers but look at the percentages you also posted those are fairly low. I agree with what Lexxy's saying in that we've had a lot of people on the board who seem to feel that they're getting great benefits from 25 mg or less and I too am skeptical about that based on the double-blind drug trials. I think it is always hard to tell with something like ADHD, where symptoms often worsen and improve without any rhyme or reason even without meds, whether the meds are really working. I know Concerta worked great for me but there were those days when I felt like I hadn't even taken it, and others when I'd forget to take it and think that I had. Basically I'm just saying what I say to parents at the training workshops I do "ADD is consistently inconsistent." So I think the caveat is to be careful if you're at a dose that is lower than that which is even considered therapeutic for a child to watch and make sure it lasts.
That being said I think both Lexxy and I would agree with starting slowly. If you've read my previous posts, I've been slowly increasing for the last two months and have finally made it to 80 mg. I'm very glad my doctor made me go up only 10 mg per week as I read about people who started much more quickly, had horrible side effects and quit.
Finally, Lexxy, I agree about taking it twice a day. I had been taking 40/40 in the am and again at 3 but had whined to my doctor that I only wanted to take meds once a day :-) so he said to go ahead and try it! As you say, we all know by now that the side effects seem to lessen as the days pass so I'm going to hang in for the rest of the week and then go back to 40/40 until I see my doc and ask for 60/40 for a trial without the Concerta.
We'll see what happens. Thank you all for being here and all the support and shared experiences. This board has been a lifesaver!
Posted by Lexxey on April 16, 2003, at 12:06:30
In reply to Re: Atomoxetine (Straterra) dsage, posted by teacherkris on April 16, 2003, at 11:30:40
Having to do with the slow metabolizers...I'm not sure I grasp the explanation but maybe other folks are smarter than I am and do. If a person isn't metabolizing a drug how would it be available in the body to induce an effect? It seems like they would notice little or no effects. I have heard of drug sensitive folks who need less but this drug takes a while to do the work it's supposed to do. I didn't invent the info on it...only repeat it. And I never called anyone a liar or anything.
I'm skeptical [thanks TKris, for the right spelling] about a whole lot of things. I'm just not real easily influenced and there must be a lot of folks who also do a lot of research into how these drugs work in our bodies or there wouldn't be so many folks on the net!!! For something to stick in my head I have to read a lot about it and internalize the info...took me a while to finish college...what a pain! Wish I'd had Ritalin then.
I was the one who also said that I noticed a difference in my handwriting and typing right off...just a few days after starting it and I knew that wasn't expected....but that's all I got from it until now....and actually I feel better today than I have in a whole long time...yea!!! Again!!!
Posted by paulk on April 16, 2003, at 12:28:27
In reply to Re: Atomoxetine (Straterra) dsage, posted by Lexxey on April 16, 2003, at 12:06:30
> Having to do with the slow metabolizers...I'm not sure I grasp the explanation but maybe other folks are smarter than I am and do. If a person isn't metabolizing a drug how would it be available in the body to induce an effect? It seems like they would notice little or no effects. I have heard of drug sensitive folks who need less but this drug takes a while to do the work it's supposed to do.
Once the drug is in your system it does not stay forever. Most drugs get borken-down(metabolized) into simpler parts that mostly have no effect.If someone is a poor metabalizer, the drug stays around longer and build up to higher levels.
The big point is that people don't know how well they metabalize, so it is a good idea to start slow so that they won't reach too high a level.
The trade off is that it will take longer to get a good reaction for normal metabolizers as they slowly increase the dosage. On the other hand if people start off at a higher doseage and get a lot of side-effects, these people often won't even try again at a lower dosage.
Posted by fallsfall on April 16, 2003, at 13:33:18
In reply to Atomoxetine (Straterra) dosage » Lexxey, posted by paulk on April 16, 2003, at 12:28:27
People who take Prozac (and Paxil, I think) are also slow metabolizers. I take Prozac, but I had to go to 80mg of Straterra to have any impact on my depression (and it is quite effective). I take all 80mg in the morning because if I take it at night, I can't sleep (even with the Sonata I take for the insomnia due to the Prozac...). The side effects do seem to keep going down over time (10 weeks for me, I think).
