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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 989 to 1013 of 1242. Go back in thread:
Posted by lessismore on October 10, 2003, at 21:38:27
In reply to Re: Straterra approval., posted by deLane on October 10, 2003, at 20:27:05
My dry mouth is much better, but stii dry. The sweating has gone away, but I flush red (feels like a hot flash...I think) when I have a strong emotion--anger, apprehension. All the other side effects are gone. I take 40 mg at 7:30 and another between 2:00 and 5:00.
Posted by Viridis on October 10, 2003, at 22:27:57
In reply to Re: Straterra approval., posted by lessismore on October 10, 2003, at 21:38:27
For me, the side effects of mild nausea and muscle aches went away within about a week of each dosage increase. Dry mouth lasted a long time (a few months) but is finally starting to subside. It wasn't too bad anyway, as long as I had lots of water to sip on. I'm currently at 80 mg/day and still find it a strong appetite suppressant.
This definitely is a med to titrate up on in steps, but for me at least, it's good for concentration and also has substantial antidepressant effects.
Posted by manyparts2001 on October 11, 2003, at 5:41:46
In reply to Re: Straterra approval., posted by Viridis on October 10, 2003, at 22:27:57
> For me, the side effects of mild nausea and muscle aches went away within about a week of each dosage increase. Dry mouth lasted a long time (a few months) but is finally starting to subside. It wasn't too bad anyway, as long as I had lots of water to sip on. I'm currently at 80 mg/day and still find it a strong appetite suppressant.
you said you have been on this for a few months, did you ever experience a personality change of a lot of anger or agitation? I was on it for about 4 months and did, but it went away after I quit taking it. Plus, do you take anything else with it like Ritalin?
>
> This definitely is a med to titrate up on in steps, but for me at least, it's good for concentration and also has substantial antidepressant effects.
Posted by manyparts2001 on October 11, 2003, at 5:43:31
In reply to Re: Straterra approval symptoms, posted by manyparts2001 on October 11, 2003, at 5:41:46
I am resubmitting this because I forgot to check the follow-up box.
Posted by manyparts2001 on October 11, 2003, at 5:48:38
In reply to Re: Straterra approval., posted by lessismore on October 10, 2003, at 21:38:27
> My dry mouth is much better, but stii dry. The sweating has gone away, but I flush red (feels like a hot flash...I think) when I have a strong emotion--anger, apprehension. All the other side effects are gone. I take 40 mg at 7:30 and another between 2:00 and 5:00.
I experienced constant and massive hot flashes with profuse sweating when I was taking Straterra, which lessened and practically went totally away after coming off it. The sweating was really uncomfortable, as I would towel off from a shower-even a cool one, and sweat would pour off of me as I finished getting dressed.
Posted by MamaB on October 11, 2003, at 7:30:49
In reply to Re: strattera and wellbutrin » keffrey, posted by Lasagne on September 2, 2003, at 14:27:56
I have been on Wellbutrin SR 400mgm a day for about two and a half years at first it REALLY addressed the ADD well, but that effect is much less now. About a month ago My doctor started me on Strattera. I was fine at the lowest dose, but as soon as it was increased, I became anxious and almost paranoid. I also had PROFUSE sweating and some minor vaginal bleeding.(I am 60 years old and 10 years post-menopause.) My p-doc insists that the Straterra couldn't have anything to do with the vaginal bleeding ( I am not as convinced).
Well, I started the Straterra again two days ago, and what a difference! Minimal sweating and about a 50% increase in motivation and ability to focus! I plan to stay on the very low dose as long as it keeps working. What happened? I have no idea, but at least it got me a thorough GYN checkup, including a pelvic ultrasound --everything was normal.
I will keep you posted. MB
Posted by bige on October 11, 2003, at 12:02:13
In reply to Re: strattera and wellbutrin, posted by MamaB on October 11, 2003, at 7:30:49
I went up on my strattera to 100mgs from 80mg I am having hot flashes constantly It is like I darnk a bottle of Niacin, Also am having generalized anxiety with the new dose. Sometimes this all seems like it is to much to deal with, I think I should move to a Island somewhere where I can just be hyper and have my racing thoughts all to myself.
