![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 939 to 963 of 1242. Go back in thread:
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?
Posted by Kacy on September 25, 2003, at 13:23:38
In reply to Re:adult addhd, posted by mhj on September 25, 2003, at 11:29:51
Here's a chart distinguishing bi-polar and adhd. You'll note that although the add people have the same symptoms as bi-polar, the percentages of people with those same problems amongst adhders are much lower. One deal breaker for add is 'racing thoughts'. Bi-polar - 48% have it. Add- 0 %. Another is 'Suicidal thoughts with plan or intent', emphasizing the word "with". Bi-polar - 27 % have had a plan or intent. Adhd - 0 %.
http://www.psycheducation.org/PCP/handouts/ADHD.htm
Scroll down on this page to "What is attention deficit disorder (ADD / ADHD)?" for the DSM-IV definition for the different types. I found it a little confusing trying because of the "meet requirements 1 and 2" bit. There is other useful information there.http://user.cybrzn.com/~kenyonck/add/add_legal_public.htm
This link has the actual page in the DSM-IV.http://aafp.org/afp/20001101/2077.html
Suggested criteria:http://www.adders.org/info7.htm
Posted by Kacy on September 25, 2003, at 13:32:52
In reply to Re:differences in Add and Bi-polar , posted by Kacy on September 25, 2003, at 13:23:38
…will work.
Here they are again in order for less irritating copying (i.e. not dragging carefully to avoid the quote marks or getting the bad links):
http://www.psycheducation.org/PCP/handouts/ADHD.htm
http://user.cybrzn.com/~kenyonck/add/add_legal_public.htm
http://aafp.org/afp/20001101/2077.html
http://www.adders.org/info7.htm
How do you make a link?
Posted by Kacy on September 25, 2003, at 13:35:44
In reply to Couldn't make links above work. (?) Copy and paste, posted by Kacy on September 25, 2003, at 13:32:52
Posted by KimberlyDi on September 25, 2003, at 15:34:17
In reply to Re: Adderall advise!, posted by cathal on September 24, 2003, at 9:20:08
"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."
That's ME minus the phobic disorders.
KDi in Texas
and Strattera is FANTASTIC. I never want to give it up. I feel intelligent again and stammer less.
Posted by JMom on September 25, 2003, at 22:09:19
In reply to Re:adult addhd, posted by JMom on September 25, 2003, at 0:35:52
> 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!!
Oops, my bad, I am taking 80mgs not 40.
Posted by alwaysblue on September 25, 2003, at 22:45:03
In reply to Re: Strattera and fatigue: AM or PM dose? » Trixie, posted by Lasagne on August 29, 2003, at 14:59:56
I just gor a prescription today for strattera. I suffer from, STUBBORN, STUBBORN, DEPRESSION. I have been fighting depression for the last 7 or so years, it has hit me again FULL SWING. No one in my family understands, I have NO oNE to talk to.
I had a bad accident in the summer and I went OFF ALL MEDS. I wanted to try to do it the "natural way", to NO AVAIL. I even went the spiritual route, but depression will not leave. Today, I finally went to the doctors, after cancelling a couple of appointments, which I like to blame on depression. None of the other anitdepressents work.
He prescribed Strattera. I was hopefull to find relief with my depression and morning sluggishness and lethargy. However, after reading all of these messages, I am feeling discouraged. I will start in the A.M tomorrow. I JUST WANT THE DEPRESSION TO END............. Good luck to everyone, I know how awful you feel
Posted by lessismore on September 25, 2003, at 23:58:11
In reply to Re: Adderall advise!, posted by KimberlyDi on September 25, 2003, at 15:34:17
I have been on Strattera for 6 weeks now, and I love it too! I am becoming the person I always wanted to be. I closed a house today (Realtor) and for probably the second time in my career I had all the paperwork in the file. I still hate paperwork, but when I sit down to it, it doesn't seem impossible anymore. And I'm getting up 1/2 an hour early to read the paper and get ready slowly, instead of rushing out of the house. I do things instead of just thinking about them. I don't have insurance, and am paying $193 a month out of pocket, but it's worth it!
