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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 658 to 682 of 1242. Go back in thread:
Posted by Susannah on May 28, 2003, at 16:11:27
In reply to Glad To Find This Group -- Starting Straterra, posted by froggyanna on May 22, 2003, at 4:32:32
Does anyone have anything positive to say about treating ADHD children with Strattera? My 9 year old daughter has been taking Adderall XR 10mg/day for about a year now and I have not seen any improvement. Before Adderall XR she took regular Adderall (15mg/day bid) for about 2 years and that worked much better; however our doc insisted that we switch to a once a day formula. She took Ritalin once, very briefly, but had an increased heart rate from med and was promptly taken off. She is already very small and thin for her age, she is only 50lbs. She has trouble falling asleep at night ans is subsequently tired and irritable in the mornings.
Her therapist thinks she will do better on Strattera because he claims she is "sad" as well and this med should treat both ADHD and her sadness. I'm taking her to the psychiatrist on Monday and I am going to ask him to switch her meds. I have read boards similiar to this and only see bad things. Does anyone have anything good to say or has anyone or their child had a positive experience with Strattera?
My daughter has a relatively mild cause of ADHD, more inattentive than hyperactive although her symptoms can change in response to social situations, school, ect.
Any information would be greatly appreciated.
Posted by Hattree on May 29, 2003, at 8:16:19
In reply to Re: ? for the strattera veterans, posted by Ritchie on May 28, 2003, at 15:42:46
Posted by Hattree on May 30, 2003, at 10:38:47
In reply to Anything Good to Say about Strattera?, posted by Susannah on May 28, 2003, at 16:11:27
Posted by gouda on May 30, 2003, at 11:25:43
In reply to Anyone taking Strattera with SSRI's like Lexapro?, posted by theo on May 26, 2003, at 16:23:26
> I am currently taking 10mg Lexapro and thinking about adding Strattera. Any input??
I am taking 20 mg Celexa (which is the "older precursor version" to Lexapro - the newer and revamped version of Celexa)
Just started Strattera, yesterday @ 18 mg, I'll keep you posted .... so far:
SLEEPY! TIRED! but pdoc said this is normal! I am hopeful!
Posted by gouda on May 30, 2003, at 11:44:56
In reply to Atomoxetine (Straterra) poop out, posted by paulk on May 27, 2003, at 11:04:47
Hello all! Enjoyed reading posts!
I just started @ 18 mg, am kinda afraid about initial experience!
Got very sleepy! Knocked out for 20 hours! Dreams were short, which was kinda nice!
Starting to feel moody! I ranted over the phone to my boyfriend for 2 hours about all his flaws ... felt kinda strange and guilty about it.
Can anyone tell me what I should expect in the coming weeks?
What is ato-moxe-tine stand for anyway? All I know is that this is NOT an amphetamine, which is a good thing.
Posted by bookgurl99 on May 30, 2003, at 12:05:48
In reply to I am a Newbie on Strattera: need support!, posted by gouda on May 30, 2003, at 11:44:56
were short, which was kinda nice!
>
> Starting to feel moody! I ranted over the phone to my boyfriend for 2 hours about all his flaws ... felt kinda strange and guilty about it.My pdoc said this is due to _too much_ dopamine. Maybe you want to lower your dose?
Posted by littie on May 30, 2003, at 12:30:20
In reply to Keep the Strattera updates coming! (nm), posted by Hattree on May 30, 2003, at 10:38:47
Let's just say, I feel okay. Not great, but not depressed. I was really beginning to have trouble getting to sleep and staying asleep but my doctor gave me some trazadone and I slept for eight straight hours last night. As far as staying on task goes, I think I'm better--much better. I don't have that I-can't-deal-with-the-laundry feeling anymore. I was hoping to feel more "up" from this drug, but I've only been on it a couple of weeks so time will tell. Just started 80 mg a week ago. I have ADD but can't take any stimulants because of a long-ago substance abuse problem. Pity. Stimulants used to be my drug of choice, because they solved all the problems I have being a citizen of the world.
Posted by gouda on May 30, 2003, at 12:52:58
In reply to Re: I am a Newbie on Strattera: need support!, posted by bookgurl99 on May 30, 2003, at 12:05:48
> were short, which was kinda nice!
