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Dr. Bob is Robert Hsiung, MD,
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Posted by Trixie on August 29, 2003, at 14:25:13
In reply to Re: What Strattera dose is too low/high, help.., posted by lessismore on August 21, 2003, at 12:39:29
I started Strattera 40 mg in the AM a week ago and am experiencing a tremendous degree of fatigue. I'm exhausted by noon and if left to my own devices, would sleep for the rest of the afternoon. I am also experiencing insomnia; I can fall asleep if I take an Ambien but as soon it wears off, around 4 am, I cannot get back to sleep.
I can't tolerate this for much longer b/c it is destroying my ability to perform at work.. .I was wondering whether anyone has been able to overcome this side effect through evening or night dosing, and whether anyone has had this side effect resolve in time.
This is my first posting here - I was recently diagnosed with ADD and this is the first ADD med I have tried.
Thanks.
Posted by Lasagne on August 29, 2003, at 14:59:56
In reply to Strattera and fatigue: AM or PM dose?, posted by Trixie on August 29, 2003, at 14:25:13
> I started Strattera 40 mg in the AM a week ago and am experiencing a tremendous degree of fatigue. I'm exhausted by noon and if left to my own devices, would sleep for the rest of the afternoon. I am also experiencing insomnia; I can fall asleep if I take an Ambien but as soon it wears off, around 4 am, I cannot get back to sleep.
>
> I can't tolerate this for much longer b/c it is destroying my ability to perform at work.. .I was wondering whether anyone has been able to overcome this side effect through evening or night dosing, and whether anyone has had this side effect resolve in time.
>
> This is my first posting here - I was recently diagnosed with ADD and this is the first ADD med I have tried.
>
> Thanks.
>Response to above:
Hi: I began the Strattera in the morning and I experienced the same as you are. The doctor advised me to switch to the evening. It helped resolve the daytime sleepiness, but after about a week or so I began having several wakeful periods in the middle of the night. It seems like every two hours I would awaken instead of just sleeping all the way through the night. My doctor then put me on a small dose of Flexeril 10 mgs (a muscle relaxer) at bedtime. That resolved the sleep issues. After about 5-6 weeks on the Strattera most of the obnoxious side effects reduced or completely went away. I can understand your frustration especially if you have to work a full time job. Luckily when I started the Strattera I was a stay at home mom and had flexibility with my schedule. I didn't seem to get much done during the foginess, nausea, lethargic period, but now I do get a lot accomplished and I can go without a nap more often than before my ADD treatment. So all I can say is be patient. If the Ambien doesn't do the trick for you, then you might want to consider a small dose of a muscle relaxer. It really makes a huge difference in how I sleep.
Good luck, Lasagna
Posted by lessismore on August 29, 2003, at 15:14:42
In reply to Strattera and fatigue: AM or PM dose?, posted by Trixie on August 29, 2003, at 14:25:13
I take it at 11:00 or so at night, and I also experience fatigue, but not as much as if I took it in the morning. I am about to start my third week, I'm at 40mg, and have noticed a big improvement. Side effects suck, but it's worth it if I can get organized! And they'll go away.
Posted by manyparts2001 on August 29, 2003, at 16:26:32
In reply to Strattera and fatigue: AM or PM dose?, posted by Trixie on August 29, 2003, at 14:25:13
I never experienced drowsiness with Straterra, but did have wakefulness during the night, so I took an herbal supplement of melatonin which is not habit forming and doesn't leave me feeling drowsy in the morning.
After being on it since April at 80mg/day divided twice/day I finally stopped taking it because of all of the side effects, aggressive behavior, rapid heart beat, profuse sweating and a lot of anger. The benefits were not worth it to me even thoughI was able to concentrate so much better. Oh yes, I also, supplemented with Ritalin 2-3 times /day, and that is what I am on now, with none of the able side effects. Good luck. I hope it works out for you.
Posted by Trixie on August 29, 2003, at 20:19:53
In reply to Re: Strattera and fatigue: AM or PM dose?, posted by manyparts2001 on August 29, 2003, at 16:26:32
Thanks, everyone, for sharing your experiences.
Posted by keffrey on September 1, 2003, at 7:29:01
In reply to Re: Strattera and fatigue: AM or PM dose?, posted by Trixie on August 29, 2003, at 20:19:53
Does anyone have any experience with Wellbutrin and strattera? My 12 year old son has been on Wellbutrin for over a year with pretty good social skills related results. However, Wellbutrin has done nothing for pretty severe attention issues. We are now considering Strattera for those.