Posted by Viridis on October 12, 2003, at 2:41:37
In reply to Re: Straterra approval symptoms, posted by manyparts2001 on October 11, 2003, at 5:41:46
Strattera actually makes me feel pretty mellow. Wellbutrin, on the other hand, caused bizarre outbursts of anger (totally uncharacteristic for me). Funny how differently these meds can affect different people.
I haven't used Ritalin, but I do take Strattera along with low-dose Adderall (and Klonopin). It seems like a good mix.
Strattera certainly won't be right for everyone, but the big thing (and my pdoc agrees strongly with this, given his experience with many other patients) is that you need to increase the dose gradually. Otherwise, the side effects can be intolerable, and could scare you off a drug that might otherwise be helpful.
Posted by MamaB on October 12, 2003, at 6:44:12
In reply to Re: Straterra approval symptoms » manyparts2001, posted by Viridis on October 12, 2003, at 2:41:37
Thanks for the warning. That may have been what happened to me the last time, increasing too rapidly. My p-doc wanted me to do the same this time (20mgm for one week then boost it up to 40mgm the following week). With my dose yesterday, I think I had a somewhat "mellowing" response and I found it a bit easier to concentrate. Best part --no sweating or anxiety! I may call the doc tomorrow and ask about sticking to the 20mgm for another week.
Posted by MamaB on October 13, 2003, at 11:59:40
In reply to Re: Straterra approval., posted by deLane on October 10, 2003, at 20:27:05
Hi again,
I have been reading some of the back-posts on Strattera and I notice that quite a few people mention that they have problems with fatigue. I didnt really have any fatigue/tiredness symptoms UNTIL I forgot to take my afternoon dose of Wellbutrin SR! Then whoa, I couldn't stay awake!
I am only on 20mgm of the Strattera and will go to 40mgm this coming Thursday. I took Ritalin for about five years quite a while back, when I was first diagnosed, but cannot take stimulants now as I began to "abuse" the Ritalin. (this depends who you talk to; my husband is the one who felt I was "abusing" it, my doc did not, but that's another long story). Anyway, the Ritalin worked like a charm. The Straterra already seems to be having a mild effect. By the way, I am 62 years old and was diagnosed ADD WAY back before too many folks believed that adults could be ADD. Twenty-two years ago to be exact. Is there anyone else out there in a similar situation, I mean senior folks say +55? One more thing, I am also an ADD(H)D coach and clinical specialist RN in adult psychiatry. MamaB
Posted by Mid- Life Crisis on October 13, 2003, at 18:52:04
In reply to Re: Straterra approval., posted by MamaB on October 13, 2003, at 11:59:40
> Hi again,
> I have been reading some of the back-posts on Strattera and I notice that quite a few people mention that they have problems with fatigue. I didnt really have any fatigue/tiredness symptoms UNTIL I forgot to take my afternoon dose of Wellbutrin SR! Then whoa, I couldn't stay awake!
> I am only on 20mgm of the Strattera and will go to 40mgm this coming Thursday. I took Ritalin for about five years quite a while back, when I was first diagnosed, but cannot take stimulants now as I began to "abuse" the Ritalin. (this depends who you talk to; my husband is the one who felt I was "abusing" it, my doc did not, but that's another long story). Anyway, the Ritalin worked like a charm. The Straterra already seems to be having a mild effect. By the way, I am 62 years old and was diagnosed ADD WAY back before too many folks believed that adults could be ADD. Twenty-two years ago to be exact. Is there anyone else out there in a similar situation, I mean senior folks say +55? One more thing, I am also an ADD(H)D coach and clinical specialist RN in adult psychiatry. MamaBHi, I'm another "senior", age 52. I suffered all the symptoms of ADHD all my life, have a son and brother diagnosed with it, and finally, at age 51 went through the formality of getting diagnosed because I had come to a point in my life where I realized I was never going to accomplish what I wanted to if I didn't at least try some ADHD meds. Prior to that I had gone through life self-medicating with lots of coffee as best I could, but so far, Strattera works better. (I'm now at day 13, and my son, age 15, is on day 4, both of us at 40 mg.) I tried Adderall and Concerta, but both made my anxiety worse (I have anxiety, but not depression.) Plus, I don't like the ups and downs of stimulants and find that, so far, Strattera is a much kinder and gentler drug for me and actually decreases both my blood pressure and anxiety. I do have side effects similar to others reported here; fatigue, increased sweating, dry mouth, but not insomnia. In fact, so far I actually sleep longer and better through the night on it. (Am only on this one drug, plus one for allergies.)