> >
> > Starting to feel moody! I ranted over the phone to my boyfriend for 2 hours about all his flaws ... felt kinda strange and guilty about it.
>
> My pdoc said this is due to _too much_ dopamine. Maybe you want to lower your dose?
>
>Thank you for your post, I will make sure to sure to ask about "too much dopamine" to my pdoc next visit! ...
I thought Strattera is only supposed to affect "nonepinephrine"? How does dopamine come into play as well?
Posted by teacherkris on May 30, 2003, at 13:02:15
In reply to Re: I am a Newbie on Strattera: need support!, posted by gouda on May 30, 2003, at 12:52:58
I know I'm repeating myself but just in case you haven't read the old posts I say hang in there with the side effects and go up as slowly as possible. I started at 10 mg for a week and added 10 mg each week until I got to 80. I am now doing great with 80 1x a day. The first few weeks were rough. My students, i teach middle school, definitely had to suffer through my extreme irritability and tiredness. The first few days the tiredness was the worst and I slept a lot! I was worried and ready to give up many times during the whole process but in retrospect I'm glad he made me go up so slowly. I seemed to get the side effects back for one or two days each time they raised the dose but now it's fine. I currently take 80 mg once a day along with 25 mg of Zoloft.
Posted by gouda on May 30, 2003, at 13:16:34
In reply to Re: I am a Newbie on Strattera: need support!, posted by teacherkris on May 30, 2003, at 13:02:15
Thanks teacherkris for your reply! ... (its so hard to go through every past thread, not very organized, so I must not have read your past post)
Wow, my pdoc started me on "18 mg - 1st four days, then 25 mg - 2 week" Starter PACK ! You started on 10 mg (which I now wish I had) ... I am very sensitive to medicine, so I don't understand why he started me on 18 mg.
I am glad you told me about your irritability and sleepiness. Poor students!
I'm still very tired after 20 hours of sleep. I totally want to conk out! This is kinda a scary experience for me b/c it feels like I'm am having the flu without the high temperature.
Posted by Susannah on May 30, 2003, at 13:51:38
In reply to Re: I am a Newbie on Strattera: need support!, posted by gouda on May 30, 2003, at 13:16:34
Does anyone have anything positive to say about treating ADHD children with Strattera? My 9 year old daughter has been taking Adderall XR 10mg/day for about a year now and I have not seen any improvement. Before Adderall XR she took regular Adderall (15mg/day bid) for about 2 years and that worked much better; however our doc insisted that we switch to a once a day formula. She took Ritalin once, very briefly, but had an increased heart rate from med and was promptly taken off. She is already very small and thin for her age, she is only 50lbs. She has trouble falling asleep at night ans is subsequently tired and irritable in the mornings.
Her therapist thinks she will do better on Strattera because he claims she is "sad" as well and this med should treat both ADHD and her sadness. I'm taking her to the psychiatrist on Monday and I am going to ask him to switch her meds. I have read boards similiar to this and only see bad things. Does anyone have anything good to say or has anyone or their child had a positive experience with Strattera?
My daughter has a relatively mild cause of ADHD, more inattentive than hyperactive although her symptoms can change in response to social situations, school, ect.
Any information would be greatly appreciated.
Posted by theo on May 30, 2003, at 15:07:03
In reply to Re: Anyone taking Strattera with SSRI's like Lexapro?, posted by gouda on May 30, 2003, at 11:25:43
Thank you, keep me posted. I see my doc this Monday and I'm going to probably be getting some samples of Strattera to add to my daily Lexapro.
Posted by Angel1 on May 31, 2003, at 18:38:19
In reply to Keep the Strattera updates coming! (nm), posted by Hattree on May 30, 2003, at 10:38:47
I think Strattera sucks. I took 40mg for 3 days and that was enough for me. It increased my appetite and made me really sleepy.....more so than I usually am, which is too much already. I went back to good old ritilan which I take as needed. This is my opinion and experience with Strattera. no good.
