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Dr. Bob is Robert Hsiung, MD,
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Posted by LightShifter on January 21, 2004, at 15:28:46
In reply to Re: Straterra » micro, posted by blondegirl47 on January 21, 2004, at 11:07:14
I would be carfeul about using Lilly's guidelines for weight dosing. I and many others have found that for us, 10 to 20 mgs is enough. Rather than using weight dosing guidelines, I would start at 10 mgs. and work up as necessary. The 40 mg startup idea is way too much for many.
Everybody has different metabolism and depending upon how much CYP2D6 enzyme your liver has to process the atomoxitine into 4-hydroxyatomoxetine which is what our bodies process as the actual effective drug that Strattera initiates, you will need less or more of it.
If you want the technical details you can go to
dmd.aspetjournals.org/cgi/content/full/30/3/319The generalized weight dosing idea is not a good idea not only because of the above reason which applies to most if not all drugs, but because of many other factors including harmones, thyroid condition, what other drugs are involved etc. I find it's always best to start low and work up only if necessary after a week or 2 trial.
Blessings, ...Dan
> It made me very tired. Sometimes during the day I would feel dizzy. About the 2nd or 3rd week I was mad all of the time. I can't remember how long that lasted. I would hyperfocus on fun things and not get work done.
>
>rom going off adderall. My pdoc, let me stay on adderall, he said it wasn't a good test of strattera if I was crashing f
>
> If you do a websearch on starttera dosing, you should be able to find a chart that gives weight to dose ratio.
> Blondegirl
Posted by jcbikermom on January 23, 2004, at 13:19:12
In reply to Re: Straterra, posted by LightShifter on January 18, 2004, at 22:06:06
My son is 11 years old and started taking 18mg a little over a week ago. The Dr. wanted to up the dose to 2 pills after 1 week. That was too much. He was sleepy and wouldn't wake up. I changed the dose to 25mg and that seems to be working. The Drs. always want to go by the weight chart and that's usually too high a dose.
Posted by debbie m on January 23, 2004, at 17:58:21
In reply to Re: Started Strattera Yesterday Woo-Hoo! » SLynn, posted by HADD Enough on February 2, 2003, at 18:02:19
Posted by Palbella on January 23, 2004, at 18:42:01
In reply to Re: Straterra, posted by jcbikermom on January 23, 2004, at 13:19:12
> My son is 11 years old and started taking 18mg a little over a week ago. The Dr. wanted to up the dose to 2 pills after 1 week. That was too much. He was sleepy and wouldn't wake up. I changed the dose to 25mg and that seems to be working. The Drs. always want to go by the weight chart and that's usually too high a dose.
How much does your son weigh? They told me my son which is 12 would end up taking 80 milligrams a day. He weighs 175 lbs and 60 milligrams seemed too much and didnt help him with school at all. Seem to make things worse.
Posted by Palbella on January 23, 2004, at 18:57:27
In reply to Re: Strattera--just for depression????-Jack Smith, posted by nmk on January 28, 2003, at 15:32:06
My son was taking Strattera and we took him off of it. We were not seeing any positive results for school. He was however more sociable. He has ADD and also has depression. I've read more post talking about opening the caps? I didn't know you could...?? I'm beginning to think he was on way to high a dose much too fast. Started on 40milligrams then 60 and would eventually go to 80 mgs. He's 12 years old and weighs 175 approx. The Zoloft he's on works very well for him but he still needs something more for the ADD. I'm thinking i might try him back on Strattera but open the cap and divide it. Anyone have more info on this subject? Thanks *S*
Posted by LightShifter on January 24, 2004, at 14:12:57
In reply to Re: Straterra » jcbikermom, posted by Palbella on January 23, 2004, at 18:42:01
The only person who knows if its "too much" or "too little" is the person who is EXPERIENCING the drug. No matter what any doctor may think, we all work dirrerently.
As I posted here before, the weight charts are a very poor way to start dosing people. Start low (say 10 mgs. and work up SLOWLY as necessary). For most people, 40 mg is way too much from what I've heard.
...Dan
> > My son is 11 years old and started taking 18mg a little over a week ago. The Dr. wanted to up the dose to 2 pills after 1 week. That was too much. He was sleepy and wouldn't wake up. I changed the dose to 25mg and that seems to be working. The Drs. always want to go by the weight chart and that's usually too high a dose.
>
>
> How much does your son weigh? They told me my son which is 12 would end up taking 80 milligrams a day. He weighs 175 lbs and 60 milligrams seemed too much and didnt help him with school at all. Seem to make things worse.