I'm curious...how did you figure out you had ADHD 22 years ago? Was it due to your psychiatric nursing training? You (or your doc) must have been a real visionary to realize it wasn't just for kids back then! I was "tested" for it (called Minimal Brain Damage then) in the 1950's after my 3rd grade teacher told my mother she thought I had it because I talked too much. (Still do.) The test? An EEG!! (And a 1 hour question and answer test!) My brother and I were both pronounced OK because there was no "minimal brain damage" on the EEG!! We've come a long way, don't you think?
Thanks to all who have posted on this site...it has really decreased my anxiety about trying this drug to read that what I am experiencing are normal side effects and that we MUST be patient and give it time to work. Also, thanks to the moms that posted with information about how their teens did on it...so far, day 4, my 15 year-old is absolutely more impulsive and more hyper than he ever was on Adderall or nothing, but I am hoping this passes as well (because he was flunking 10th grade on Adderall and getting "disruptives" for his behavior in class on Adderall.)
Good luck with Strattera and let's all encourage each other to hang in there!
Posted by MamaB on October 14, 2003, at 6:12:35
In reply to Re: Straterra approval., posted by Mid- Life Crisis on October 13, 2003, at 18:52:04
Dear MidLife
Glad to hear that the Strattera seem to be working for you. I too was tested for all sorts of things back in the early fifties and some where along the line picked up the "minimal brain damage" label also. That is what AD(H)D as we know it today was called back in those days. As for my choice of profession -- things happened quite in reverse. I was a coronary care nurse, quit to raise my boys and then had a terrible bout of depression (genetic influence) made worse by heavy drinking and of course, the unknown ADD. I was diagnosed just before I started to work by a VERY competent psychologist.
Once things got under control, I went into psychiatry, hoping to share what I had learned. My specialty is Dual-diagnosis, those with both mental health and addictive problems. I have not had a drink for 25 years and love what I do.
Posted by Cruz on October 15, 2003, at 9:32:49
In reply to Re: Straterra approval., posted by MamaB on October 14, 2003, at 6:12:35
I am on my 12th day with Strattera. Now at 60mg in the AM. Still struggling with the SE's but I am haveing some positive effects too. Tomorrow I think I may go up to 80 mg's. I would like to know how others are doing with Strattera.
Posted by MamaB on October 15, 2003, at 10:03:33
In reply to Strattera updates?, posted by Cruz on October 15, 2003, at 9:32:49
Cruz
I am on day 6 at 20mgm. Because I had a bad experience when I tried Strattera before, we are going VERRRRY SSLLOOOWLY! I do concentrate a bit better, the nausea is minimal and managable. Best of all, no overwhelming "hot flashes/sweats".
Posted by frustratedmom on October 15, 2003, at 19:26:35
In reply to Strattera updates?, posted by Cruz on October 15, 2003, at 9:32:49
My 15 year old son was on Straterra for 4 months. Increased to 72mg a day with no benefit for concentration. His grades started to slip and he was getting very frustrated so we have gone back to Adderall XR. We wish the Straterra had worked but it was disappointing for us.