Posted by zeugma on May 31, 2003, at 19:52:26
In reply to Keep the Strattera updates coming! (nm), posted by Hattree on May 30, 2003, at 10:38:47
Halfway through week 3 on Strattera,and very happy with the subtle changes that have taken place. Strattera defintely has a stimulating quality to it (at least as I experience it). I feel like I have to expend less energy *forcing* myself to pay attention to what's in front of me, and in consequence feel that my performance in the workplace is getting much better. Plus I'm less drained by every little task I have to do, and it's such a relief not feeling I have to conserve every ounce of available energy for stayong *on top* of myself. ADHD, for me, has been a disorder of the self that has been absolutely crippling. I was first diagnosed in 1980, when I was twelve, and the subsequent lack of treatment made for a series of ever-worsening disasters, culminating in total academic failure and subsequent hospitalization for severe depression. Now that I feel that the depression is under control, I am hopeful that strattera will help with this core problem.
This is how I'd say Strattera compares with TCA's: no sedative component to Strattera, and possibly a stronger anxiolytic component. Maybe this is because it targets the Executive Function part of the brain more effectively than older drugs. I was very skeptical that Strattera would improve on nortriptyline but it does seem like there is some effect that promotes clarity of thought more than the nortrip. Again, that could just be the lack of sedative effect, but it feels like something more is going on.
Currently I am taking 40 mg in the morning (along with 75 mg nortriptyline at night and 10 mg buspirone tid). I will call my pdoc on Monday to let him know how I am doing on this dose. I am so happy with the results on Strattera that i am thinking about lowering the dosage of nortriptyline while raising that of Strattera. The only thing i would worry about would be a return of insomnia on a lower dose of nortrip. Maybe i could substitute a lower dose of amitriptyline at night for the nortriptyline as it is much more sedative?
Posted by MomofBoys on May 31, 2003, at 23:00:26
In reply to Re: Keep the Strattera updates coming!, posted by zeugma on May 31, 2003, at 19:52:26
I was begun on 40 mg Strattera back in March. I didn't double my dose as I was supposed to after two weeks, thus I stayed on the 40 for six weeks. I was then seen again and did double the dose up to 80 mg.
At 40 mgs, I found morning doses made me extremely tired and nighttime doses kept me awake, however i preferred to use Strattera at nite with xanax or benadryl for sleep. When I went to 80 mgs at bedtime, this did not change and my early morning rising increased but it was a good thing! I was able to get up and work effectively and concentrate better on my work (i work at home on the computer). What a wonderful thing! However, come late morning/early afternoon i was dead tired and could do no more.
I like these effects that Strattera has given me but I will be starting Ritalin during the daytime soon to counteract these effects and be productive the entire day long, not just early morning. I had a trial of the Ritalin and found it to be a wonderful combo so I will take it regularly.
It's been a long time since I've been able to be functional and accomplish so much during my days. I feel human again!
Posted by froggyanna on June 1, 2003, at 15:26:08
In reply to Keep the Strattera updates coming! (nm), posted by Hattree on May 30, 2003, at 10:38:47
I started taking 40mg Straterra on May 22, so that's 10 days. I had a few side effects (slight queasiness, slight dizzyness) but they wore off in a couple of days. I actually got a slight little "high" the first day, but that went away after about two hours. In the afternoons, I experienced severe tiredness. Being unemployed, I could nap through that.
I have also been taking Zoloft, various dosages for several years. Right now I am at 100mg and that seems to keep the tendency to depression very nicely alleviated. And I am taking .2mg Levoxyl for Hashimoto's hypothyroidism for about a year now (Synthroid for many years before that).
Before starting the Straterra, after my first visit with a psychiatrist for the treatment of ADD, I started out with Buspar (buspirone) on April 30, so that's about a month now. The doc has experience with using buspirone to treat snoring and sleep apnea, thus allowing for better sleep and the possible reduction of ADD symptoms due to better-quality sleep. I don't think that it is improving my snoring at all -- I continue to sleep with a CPAP machine (continuous positive airway pressure). And since I have been fairly successfully using CPAP for many years, and supposedly sleeping well because of it, and I still struggle with symtpoms of ADD, I've concluded that sleep apnea (in my case) is NOT the trigger for my ADD.
But I'm still taking the Buspar, because I think it is working well with the Straterra in helping me to get a little more "regulated." That started even before the Straterra. I've noticed a slight increase in my ability to get going in the morning and a greater willingness to just DO the routine little things that one has to do every day that I typically argue with myself about (about whether I really want to do them or not). A lot of that weary emotionality about doing things seems to be fading. And that's a good thing! Oh yes, and I've finished reading two books!! I've almost never finished a book in my LIFE!