Thanks
Posted by bige on September 1, 2003, at 7:36:30
In reply to Re: Strattera and fatigue: AM or PM dose?, posted by Trixie on August 29, 2003, at 20:19:53
In regards to wellbutrin and strattera. I have been on wellbutrin for 2 years along with Ritalin. Worked ok for me but I am 40 yrs old. Just switchedabout a month ago to strattera and Wellbutrin and it works great so far.
Posted by keffrey on September 1, 2003, at 9:55:16
In reply to Re: Strattera and fatigue: AM or PM dose?, posted by bige on September 1, 2003, at 7:36:30
> In regards to wellbutrin and strattera. I have been on wellbutrin for 2 years along with Ritalin. Worked ok for me but I am 40 yrs old. Just switchedabout a month ago to strattera and Wellbutrin and it works great so far.
ThanksHas your doctor mentioned the possibility of eliminating the Wellbutrin?
Posted by bige on September 1, 2003, at 16:33:05
In reply to Re: Strattera and fatigue: AM or PM dose?, posted by keffrey on September 1, 2003, at 9:55:16
No he hasnt mentioned going off Wellbutrin but I also was on Lexapro and I took myself off of that.
Posted by Lasagne on September 2, 2003, at 14:27:56
In reply to Re: strattera and wellbutrin, posted by keffrey on September 1, 2003, at 7:29:01
> Does anyone have any experience with Wellbutrin and strattera? My 12 year old son has been on Wellbutrin for over a year with pretty good social skills related results. However, Wellbutrin has done nothing for pretty severe attention issues. We are now considering Strattera for those.
>
> ThanksReply to above post: We don't have experience with Wellbutrin and Strattera combined, but my son does take Celexa (another antidepressant) with the Strattera. Right now he is having great results on both medications. He is 11 years old and he takes 25 mgs. of Strattera in the a.m. and 50 mgs. of Strattera in the evening along with his Celexa.
My husband takes Wellbutrin and it does have some effect on the impulsiveness of ADD, yet alone it doesn't give enough control so my husband takes Concerta (time release Ritalin) with it. The Wellbutrin mostly helps keep my husband's mood stabilized and the Ritalin helps keep him focused and not so impulsive or hyper.
Good luck!
Lasagna
Posted by utopizen on September 2, 2003, at 19:19:11
In reply to Re: Strattera and fatigue: AM or PM dose?, posted by bige on September 1, 2003, at 16:33:05
Well, when I started on Abilify, I was extremely tired just 20 minutes after taking it, it may as well have been a sleeping pill I was so slowed down, I really had to sleep when I took it. Luckily, I started taking it at night.
A few days later, however, I noticed I could take it in the AM, and that it didn't make me tired at all (it might have even made me less tired). So I think it's always good to try starting for the first week or two on a low-dose in the PM on meds, then if you notice you can still be awake like 2 hours later after taking it, take it in the AM if you want.
My sleep doc suggested Straterra as one of the options for me (I'm a bit tired during the day, and have ADD). Right now I take Desoxyn, but it is annoying to have to take it every 4 hours. I'd like to at least augument it with it if I respond well to it, it's something my doc's had in mind for me to try out for a few months.
But no one here has noticed feeling less tired than they did before after taking Straterra?
Provigil didn't do anything for me, even at 500mg.
Posted by lessismore on September 2, 2003, at 20:27:24
In reply to Re: Strattera and fatigue, posted by utopizen on September 2, 2003, at 19:19:11
Thursday will be three weeks, and I no longer feel tired. I feel more like doing the things I think of. Before I would see things I should do (pick something up, water a plant, make a phone call, whatever) and just not do it. I am a lot more productive now, and I'm sleeping about 7-8 hours a night, w/no naps. lovung it, but prepared for the mood swings that I have heard hit about now. (reading posts from parents w/ ADD kids on Strattera, their kids went wacko at three weeks...off the wall and violent.)
Posted by yeltom on September 2, 2003, at 21:57:11
In reply to Re: strattera WITHDRAWL?, posted by reba on July 30, 2003, at 17:34:27
Thanks for your post.I've been feeling exactly the same way since about two days after I went off of 18 mg of Strattera. I also have been having stomach problems. My shrink said there would be no need to taper, but my opinion is that you should taper off everything. They used to say the same thing about SSRI's. Basically shrinks and drug companies don't know shit. That's one of the reasons this website is so useful. Would be interested in hearing about others who experienced discomfort after discontinuing Strattera. Thanks.
> Ok I was the original one to ask about the withdrawal, so i though I would come back and say more about it to help those who have problems with it in the future.