Posted by Mid- Life Crisis on October 15, 2003, at 23:58:33
In reply to Re: Strattera updates?, posted by frustratedmom on October 15, 2003, at 19:26:35
Frustrted Mom,
My 15 yr. old son was also previously on Adderall (XR and the generic short-acting type) before trying Strattera. He's only been on Strattera for about 8 days, but it doesn't appear to be working for him at this point (though he's not on a full dose yet.) I'm at wit's end, because he gets in trouble for "disruptive" behavior, which the school labels disruptive even if it's only shaking his head when the teacher is talking and he tells me even the kids in his class accuse the teacher of not liking my son (and he CAN be trying, because he's the class clown type.) Believe it or not, this is an alternative high school which has loads of ADHD kids in it, and so lots of my son's friends are also ADHD. However, the teachers at this school seem to understand very little about ADHD. (Ironically, the school is sponsoring a local therapist presentation in a couple of weeks for parents entitled "What Parents Need to Know About ADHD Children". I wish this school would also consider one for the teachers as well! Sorry to vent!)
Anyhow, Adderall made my son's normally sweet (for a 15 year old boy) temperament angry and oppositional...not like him. On Strattera, he just seems out of it so far, and says it makes him feel wierd, though I think some is the drowsiness. Only thing left to try after this is Wellbutrin, but that would not seem to address his problems, as he has no depression. Guess we should feel lucky that our sons will even agree to take meds. at age 15, as plenty that age will not. So many of my son's friends who were on ADHD meds earlier in life are now out there driving cars, totally unmedicated, yet still obviously in need of them. (And I had my own share of car wrecks as an unmedicated/undiagnosed teen.)
Please keep me posted on how your son is doing back on the Adderal XR. I'm glad he's able to make good grades on it, that is a lot to be thankful for. Good luck to your both!
Posted by frustratedmom on October 16, 2003, at 8:52:50
In reply to Re: Strattera updates?, posted by Mid- Life Crisis on October 15, 2003, at 23:58:33
Dear midlifecrisis... thank you so much for your response. I can so relate to much of your story. My son too was being singled out for "disruptive" behavior, such as tapping his pencil or body language gestures. He was not at an alternative middle school though. He started the Adderall XR just before starting hight school, and it made a tremendous difference for him. He was heppy to take it, as it made life so much more bearable for him. He was fitting in, making friends and succeeding in schoolwork. But there was so much stigma associated with the Adderall XR that we were excited about the introduction of Straterra and the possibility of having the same success with a non stimulant. Unfortunately, it was not the answer for us and my son was grateful to go back on the Adderall. I am glad that he will take the meds. I too know of children who won't. We also had him on Wellbutrin before the Adderall, as a result of depression associated with constant bullying in middle school. He is no longer on that due to some problematic side effects that we are still investigating (very serious!!!). He is now taking lexapro in conjunction with his Adderall XR. When we were trying to determine the appropriate dosage of Adderall XR, we definitely noticed anger problems. 40mg was too much. He was anxious, easily set off and could not control his anger. 30mg seems to work well, with no mood problems for him. I too felt the Straterra made him drowsy, but he did not have any of the upset stomach problems so many people have complained about. He did have some trouble sleeping when we first started the Adderall, but that quickly subsided. I hope you can find some success for your son. I know how physically and emotionally draining being the mom of an ADD child can be. Every day is a battle fighting for your child. I will keep you informed of our progress. Thanks again for your response. It's good to know there are other moms out there to talk to to.
Posted by MamaB on October 16, 2003, at 11:39:10
In reply to Re: Strattera updates?, posted by frustratedmom on October 16, 2003, at 8:52:50
Dear frustratedmom,
If you don't mind my asking, was your son on the Adderal and Wellbutrin at the same time? If not, how long after the Adderal did he start taking the Wellbutrin? MamaB
Posted by Mid- Life Crisis on October 19, 2003, at 13:10:35
In reply to Re: Strattera updates?, posted by frustratedmom on October 16, 2003, at 8:52:50
Thanks so much for your response. I'm glad to know there's someone that understands. (This is the third ADHD child I suspect I've raised, but the other two had compensatory assets, so they were never tested by the school system for ADHD, only giftedness (at age 5) and were placed in the gifted program. I wish I knew then what I know now, but they are in their twenties now and I've encouraged them to get a diagnosis, possibly meds., etc. but they are both in very creative occupations and feel no desire to do so, but, boy were they a "challenge" to raise.