But I'm still feeling unwilling to tackle some larger projects and chores that are waiting for me. I still feel procrastination and scatteredness as a major element in my days, and that's what I want to change. At this point, it's crucial, because I need to find a job. We are selling our house (if someone will buy it!) because we want to find something more affordable -- my lack of income has become a crisis. Because of being laid off three times in 5 years, and because ADD has always caused me extreme strain in performing well at work, I think I've got a mild version of post-traumatic stress disorder! I need to find some kind of support, whether it's medical or ADD coaching or both, to get me to focus in on preparing a resume and preparing to go back out into the world. At this moment, I can hardly even begin to think about that.
Because I'm a believer that being hypothyroid can exacerbate ADD symptoms, I have been waiting to add any more Straterra until I can find out from my internist about the results of my latest thyroid tests. I've just recently found out that I may be missing the crucial T3 -- I'm only taking a T4 drug. I will be seeing that doctor June 10 for a complete physical and discussion of my test results. I think that getting my thyroid functioning well will go a long way toward offsetting some of the side effects of the psychoactive drugs (like tiredness).
In the meantime..... I just saw my psychiatrist for the second time on May 29. I told him that I noticed a distinct drop in my appetite after starting the buspirone and continuing with adding the Straterra. He said that because of that, I might want to consider substituting Wellbutrin as my antidepressant instead of Zoloft. He said that it has less of a chance of increasing your appetite than Zoloft does (and I have really struggled with binge eating since taking antidepressants). He said that Wellbutrin will help to reinforce the appetite-reducing qualities of the buspirone and Straterra. Plus, it might keep me from participating in my lifelong habit of ripping my fingernails! He also suggested that I take Straterra at night instead of in the morning to help stave off the afternoon tiredness (apparently studies have shown that it stays in your system for about 25 hours).
So, in summary:
0.2mg Levoxyl in morning;
100mg Zoloft in morning;
60mg buspirone at night;
40mg Straterra at night;
Add and gradually increase Wellbutrin, 100-200mg twice a day over 10 days;
Try eliminating Zoloft after this;
Add T3 thyroid treatment, possibly Cytomel;
Depending on effect of thyroid treatment, increase Straterra to 120mg max.That's my current "recipe," and I feel like I am on the right path. I'm noticing gradual improvement in my functioning and the side effects are not unmanageable. I am looking very favorably right now on Straterra, by itself and in combination with other medications.
GOOD LUCK TO ALL OF YOU!
froggyanna
Posted by LenasGrandkids on June 1, 2003, at 21:41:04
In reply to Re: Keep the Strattera updates coming!, posted by froggyanna on June 1, 2003, at 15:26:08
My wife is in the midst of a severe depression, now on its 7th month. She's bipolar and has tried all of the usual suspects - you all know how long the list is. Now on our 5th doctor, the hope is that a combination of Lamictal (as a stabalizer) and Strattera will break the cycle, bring her out of this depression (which is really, really bad and nasty) and be the combination going forward. The problem, or question, is... how long has it taken, in the experience of anybody with similar history or knowledge, for the Strattera to take effect, or at least before we know if we should give up on it? She's been taking 40mg for 5 days now and is going up to 80 after a week. Any advice would be greatly appreciated. I have gathered a great deal of insight and support from reading the expreiences of the members of this group. I do not suffer from depression, but after seeing what my wife is going through and reading the posts here I have the greatest sympathy and awe for those who have to suffer this incerdibly evil and nasty disease and somehow survive.
Thank you in advance for any help you can give us.
Posted by Hattree on June 2, 2003, at 8:56:27
In reply to Urgent question about Strattera for depression, posted by LenasGrandkids on June 1, 2003, at 21:41:04
Lamictal is a very good choice and kicks in within a couple of weeks (sometimes even days). Strattera seems to involve wading through an unpleasant period of sedation and irritability, but a lot of people here seem to be reporting success on the other side. Best of luck to you.