> Ok, so I looked for ever on the internet about people experiencing strattera withdrawal symptoms and found NOTHING except on the lily website about strattera stating that there was no withdrawal effect.. haha THANKS! so I have been doing a little reasearch on other anti-depressant withdrawal symptoms becuase this is the first kind of med i have taken for anything. My symptoms seem to be alot like other anti-depressant withdrawal symptoms. I did do a little tappereing off; I was originally taking 80mlg, and for a week a went to 40, then after o week on 40 I stopped. I had flu like symptoms such as feeling very tired for no reason, feeling very achy, including very sore muscles, also had bad head aches on and off. I also went through periods of mood swings, like crying over nothing, and having a very short fuse. I aslo seemed to be very sensative to light and sounds. I wasnt hungry and was naushous alot. For me these didnt last that long but long enough... I have been off strattera now for 3 days, and today wok eup feeling a little better. so since messing with my dose ive felt yucky about a week and a half, which isnt so long consedering some of the other things i have read about other anti-depressants! lol. I feel lucky that it is summer and I can allow myself to just lay down and do nothing.. Some of the other things I felt were not being able to wake up for a couple hours after getting out of bed, and also my head feels very weird, almost like i get dizzy, but more like i have soup sloshing around in my head. haha Just very spacy in a bad way i guess. Hopefully this will help some of you! Oh and i was on Strattera for 6 months before going off it. good luck to everyone and thanks for responding!
Posted by reba on September 3, 2003, at 9:39:36
In reply to Re: Strattera and fatigue: AM or PM dose?, posted by bige on September 1, 2003, at 16:33:05
to all experiencing sleepyness at weird times; when i was on strattera i had the same type of thing. i took my dose at night before i went to bed and it seemed to wake me up so i was resless all night. when i got up in the morning i was ok, but then by afternoon i would be dead tired. so i decided that if im awake when i want to sleep and want to sleep while im awake, then maybe taking my dose at the opposite time would do the trick.... so instead of 11:00 pm, id take it at 11:00. this def helped....
the other thing that i realized was that i would be so busy in the morning doing stuff that i wouldnt eat very much at all. and since i never really fest super hungry on strattera i didnt eat when i was supposed to. i realized that not eating at the prober times during the day made my add symptoms worse and i didnt even realize it, i just blamed it on the meds! so my advise is MAKE SURE YOU EAT RIGHT! because you have no idea what kind of effect food can have on you even if you dont feel hungry! changing my diet helped my add symptoms so much, and it seems like such a non important thing! so to everyone having problems, try that before other meds!
Posted by Nachoman on September 18, 2003, at 11:44:46
In reply to Re: strattera WITHDRAWL? (it's real) » reba, posted by yeltom on September 2, 2003, at 21:57:11
I was on Strattera for 2 months at 80mg. I decided to switch back to Adderall because it was having no effect on my ADD symptoms. At the same time that I started back on 40mg Adderall, I completely stopped taking the Strattera. I had no withdrawal symptoms at all.
If it wasn't for the weird and uncomfortable side effects commonly found with Strattera, I would have thought I was taking sugar pills. :)
------ Reply to:
> Thanks for your post.I've been feeling exactly the same way since about two days after I went off of 18 mg of Strattera. I also have been having stomach problems. My shrink said there would be no need to taper, but my opinion is that you should taper off everything. They used to say the same thing about SSRI's. Basically shrinks and drug companies don't know shit. That's one of the reasons this website is so useful. Would be interested in hearing about others who experienced discomfort after discontinuing Strattera. Thanks.
Posted by ready for change on September 18, 2003, at 13:01:22
In reply to Re: Strattera and fatigue, posted by lessismore on September 2, 2003, at 20:27:24
In response to the message below... wow, it is such a "load off," if you will, to see symptoms of other ADDers such as the ones listed here (wanting to do things, but just not doing ANY of them...unless you are going to have something removed from your possesion or something might die - i have to laugh at myself sometimes... the extremes i go through over the most mundane tasks) i have felt so anxious, and stressed over, and guilty thinking i was just lazy. but as i am taking strattera at my own comfort level of increasing dosage ( i don't always listen to the doc - i know my body handles things better with time)and combining it with buspar for the anxiety, i am actually doing things. As my body adjusts to the drug levels and begins to have a constant level, i think i will have more consistant behavior ( sometimes i don't get charged up until 10 at night, and i'll work until 2... but thats better than not sleeping all night stressing over all things i have to do in the morning to make up for what i didn't do that night before i went to bed (all of which i probably wouldn't get done anyways!) ok, i'll stop blabbering... but be patient (WHAT??? how can an ADDer be patient... just try to breathe and as time goes on you will learn patience... i am still trying)and dig deep in your mind and let it all go... and the straterra will start working - we have to relearn all of our old habits too... perfection will never happen! (its ok to make mistakes, that is something i didn't realize kept me from doing alot of things i wanted to do)...any comments from others going through this is very helpful in the growing process... best of luck to ya!