Anyhow, my 15 year-old is doing no better/ no worse behavior-wise on Strattera 40 mg. daily than on the Adderall, but he's at least back to his old sweet (not angry) self. I hope your son continues to do well on the 30 mg. Adderall XR. Perhaps that dose will end up being the answer for us as well, as I do think 40 was too high, though my son argued that it wasn't. (Actually, just plain old Dexedrine seemed to work as well as Adderall for him for years, and without the anger.)
Did you see the information regarding kids and bullying on the www.aboutourkids.org site? I didn't read it, but it might address some of your concerns.
Posted by frustratedmom on October 19, 2003, at 13:23:48
In reply to Re: Strattera updates? frustratedmom, posted by MamaB on October 16, 2003, at 11:39:10
>
> Dear frustratedmom,
> If you don't mind my asking, was your son on the Adderal and Wellbutrin at the same time? If not, how long after the Adderal did he start taking the Wellbutrin? MamaBDear MamaB... sorry to take so long to respond to your inquiry. My computer wouldn't access the site for some reason. I don't mind sharing my son's medication history at all. He started taking the Wellbutrin first... prescribed to him for depression resulting from bullying at middle school. He was prescribed the Adderall a lttle over a year later for ADD. While his depression was better, i was told I could not take him off the Wellbutrin and start the Adderall at the same time, so he took both Wellbutrin and Adderall in their fully prescribed dosages for 6 weeks. Then we weaned him off the Wellbutrin. He took the Adderall for 10 months with great success. A few sleep problems at first, but those soon subsided. He is presently back on an anti depressant, but not Wellbutrin. We have some serious concerns that we are investigfating with that drug. He is taking lexapro. He definitely notices his concentration being better since stopping the Straterra and going back to the Adderall. While we were hopeful of a non stimulant having the same benefits, unfortunately for us, it was not the answer. Hope that answers your questions. Frustratedmom
Posted by The Bean on October 22, 2003, at 18:06:42
In reply to Straterra approval., posted by scoper on December 28, 2002, at 2:19:34
Hello all,
Wanted to post my experience with Strattera - as it has been very positive overall - albeit difficult to get to the optimal dosage. I preface all of this with the fact that I have THE BEST "team" to work with, and I do so at a facility that specializes in treating both adults and kids with ADD/ADHD. I see my PhD Doc (therapist) at this facility every 4-6 weeks and my MD Doc (Family Practice Physician) a minimum of 4x a year. They are VERY good about listening to my experiences and allow me flexibility to "tinker" slightly with my meds. I see them more often if were "tinkering" a lot - like adding new things to the mix - and have seen one or the other of my docs every 3 weeks through the process of "testing" Strattera. I also attend some of the things the facility offers, like Tai Chi classes and educational seminars presenting research in the field.
I was diagnosed with ADD - Inattentive Type about 5 years ago as an adult, at age 37. Have tried a million different combinations of things . . . but I'm currently taking 75mg Adderall XR in the morning after breakfast and recently (8 weeks ago) added Strattera to the mix and am delighted with the results! We've settled on a low dosage of 10 mg a day and I take it at bedtime. I wake up more alert, and sleep about 1 hour longer than I did with just Adderall XR alone, so I'm now getting a decent 6.5 hours a night. Usually a much higher dose of Strattera is recommended, but that didn't work for me. I'll give you the whole history of drugs and you can see if it's helpful to you!
Ritalin made me anxious (like for no reason I wanted to bang my head against the table because I somehow felt that might help) and creepy (like I wanted to crawl out of my skin). Because of THAT experience, I never wanted to try Concerta.