Posted by tanafofana on June 2, 2003, at 10:29:47
In reply to Re: Urgent question about Strattera for depression, posted by Hattree on June 2, 2003, at 8:56:27
I've been on strattera since May 9th. Started with 40mg and increased to 80mg after a week or so. I really haven't noticed any great effects. In fact, I really haven't gotten anything done around my house in weeks. I have had terrible sleepiness which the doc counteracted somewhat with provigil. I go back to see the doc on Friday which will be four weeks. So far, I'm not very impressed. However, I added strat to wellbutrin which makes me wonder if my norepinephrine was as "uptaken" by wellbutrin as possible and there was nothing left for for the strattera to do. Any comments on that idea?
Posted by teacherkris on June 2, 2003, at 10:41:41
In reply to Re: Urgent question about Strattera for depression, posted by tanafofana on June 2, 2003, at 10:29:47
My only thought would be that the sleepiness is a result of your doctor raising your dose so quickly. From 40 to 80 and even starting at 40 is really quite fast, especially when you're on other medications. Of course I'm not a doctor but from what I experienced the slower the better. As for postive effects, it seems to take up to 6 weeks at the top dose for it to take effect so you might want to give it some time. Also, in the clinical trials most people found the therapeutic dose to be around 110. Just an FYI. Good luck!
Posted by froggyanna on June 2, 2003, at 15:54:12
In reply to Re: Urgent question about Strattera for depression, posted by teacherkris on June 2, 2003, at 10:41:41
Hi teacherkris,
Are you talking about using Straterra for depression, which is what LenasGrandkids asked about, or does the "therapeutic dose" you mention refer to treating symptoms of ADD? I'm confused, because I thought that Straterra was approved specifically for treating ADD. LenasGrandkids, I was touched by your message and impressed by your support for your wife. If she has already tried "all of the usual suspects," I am curious to know what your doctor said about the usefulness of Straterra in treating her depression.
Keep seeking the light, LenasGrandkids. It is a very, very sad thing that you and your wife are going through, but she is very lucky to have you. Believe that the solution is out there.
I have some other questions about Straterra, but I'll start a new subject line....
froggyanna
> My only thought would be that the sleepiness is a result of your doctor raising your dose so quickly. From 40 to 80 and even starting at 40 is really quite fast, especially when you're on other medications. Of course I'm not a doctor but from what I experienced the slower the better. As for postive effects, it seems to take up to 6 weeks at the top dose for it to take effect so you might want to give it some time. Also, in the clinical trials most people found the therapeutic dose to be around 110. Just an FYI. Good luck!
>
Posted by froggyanna on June 2, 2003, at 16:52:39
In reply to Keep the Strattera updates coming! (nm), posted by Hattree on May 30, 2003, at 10:38:47
Hi All,
I posted in another message:
> So, in summary:
> 0.2mg Levoxyl in morning;
> 100mg Zoloft in morning;
> 60mg buspirone at night;
> 40mg Straterra at night;
> Add and gradually increase Wellbutrin, 100-200mg twice a day over 10 days;
> Try eliminating Zoloft after this;
> Add T3 thyroid treatment, possibly Cytomel;
> Depending on effect of thyroid treatment, increase Straterra to 120mg max.
>
> That's my current "recipe," and I feel like I am on the right path.
> I'm noticing gradual improvement in my functioning and the
> side effects are not unmanageable. I am looking very favorably
> right now on Straterra, by itself and in combination with other medications.I have to kind of amend that statement. I'm on my 11th day today and over the past two days, I began to notice an increase in irritability. It's been years since I've had a problem with that. Yesterday (Sunday), it was so bad that I found myself being very sarcastic to my husband in a very rare, emotional kind of argument. We made up OK, but I hated it. The irritability is definitely being caused by something I'm taking. Along with the irritability, I'm feeling increased agitation. I kind of always used to shake my leg a bit when sitting, but that has gotten even worse.
As I also said in that message, my pdoc suggested I take Straterra at night to forestall the daytime sleepiness. That seems to work a bit, but yesterday, because of the argument, and because I just want to get my act together NOW, I decided to take an additional 40mg daytime dose after the one I took at bedtime the night before. MISTAKE. The tiredness hit me like a brick and I was out for three hours. Woke up even more agitated and only slightly less irritable.
I had been told by the doc to start with 40, go up to 80, and then 120. But now I'm really beginning to BELIEVE the people who are saying to take it in 10mg increases. And teacherkris mentioned a study saying 110mg was found to be the "therapeutic dose."