Posted by Lexxey on April 16, 2003, at 15:03:57
In reply to Atomoxetine (Straterra) dosage » Lexxey, posted by paulk on April 16, 2003, at 12:28:27
thanks...I think I see what you are getting at. I only know about what I have read and how this drug affects me and that is keeping me busy enough.
Posted by fairnymph on April 16, 2003, at 23:51:52
In reply to Re: Strattera headaches and coffee, posted by Lexxey on April 11, 2003, at 12:54:32
When I was taking reboxetine, a drug that works in the same way as strattera/reboxetine, I found that drinking coffee gave me bad headahces! I had to give up coffee basically.
> See if those headaches take place after drinking coffee. I sent the post on the throbbing feeling about an hour after my first dose and I had decided that it's due to coffee and strattera. It's not recommended but I'm not ready to give up my one cup in the am....it just smells like morning.
>
> I have always been able to sleep on coffee and even ritalin...lots of ADHD folks can.
Posted by PuraVida on April 17, 2003, at 1:46:26
In reply to Re: Atomoxetine (Straterra) dsage, posted by Lexxey on April 16, 2003, at 12:06:30
Lexxey,
The whole metabolizing thing is like the rest of what we are dealing with - looking for answers through science, and no one knows for sure. I did look it up "on the net" and basically there are a lot of guesses on how and why it is that people react differently at different times, but we do. Some of the research I saw said that people could react differently from week to week, or month to month. I know from experience that I can react differently depending on circumstances - I don't need a monograph to tell me that. Have you ever had just one drink and felt really tipsy, when usually it takes two to feel the same way? You're not less smart than anyone else is - listen to your body and intuition - do what feels right.
PV
> Having to do with the slow metabolizers...I'm not sure I grasp the explanation but maybe other folks are smarter than I am and do.
Posted by Hattree on April 17, 2003, at 9:42:10
In reply to Re: Metabolizing » Lexxey, posted by PuraVida on April 17, 2003, at 1:46:26
I'm one of those slow metabolizers--I used to take prozac for a few days and be covered for a month. Tiny bits of some drugs do it for me when standard doses just make me feel bad. (Not so others. Immediate action meds seem to be different.)
I'm on day 3 of Strattera for the second time around. Gave up the first time because I couldn't sort out the Strattera effects from stimulant withdrawal. I feel alternately sedated and then energetic and nicely focused...possibly at onset it sedates me and then the more positive effect kicks in (including appetite supression). Sleep is definitely weird, though.
Maybe the reason some people feel an almost immediate response is something like what commonly happens with Lamictal—an initial improvement after a few days which levels off or decreases but kicks back in when the theraputic dose is reached.
Posted by Ritchie on April 17, 2003, at 11:58:43
In reply to Re: Please keep the Strattera updates coming!, posted by carlyb on April 11, 2003, at 20:39:54
If you are having trouble sleeping on the Strattera I find that taking the 5 HTP 200 mg at night helps extremely well. It also reduces carbohydrate cravings.
Posted by Lexxey on April 17, 2003, at 14:12:49
In reply to Re: Strattera headaches and coffee, posted by fairnymph on April 16, 2003, at 23:51:52
I have skipped coffee for 2 days now and no headaches...but it doesn't taste like morning anymore. Maybe I will try decaf!!! I had 3 glasses of tea for lunch and started to feel like a sinus swelling type headache come on and switched to water.
Perhaps when I have taken this a while I will try it again. I'm also not feeling as drugged after the am 60mg dose so I guess I will stick with this for a while....until the appetite comes back anyway.