We next tried Adderall, which was good, but didn't last long enough. Started Adderall 40mg in the am and Ritalin 20mg in the afternoon for about 2 years. Adderall's 1/2 life kept me awake too long at night, and for some reason, when I started the day with Adderall and took the Ritalin later in the day, I didn't get the "anxious/paranoid" feeling I had taking Ritalin alone.
Started on Adderall XR when it came out and it was REALLY great for several years, but over the whole 5 years on medication, I've lost about 15-20 lbs (I am NEVER hungry and have to set my Palm Pilot to beep and remind me to eat - and I do - 6 small meals a day!) and after I got down to about 110 lbs (I'm only 4'11", so it's not as thin as it sounds!) the Adderall XR began to make me feel edgy and impatient all the time. It was MUCH worse in the week before my menstrual cycle.
We tried adding 2 different anti-depressants to help with the "mood dysregulation" and depression issues around my cycle. Effexor, which was great at first, but seemed to build up in my system and I got progressively sleepier and more sluggish the longer I took it. Then Wellbutrin - and on the Wellbutrin, I didn't sleep for 4 days straight, got MORE depressed and actually felt suicidal. I stopped the Wellbutrin at that point : - )
So we tried Dextrostat, thinking it might take that "edge" off, and it did, but I never felt like I had the mental clarity I got with the Adderall XR, and it didn't change the "hell week" experience before my period all that much, so went back to Adderall XR and we added the support of Celexa tablets. Taking Celexa all the time though was too much (it makes me VERY sleepy - even at low dosages) similar to the Effexor issue. So my MD doc suggested we try LIQUID Celexa which I now take 1/2 tsp of ONLY the 10 days before my period is supposed to start. I've taken as much as 1 tsp at times too. I just count 19 days from the start of my last cycle, as I have a 29 day cycle and start taking it. At that dosage it is technically not at a "therapeutic" level - so it supposedly wouldn't have any effect - but it TOTALLY evens out the "witch" behavior and crying hysteria that I used to have, so - conclude what you will!
Six weeks ago, we decided to try Straterra, since I was still feeling the "edgy" with Adderall XR, but had decided to live with it! I was to begin with 18 mgs, and was supposed to increase the Strattera while decreasing the Adderall XR. I was advised NOT to cold turkey on the stimulant, but to ramp up the Strattera and ramp down the stim.
The FIRST DAY on 18 mgs and my full dose of Adderall XR was AMAZING!! I had the 3 most productive, happy and "smart" days I've had in 20 years. Then, I started the ramp up/down process and it went to hell in a handbasket! 24 mgs of Strattera and 75 of Adderall and I was MEAN. 24 mgs of Strattera and 50 of Adderall and I was fuzzy and slow. 40 mgs of Strattera and 50 mgs of Adderall and I was sluggish and "dopey" - like I feel on antihistamines (like I can't put two sentences together, am clumsy and tired, etc.) 60 mgs Strattera and 50 of Adderall was even worse for the sluggish/dopey feeling, so we stopped the Strattera to start over again and get feeling of the 3 good days back. It took about 3 days for all the effects of the Strattera to clear my system.
Starting over, after a week at 18 Strattera/75 Adderall, I was not sleeping well and was very impatient and snippy. We tried it without adding Celexa for those 10 days before my period the first time around and that was a BIG MISTAKE! Dropped the dosage to 18 mgs every other night before bed and found that day 1 was still edgy, but on day 2 was not, AND I still had the increased clarity from before. I added Celexa this time for the 10 days in my cycle and it was great - except I think I need to keep taking Celexa all the way through my cycle. Stopping on the day my flow starts seemed to trigger a migraine (too fast a drop in my Seratonin level, I suspect!) next month a new adventure!
Three days ago, I started taking 10 mgs Strattera at bedtime, and so far, so good!! My PhD doc tells me I'm a "statistical outlayer" (which I suppose is a polite way to say that I'm a wierdo) but apparently using Strattera this way is not the "norm" - but nothing I've ever tried is, so I'm just delighted to have what feels like a great combination (at least for now!)