So my questions are:
1. Has anyone else been advised to take Straterra at night? If so, is that decreasing your daytime sleepiness?
2. If you increased your dosage slowly, did you avoid the tiredness? The agitation? The irritability?
3. Would there be any benefit to taking part of the dose before bed and part in the morning?
4. How many days did you go before increasing?
5. Was it a month or more before you started experiencing any real effect on your ADD symptoms? Are you MAINTAINING those effects?
Those are only some of my questions, actually. I'm just so eager to get my head straightened out that I'm feeling impatient, even though I KNOW that I have to give it time. I suppose that if someone had actually stabilized on Straterra they might not still be hanging around this discussion forum. But I sure would like to hear some real success stories. I am "afraid" to start taking the stimulants... at least not until I've done all I can without them.
Thank you VERY much for any and all advice you can offer!
froggyanna
Posted by Ritchie on June 2, 2003, at 17:50:52
In reply to Urgent question about Strattera for depression, posted by LenasGrandkids on June 1, 2003, at 21:41:04
> My wife is in the midst of a severe depression, now on its 7th month. She's bipolar and has tried all of the usual suspects - you all know how long the list is. Now on our 5th doctor, the hope is that a combination of Lamictal (as a stabalizer) and Strattera will break the cycle, bring her out of this depression (which is really, really bad and nasty) and be the combination going forward. The problem, or question, is... how long has it taken, in the experience of anybody with similar history or knowledge, for the Strattera to take effect, or at least before we know if we should give up on it? She's been taking 40mg for 5 days now and is going up to 80 after a week. Any advice would be greatly appreciated. I have gathered a great deal of insight and support from reading the expreiences of the members of this group. I do not suffer from depression, but after seeing what my wife is going through and reading the posts here I have the greatest sympathy and awe for those who have to suffer this incerdibly evil and nasty disease and somehow survive.
> Thank you in advance for any help you can give us.I have taken the Stattera specifically for depression and it took a couple of months and I am at 120 mg which has been working. The depression is better and suicidal thoughts are gone. I know the FDA has only approved 100 mg but Strattera is specifically for ADD, my doctor just ran out of choices for me and we thought we would try it and it is working, it is nice to be out of the hell I was in for so long. I am not taking anything else cause I have horrible side effects. The worse effect I have on Strattera is dry mouth. Hope this helps.
Posted by fallsfall on June 2, 2003, at 20:56:11
In reply to Straterra at night ? Other questions....., posted by froggyanna on June 2, 2003, at 16:52:39
> So my questions are:
I take Strattera for Depression
>
> 1. Has anyone else been advised to take Straterra at night? If so, is that decreasing your daytime sleepiness?When I was increasing my dose I took some in the morning and some at night to decrease the side effects. Strattera wakes me up, so I now take it all in the morning.
>
> 2. If you increased your dosage slowly, did you avoid the tiredness? The agitation? The irritability?I started at 10mg and increased 10mg every 3 days. I did not have tiredness, agitation or irritability (but, again, I don't have ADD).
>
> 3. Would there be any benefit to taking part of the dose before bed and part in the morning?For me it reduced side effects.
>
> 4. How many days did you go before increasing?3
>
> 5. Was it a month or more before you started experiencing any real effect on your ADD symptoms? Are you MAINTAINING those effects?I felt a difference right away. But I have to be taking both Strattera and Provigil. Just Strattera didn't do it for me. The effects I have are increased initiative, energy and vastly reduced suicidality. My world has been turned upside down since I started the Strattera, so I don't know how good it will get, but I can tell despite my turmoil that it is helping significantly.
>I know things are a little different between depressed people and ADD people and Strattera. So our results may vary. The most important thing for me was going up slowly. I still had some side effects, but they were managable.
Be patient. Good Luck.
Posted by paulk on June 2, 2003, at 21:42:08
In reply to Re: Straterra at night ? Other questions..... » froggyanna, posted by fallsfall on June 2, 2003, at 20:56:11
I tried taking it at night - didn't work out too well. My sleep was disturbed too much.I think there is something going on with interactions between dopamine and norepinephrine levels in the brain.
I find that a reduced dosage helps with the sleepyness.
Has anyone found a successful way to overcome Straterra induced sleep disturbances?
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