Posted by cathal on September 26, 2003, at 11:29:41
In reply to Re:adult addhd, posted by mhj on September 25, 2003, at 11:29:51
stratera is a fairly new drug and i've gotten 50/50 responses from my anecdotal research: some men report more sexual dysfunction than with zoloft, a drug used with great effect for adult ADD. who is your "doctor"? your family physician? just ask for a referal to a clinical psychologist or psychiatrist and they can prescribe you ANYthing (within reason of course)
Posted by cathal on September 26, 2003, at 11:37:14
In reply to Re: Adderall advise! » cathal, posted by loolot on September 24, 2003, at 12:00:25
the real symptoms of ADD are somewhat confusing to people who don't have it or don't live with someone who has it. they think it's all controlable and behavioral personality stuff
there are three types recognized in the DSM-IV, ADHD (attention deficit hyperactivity disorder), ADD, (no hyperactivity) and combined type (just what it says, half the time you are hyper, the other half not). people often miss plain ADD because it's the hyperactivity and running around that tips off most parents. plain ADD is kids who just daydream and stare out the window and do all the same stuff as ADHD but without the running around. SOME of the symptoms of adult ADD/ADHD include:-inability to organize thoughts
-losing things, misplacing things
-low tolerance for frustration, easily upset
-short fuse, explosive temper
-ability to hyperfocus at times and ignore all around you
-high level of what we call novelty seeking behavior (sometimes thrill seeking) such as downloading porn at work and risking getting caught, driving recklessly, promiscuity, petty crime
-leaving lots of messes and projects lying around, never finishing them
-feeling self doubt and insecurity because you can't finish things and you must be 'defective' or otherwise people wouldn't be mad at you
-finishing people's sentences, talking over them in conversationhmmmm, i'd be looking at the depression more than the ADD and you might not have ADD at all. it's true ADD can co-exist with depression, but consider two things.
1. everybody focuses on the 'classic' symptoms of depression: being suicidal, hopeless, etc. Other common symptoms we use in depression screening include irritibility, restlessness, disrupted sleep patterns, lack of ability to focus or pay attention.
2. people get mad at health care professionals for using esoteric terms but keep in mind that you can have an attention deficit without having ADD. you can have chronic headaches without having a brain tumor, you know? and a woman can throw up in the morning and not be pregnant. one is a condition the other is a SYMPTOM of the condition. lots of people have an attention deficit, that just means they have trouble paying attention and it can be for a variety of reasons which is why all those reasons have to be screened out before diagnosing ADD. ADD is a cluster of symptoms, not just attention deficit, but attention deficit coupled with things like (i'm reaching for my DSM-IV and quoting here) : "often fails to give close attention to details or makes careless mistakes in work or other activities...often has difficulty organizing tsks...often loses things necessary for tasks...often talks excessively..."
so just having an attention deficit doesn't mean one has ADD. personally, i'd focus more on treating your depression. too bad SSRIs seem tohave a bad effect on you. have you tried Lexapro? this is the latest miracle drug and, from my experience, seems to be quite effective in treating people with atypical depression or who can't take SSRI's
Posted by cathal on September 26, 2003, at 11:40:52
In reply to Re:differences in Add and Bi-polar , posted by Kacy on September 25, 2003, at 13:23:38
all true and for me, one of the keys to a diagnosis of bipolar over ADD are the EMOTIONAL swings, not mental problems. bipolar disorder is classified as a mood disorder which is why when someone is on an "up" we see a lot of giddiness, silliness, laughing, ecstatic excited moods REGARDLESS of what their thoughts are and when they cycle down we see depression, hopelessness, bleak outlook, crying unhappiness, despondency no matter waht they are thinking
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.