Hope this helps someone!
The Bean
Posted by trying to help on October 23, 2003, at 14:09:52
In reply to Re: Straterra approval., posted by The Bean on October 22, 2003, at 18:06:42
Hi - my son just turned 11 and has been on Ritalin since 1st grade (diagnosed with ADD). He seemed fine for the last few years. Now, he started 5th grade and is suddendly very anxious, angry, nervous and hyper-emotional. He'll start crying in school for no reason, has no friends, is depressed, etc. He's tall, good looking, smart, and should be one of those kids who just breezes through school. Now suddenly he's sad, crying and friendless.
His pediatrician has suggested Straterra -- any throughts or suggestions would be appreciated.
I just want to help my son be happy and successful.
Thanks.
Posted by Plucky on October 23, 2003, at 17:32:21
In reply to Adderall advise!, posted by reba on August 6, 2003, at 21:16:16
Hello, everyone! I'm new to this board, but have been reading over the previous posts on the ADD meds and I appreciate everything you've all been sharing.
My psych doc would like me to try using Straterra. I've been taking Adderall for two years, and find it quite helpful. As much as the monthly triplicate prescription paperwork is a hassle for both of us, I'm hesitant to try switching meds now. The six months of "med-hopping" I did before ending up with Adderall were nothing short of hell for me. Nothing else I've tried has worked near as well as Adderall, with only Ritalin coming close but being too short-acting. Everything else I tried was in the anti-depressant category, and every one of them had unmanageable (an understatement in the case of "In"Effexor!) side effects. (My ADD is of the type that tends to swing between Inattentive and Overfocused, and just seems to focus best with the stimulant meds.)
I’m curious if anyone else has had a similar experience. Have any of you tried switching from one of the stimulant meds to Straterra? Has anyone who was relatively happy with Adderall or Ritalin found Straterra to be any better (or worse)?
Another thing I’m wondering: Has anyone who has trouble waking up in the morning found help with any of the meds? (Yes, I’ve tried taking my Adderall an hour before I have to wake up, but usually I can’t wake up enough to do even that!)
Thanks in advance for your advice,
Plucky
Posted by Kacy on October 23, 2003, at 19:39:43
In reply to Re: Straterra approval., posted by trying to help on October 23, 2003, at 14:09:52
Is he crying because he's not keeping up in school? Was he keeping his grades up? So far, nothing you said sounded like a change in the drug. Does he say that it still feels the same? Is his breakfast different? (I killed my Adderal trial with oatmeal cooked in apple juice and had no idea it was canceling out the drug. I just thought that Adderal had a big kick at the end. During the first three hours, it didn't work at all. The juice was apparently killing the Adderal.)
Is he being bullied? Have you asked his teacher?
Posted by The Bean on October 24, 2003, at 9:20:58
In reply to Switching from Adderall to Straterra, posted by Plucky on October 23, 2003, at 17:32:21
I've posted a longer version of the whole med history rollercoaster which you can read if you want too - I'll focus on the Strattera/Adderall part.
My experience with Strattera - as it has been very positive overall - albeit difficult to get to the optimal dosage.
I was diagnosed with ADD - Inattentive Type about 5 years ago as an adult, at age 37. Have tried a million different combinations of things . . .
I'm currently taking 75mg Adderall XR in the morning after breakfast and just started on a low dosage of Strattera at 10 mg/day and I take it at bedtime. I wake up more alert, and sleep about 1 hour longer than I did with just Adderall XR alone, so I'm now getting a decent 6.5 hours a night. Usually a much higher dose of Strattera is recommended, but that didn't work for me.
I started with short acting Adderall, years ago and it was good, but didn't last through my whole day. Started Adderall 40mg in the am and Ritalin 20mg in the afternoon for about 2 years. Adderall's 1/2 life kept me awake too long at night, and for some reason, when I started the day with Adderall and took the Ritalin later in the day, I didn't get the "anxious/paranoid" feeling I get when I take Ritalin alone.