Posted by Lexxey on April 17, 2003, at 14:20:40
In reply to Re: Please keep the Strattera updates coming!, posted by Ritchie on April 17, 2003, at 11:58:43
What a great idea....I'm going to run out right now and get some...but it is expensive! Maybe I'll check the net.
Talking about buying supplements on the net...where do you folks get good prices on nutritional things? There are just so many.
Posted by Ritchie on April 17, 2003, at 14:33:20
In reply to Re:Strattera updates/good buys, posted by Lexxey on April 17, 2003, at 14:20:40
5 htp can be expensive, i buy mine at Green Earth, they are probably the most reasonable, I haven't checked the net, but it works and it is will worth the money and my physician recommends it.
Posted by Viridis on April 17, 2003, at 22:24:26
In reply to Re:Strattera updates/good buys, posted by Lexxey on April 17, 2003, at 14:20:40
I've had very good success (in terms of service and prices) with www.iherb.com
Posted by Lexxey on April 18, 2003, at 9:50:14
In reply to Re:Strattera updates/good buys--supplement sources » Lexxey, posted by Viridis on April 17, 2003, at 22:24:26
You are right about I-herb ...I spent 2 hours comparing sites for prices on the net yesterday and this place has good prices on all the stuff I was interested in and not just one...thanks a bunch!!!
Posted by dddiane on April 19, 2003, at 16:01:15
In reply to Re:Strattera updates/good buys--supplement sources, posted by Lexxey on April 18, 2003, at 9:50:14
> You are right about I-herb ...I spent 2 hours comparing sites for prices on the net yesterday and this place has good prices on all the stuff I was interested in and not just one...thanks a bunch!!!
Hi Lexxey!
Di from the Topamax board here. Hope you are doing well. I'm going to check out www.iherb.com. I buy a lot of my suppliments from Target ( dubious quality? I don't know?) because their prices seem ok, but I'll compare. How are you doing with Strattera? Has your hair loss slowed? Take care, and have a wonderful holiday.
Diane :)
Posted by labrat0017 on April 20, 2003, at 1:45:39
In reply to Re: Please keep the Strattera updates coming!, posted by Ritchie on April 17, 2003, at 11:58:43
i was on strattera for awhile and it made my depression a whole bunch worse, and i lost my appetite, and i just sort of stared at the wall all the time. i had zero enery, and could not get out of bed. anybody else find that?
Posted by Hattree on April 20, 2003, at 12:38:06
In reply to strattera, posted by labrat0017 on April 20, 2003, at 1:45:39
I'm experiencing some of the same, alas. How long did you stick with it?
> i was on strattera for awhile and it made my depression a whole bunch worse, and i lost my appetite, and i just sort of stared at the wall all the time. i had zero enery, and could not get out of bed. anybody else find that?
Posted by Ritchie on April 20, 2003, at 14:01:06
In reply to strattera, posted by labrat0017 on April 20, 2003, at 1:45:39
I am not really seeing any improvement in the depression either, my appetite is totally gone which I personally like, I have noticed the suicidal thoughts diminishing though so I am going to stick with it. Right now I am at 40g. I do get the crash and burn effect in the evenings but it hasn't interfered in my life so I can live with it.
Posted by Lexxey on April 20, 2003, at 16:13:00
In reply to Re:Strattera updates/good buys--supplement sources, posted by dddiane on April 19, 2003, at 16:01:15
Hi Di...
So nice of you to remember me. Hair is better but I may go back on topamax in a month or so when the Stratterta is out of my system. In stopped cuz I just couldn't take the blah feeling and I get the muchies instead of losing my appetite. It just got to making my heart beat too much. Blood pressure was ok due to the magnesium I take but I also have supraventricular tachacardia...sudden rapid heartbeat for no reason and I take meds for that so I don't need this heartbeat problem and I tried Strattera for 6 weeks and wasn't impressed.
Posted by Lexxey on April 20, 2003, at 16:15:51
In reply to strattera, posted by labrat0017 on April 20, 2003, at 1:45:39
..."and could not get out of bed. anybody else find that?"