> Thursday will be three weeks, and I no longer feel tired. I feel more like doing the things I think of. Before I would see things I should do (pick something up, water a plant, make a phone call, whatever) and just not do it. I am a lot more productive now, and I'm sleeping about 7-8 hours a night, w/no naps. lovung it, but prepared for the mood swings that I have heard hit about now. (reading posts from parents w/ ADD kids on Strattera, their kids went wacko at three weeks...off the wall and violent.)
Posted by Kacy on September 20, 2003, at 8:11:52
In reply to Re: Strattera and fatigue... patience, posted by ready for change on September 18, 2003, at 13:01:22
My doctor won't augment Strattera with a stimulant and insisted on evening dosing to get rid of the afternoon sedation that just won't end. He believes that eliminates the problem and anything else is all in my head. Well, it did end the problem, but it also eliminated the Strattera. With evening dosing, I don't get any effect during the day.
The drug doesn't last 24 hours at a therapeutic level for me. It lasts about 10 hours. The decline in the evening is easy to track by the return of anxiety. It keeps increasing from late afternoon on. The best thing Strattera has done for me has been to take that away. I don't think I realized how much anxiety I had and how much I must have always had until I began Strattera. Taking away anxiety, alone, helps some with add/inattentive problems. The kicker is killing me, though. I just went back to am dosing and the afternoon sedation is back full force.
I understood more when I saw that the drug's half-life was 5.15 hours. But, that is about the same half-life as Effexor. So, why would Effexor last 24 hours a day while Strattera lasts ten?
Do the rest of you who take it in the evening get the benefit of the drug during the day? Does anyone else experience what I do?
Posted by free wheelen on September 20, 2003, at 8:36:18
In reply to Re: Request Straterra side effects solutions?, posted by readyforchange on August 10, 2003, at 14:09:21
I have lived my life thinking that I was superior to most people. Why? because I able to work at 100 miles an hour for 14+ hours a day for weeks on end until I would crash for a day or two and then I would be right back to it. Because I could multi task,I couldn't figure out why no one else could or wanted to drive down the expressway at 80+ eating lunch,working on their laptop, talking on 2nextells and of course listening to the radio full volume. Because I loved drinking 3 to 4 44oz dietsodas(diet of course)a day along whith a couple of Metabo Life just to get me going, yea maybe I couldn't remember what my customers name was or where I left my pen, glasses,day planner,phone ect. Sound familiar?
Posted by Ritchie on September 20, 2003, at 8:49:37
In reply to Re: Strattera am or pm dose and response, posted by Kacy on September 20, 2003, at 8:11:52
> My doctor won't augment Strattera with a stimulant and insisted on evening dosing to get rid of the afternoon sedation that just won't end. He believes that eliminates the problem and anything else is all in my head. Well, it did end the problem, but it also eliminated the Strattera. With evening dosing, I don't get any effect during the day.
>
> The drug doesn't last 24 hours at a therapeutic level for me. It lasts about 10 hours. The decline in the evening is easy to track by the return of anxiety. It keeps increasing from late afternoon on. The best thing Strattera has done for me has been to take that away. I don't think I realized how much anxiety I had and how much I must have always had until I began Strattera. Taking away anxiety, alone, helps some with add/inattentive problems. The kicker is killing me, though. I just went back to am dosing and the afternoon sedation is back full force.
>
> I understood more when I saw that the drug's half-life was 5.15 hours. But, that is about the same half-life as Effexor. So, why would Effexor last 24 hours a day while Strattera lasts ten?
>
> Do the rest of you who take it in the evening get the benefit of the drug during the day? Does anyone else experience what I do?
I find the best way to get the benefits of Strattera is I take 40 mg in the a.m. and I take 40 mg around 12:30, it works for me. I don't have ADHD or ADD, I take it for depression, suicidal idealtions and anxiety and it works for me. I think the sleepiness will wear off with time as will the dry mouth. All I know is it works for me and it evens me out.
Posted by Kacy on September 20, 2003, at 9:55:55
In reply to Re: Strattera am or pm dose and response, posted by Ritchie on September 20, 2003, at 8:49:37
Thanks, Ritchie. I tried that, too. I took 60 in the morning and 40 after lunch for a while. Then, I took 60 at noon and 40 late afternoon. I ended up reducing my response to the drug and just moving the sedation around to different times.