Started on Adderall XR when it came out and it was REALLY great for several years, but over the whole 5 years I've been on medication, I've lost about 15-20 lbs (I am NEVER hungry and have to remind myself to eat - and I do - about 6 small meals a day). When I got down to about 110 lbs (I'm only 4'11", so it's not as thin as it sounds!) the Adderall XR began to make me feel quite edgy and impatient all the time. It was always MUCH worse in the week before my menstrual cycle.
We tried adding different anti-depressants to help with the "mood dysregulation" and depression issues around my cycle. Effexor, which was great for the first week, but seemed to build up in my system and I got progressively sleepier and more sluggish the longer I took it. Then Wellbutrin - and on the Wellbutrin, I didn't sleep for 4 days straight, got MORE depressed and actually felt suicidal. I stopped the Wellbutrin at that point : - )
So we stopped Adderall and tried Dextrostat, thinking it might take that "edge" off, (which it did) but I never felt like I had the mental clarity I got with the Adderall XR, and it didn't change the "hell week" experience before my period all that much, so I went back to Adderall XR and added the support of Celexa tablets.
Taking Celexa all the time was too much (it makes me VERY sleepy - even at low dosages) similar to Effexor. So we tried LIQUID Celexa which I now take 1/2 tsp of ONLY the 10 days before my period is supposed to start. (I just count 19 days from the start of my last cycle, as I have a 29 day cycle and start taking it). That low of a dosage is technically not a "therapeutic" level and shouldn't have any effect - but it TOTALLY evens out the "witch" behavior and crying hysteria that I used to have, for what it's worth!
Six weeks ago, we decided to try Straterra, since I was still feeling the "edgy" with Adderall XR and clearly I'm OK about "tinkering" with meds.
I started at 18 mgs, and was supposed to increase the Strattera while decreasing the Adderall XR over a period of 6-8 weeks. I was advised NOT to cold turkey on the stimulant, but to ramp up the Strattera and ramp down the stim.
The FIRST DAY on 18 mgs and my full dose of Adderall XR was good, but days 2 & 3 were AMAZING!! I had the 3 most productive, happy and "smart" days I've had in 20 years. I suddenly had a vocabulary and was really excited at my ablity to focus even better!
Then, I started the ramp down process and decreased the Adderall and it went to hell in a handbasket! 24 mgs of Strattera and 75 of Adderall and I was MEAN. 24 mgs of Strattera and 50 of Adderall and I was fuzzy and slow. 40 mgs of Strattera and 50 mgs of Adderall and I was sluggish and "dopey" - like I feel on antihistamines (like I can't put two sentences together, very clumsy and sleepy, etc.) 60 mgs Strattera and 50 of Adderall was even worse for the sluggish/dopey feeling, so we stopped the Strattera to start over again and get feeling of the 3 good days back. It took about 3-4 days for all the effects of the Strattera to clear my system.
I started over and after a week at 18 Strattera/75 Adderall, I was not sleeping well and was getting more impatient and snippy - and OVER focused. First time around, I didn't take the Celexa for those 10 days before my period and that was a BIG MISTAKE!
I dropped the dosage to 18 mgs every OTHER night before bed and found that day 1 was still edgy and tending to overfocus, but day 2 was not edgy, AND I still had the increased clarity from beore without the OVER focusing.
I took the Celexa this time for the 10 days in my cycle and it worked well - except I think I need to keep taking Celexa a little longer. I finally put it together that when I stop taking it on the day my flow starts it often triggers a migraine (too fast a drop in my Seratonin level, I suspect!)
My doc tells me I'm a "statistical outlayer" (which I suppose is just a polite way to say that I'm a wierdo) but apparently using Strattera at such a low dosage is not the "norm". I realize that nothing I've ever tried that has worked really is, so I'm just delighted to have what feels like the best combination I've ever had.
Hope that gives some insight!
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Dr. Bob is Robert Hsiung, MD,
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