That's just why I gave up on it and I have gone back to Ritalin just 2 days later and finally feel like me again. It's still in my system tho cuz I have awful problems sleeping...just 3 hours last night without the Unisom I was taking so i will have to take it a while longer. I'm really sorry it didn't work...I wanted it to.
Posted by dddiane on April 20, 2003, at 17:12:19
In reply to Re:Strattera updates, posted by Lexxey on April 20, 2003, at 16:13:00
Lexxey,
I see your name all over the web! No seriously, I have seen you on another Topamax forum and wondered about the hair question. I too am very vain, 51, and my hair is one of my better feature. Even after Depakote thinned it by half and I cut it to mid way down my back.
I afraid I might be just beginning to lose a little on the Topamax after five months, really bumming me (!) since it works for my moods and I have lost 23 lbs.
Please drop back by Topamax Talk http://pub123.ezboard.com/btopamaxtalk
we all really enjoyed your spunk and need your input on hair regrowth!Hope all else is well!
Diane
Posted by dddiane on April 20, 2003, at 18:08:25
In reply to Re:Strattera updates, posted by Lexxey on April 20, 2003, at 16:13:00
Lexxey,
Hope this link works better, I'm kind of blowing the dust off my html:
http://pub123.ezboard.com/btopamaxtalk
Oh, well, if it does not, you know where to find us,if you want to pop in and say hi!
Diane
Posted by Lexxey on April 21, 2003, at 11:45:39
In reply to Re:Strattera updates, posted by dddiane on April 20, 2003, at 17:12:19
Your nice words made my day....and I will drop by. I got all over cuz I was real curious about both Strattera and Topamax and wanted to learn everything. I just talked to my doc today and I plan to go back on Topamax in a month when this Strattera is out of my system...I still feel it and I stopped 5 days ago. I will go back on Ritalin...it works fine with me.
Don't say that not wanting thin hair is vain. Hair is one the few things I like about my looks...what I have left!!! At almost 60 I still have red hair...or strawberry anyway. I feel lucky there. My aunt was 88 when she died ans still had 50% red hair.
I plan to use the supplements and Nioxin shampoo so hopefully that will help. It didn't happen until about 6 months into taking it.
Posted by dddiane on April 21, 2003, at 17:28:03
In reply to Re:Strattera updates, posted by Lexxey on April 21, 2003, at 11:45:39
Lexxey,
Your aunt was 88 with half her red hair! Now I know why you feel the way you do about your red. I'm 51 with very little gray and I love my hair, I don't want Topamax to thin it too much. It's always a joke with in-laws (I don't know much of my real family), at holidays, they always want to know when exactly am I going to gray???
But I can't imagine anything being in the league of Depakote for out and out hair loss nightmares. I'd lose when I'd shampoo, I'd lose when I'd sleep. My husband was cursing and plunging out the shower drain. Hairs were wrapped around the legs of my pet birds. I was shedding everywhere and all the time. And that was well underway after three months of treatment. Ugh! Topamax does not yet compare. Please remind me that I said this later on if I really start dropping hair. :)
Topamax can be very kind to the figure though. But what a trade-off!
Thanks for stopping by the Topamax board.
My best,Diane
Posted by fender5 on April 21, 2003, at 20:50:29
In reply to Re: hypersensitivity, depression » disney4, posted by not exactly on January 28, 2003, at 20:13:16
After 1 week on strattera (40 mg days 1-3, 80 mg 4-7) I'm only experiencing tiredness/sedation/depression and decreased appetite with little if any noticeable adhd sx improvement. The first few days I had some nervousness, but that has completely dissapated.My understanding is that strattera is like an ssri in terms of its onset of action (2-4 wks), but many seem to claim benefits within a few days or not at all.
I'm willing to give this more time, but am also tempted to just return to the Ritalin. Will keep posted. Can anyone vouch for how long one can realistically expect to wait for a clinical response and if sedation efx are likely to dissapate?
Mike
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