I'm on my fourth month at 100 mg. I've always heard if the side effects are still there three months later, they're not going to pass. I hope that's not true. The thought of starting over with a new drug is tiring all by itself.
Posted by Kacy on September 20, 2003, at 11:11:48
In reply to Re: Strattera and fatigue: AM or PM dose?, posted by reba on September 3, 2003, at 9:39:36
Your point is excellent, Reba. I have been experimenting with that, too. It seems that eating lunch sets off the tiredness. I'm eating healthy foods, but maybe it's the kind of food. What changes did you make in your diet? Did you make any changes in the times you ate other than making sure you had breakfast?
Posted by cathal on September 24, 2003, at 9:20:08
In reply to Re: Adderall advise!, posted by reba on August 8, 2003, at 6:53:14
I am a psychiatric RN. you have too many diagnoses. i'm not a doctor but in my experience, which is not slim, the diagnoses you list conflict. you can't be bipolar and have depression because depression is one side of being bipolar, so get rid of that. i doubt you are even bipolar and ADD, more than likely one or the other. if you do some reading - especially in the DSM-IV about the diagnostic criteria for these disorders, you can begin to narrow it down. a bipolar person in a manic or hypermanic state certainly has attention deficits and other sx of ADD, but having an attention deficit doesn't mean automatically you have ADD. People with mental retardation often have attention deficits but it's not ADD, it's just a deficit existing alone and due to some other condition. And ADD can often mimic bipolar disorder. Many people with profound ADD cylce in ways similar to bipolar. See if this sounds familiar: you attempt something, sign up for a class, start a new project, etc. You can't stay focused on it and you mess it up or don't finish it. As a result parents, friends, spouses, teachers, bosses, etc get on your case, tell you you're unreliable, not effective, sloppy, etc. then you feel like shit. then you ruminate on it and get depressed and feel worthless and you're depressed. that's not bipolar disorder. bipolar disorder happens no matter whether you do a good job or bad job. bipolar is uncontrolled mood swings that aren't related to how well you perform at work or what a good husband your are, etc. but the process i described is not a mood swing, it's the sequelae of an existing condition, ADD. Just like the sequelae for someone with bad allergies is that they are exposed, they react, they have trouble breathing, they use an inhaler, the inhaler makes them hyper. Those other problems follow exposure to the allergen. And those terrible personality traits follow problems caused by ADD. I'd look for a shrink who specializes in ADD and finalize your diagnoses. Look for someone attached to a university or program that studies learning disabilities. And by the way, adults with ADD frequently also exhibit sx of OCD, phobic disorders, panic attacks, social anxiety, low self esteem, poor anger management and mood swings.
Posted by loolot on September 24, 2003, at 12:00:25
In reply to Re: Adderall advise!, posted by cathal on September 24, 2003, at 9:20:08
This is helpful. Sometimes I feel like Drs play fast and loose with the diagnosis thing.
My Dr just prescribed me some adderall. I was on Wellbutrin and at the highest does for a couple of years it pooped out, then I tried effexor which stunk. SSRIs are terrible with me-too many side effecs, robot feelings, etc
I have chronic depression but I also suspect I may have ADD,as I have always been really disorganized, avoid paying bills until power shuts off although I have money, tell people I can do stuff for work and dont do it, flake out on people, forget stuff, lose stuff, ALWAYS late.
But now that I read our post Im not sure. What are the real symtpoms of ADD? Im not asking you to make a diagnosis of me, just wondering what the actual symptoms are.
Posted by JMom on September 25, 2003, at 0:35:52
In reply to Re:adult addhd, posted by free wheelen on September 20, 2003, at 8:36:18
I can SO relate--a gazillion thoughts speeding around your head at one time, terrible CRS (can't remember shit)disease and insomnia. After talking to the doc, I have been on 40 mgs of Strattera for about a month and my life has been great. I can sleep, I can focus better, I am even happy. I wondered about ADD after my 6 yr old was diagnosed with ADHD a year ago. But, I wasn't hyper, I just couldn't stop my brain.( I took Wellbutrin to quit smoking, and I hated the nuetralness I felt. I didn't want to do much but watch t.v. and read). After reading Cathal's post describing symptoms of ADD I feel so much better about my diagnosis--I am now confident that it isn't all in my head!!
Posted by mhj on September 25, 2003, at 11:29:51
In reply to Re:adult addhd, posted by free wheelen on September 20, 2003, at 8:36:18
I've always strongly suspected that I have adult adhd. My doctor isnt' familiar with it and won't perscribe Stratera. Right now I'm on Zoloft. Does anyone in the Northern Virginia area (Fairfax County) know of a doctor who is familiar with and does perscribe Strattra?
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