>
Posted by Ragesgal on January 24, 2004, at 14:15:53
In reply to Re: Straterra, posted by LightShifter on January 24, 2004, at 14:12:57
OK.....I have had to switch to taking my 40mgs at night(bed) when I take my Seraquel (also makes me tired) so that I fall asleep and stay asleep. When I was taking it in the am at the 40mg dose, it was making me tired for those first three days. So far so good as far as taking at night with my Seraquel (mood stabliizer).
Posted by Palbella on January 24, 2004, at 15:19:19
In reply to Re: Straterra, posted by LightShifter on January 24, 2004, at 14:12:57
> The only person who knows if its "too much" or "too little" is the person who is EXPERIENCING the drug. No matter what any doctor may think, we all work dirrerently.
>
> As I posted here before, the weight charts are a very poor way to start dosing people. Start low (say 10 mgs. and work up SLOWLY as necessary). For most people, 40 mg is way too much from what I've heard.
>
> ...Dan
>
>
>
> > > My son is 11 years old and started taking 18mg a little over a week ago. The Dr. wanted to up the dose to 2 pills after 1 week. That was too much. He was sleepy and wouldn't wake up. I changed the dose to 25mg and that seems to be working. The Drs. always want to go by the weight chart and that's usually too high a dose.
> >
> >
> > How much does your son weigh? They told me my son which is 12 would end up taking 80 milligrams a day. He weighs 175 lbs and 60 milligrams seemed too much and didnt help him with school at all. Seem to make things worse.
> >
>
>I read about opening the caps and dividing....I wasn't aware you could open those. Is it true..If so i'll try less for him. Any info anyone??
Posted by Mid-Life Crisis on January 26, 2004, at 18:36:05
In reply to Re: Im 15 too, Midlife Crisis, what works for me » Mid-Life Crisis, posted by imjustme on January 17, 2004, at 21:24:55
That's great that you've found a combination of medication that works great for you, imjustme. My son will be switching to a different doctor soon, so maybe I'll suggest he try Adderall and Strattera together. (His grades don't seem to be responding to anything he's tried so far.)
As for your question about not being able to open up to your friends, it might be that you have been teased about being "different" in the past (many of us with ADHD were teased by other kids while growing up) and now you have a problem trusting your friends with your thoughts and feelings? I'm just guessing.
Someone else wrote and suggested you try getting off the medication. This person probably does not have ADHD and doesn't realize how difficult it can be to function in school wihout meds. I remember going through elementary school in the 1950's (with no meds, of course) and never knowing what we were talking about when the teacher called on me. So if your meds help you, don't feel you "should" try to get off them just because some people feel you should. That is a decision that belongs only to you, your parents and doctor.
Posted by LightShifter on January 26, 2004, at 21:15:50
In reply to Re: Straterra, posted by Palbella on January 24, 2004, at 15:19:19
> I read about opening the caps and dividing....I wasn't aware you could open those. Is it true..If so i'll try less for him. Any info anyone??
>
Yes. You can open up and split the capsules. I do myself. I open the 40 mg. caps and split into 2 or 3 equal piles and put them back into empty capsules which I buy at the health food store. I think you can also get them from your pharmacist but they might be more expensive. You may also have some vitamins laying around you'll never use that you can empty and put the Strattera in....Dan
Posted by jlawr on February 3, 2004, at 23:39:19
In reply to Re: Straterra, posted by Ragesgal on January 18, 2004, at 22:34:25
I am on day two of strattera (40mg). I am 24, male and have ADD aswell as depression. I am also taking lexapro (10mg), which I have been on for two weeks. The only side effect that I have really noticed would be the "zombie effect." I am not sure whether to blame this on the strattera or the lexapro. I have been overly tired and had maor loss of energy since I started the lexapro and it has gotten worse with the strattera. I will just have to give it time. I am going to switch to taking my pills at night rater than in the AM.
Posted by dazed on February 4, 2004, at 12:00:20
In reply to New to Straterra, posted by jlawr on February 3, 2004, at 23:39:19
I had zombie effect on Straterra too, although I was a bit happier in terms of mood.
It did othing for my ADD, however, some friends think it's straight from heaven.
Posted by kirick on February 5, 2004, at 18:58:09
In reply to Re: Straterra - No other takers? » zenclear, posted by kdg on May 18, 2003, at 0:44:50
My 6 yr. old son has been on Strattera for 5 weeks. He has just started to show some signs of improvement. I do like that he eats and does not get headaches. It has not helped with some of hyperness. He can't sit in his chair in school. Does anyone know about taking other medications for the hyperactivity?
Posted by Siraris on February 5, 2004, at 21:04:49
In reply to Re: Straterra working- but son still fidgets, posted by kirick on February 5, 2004, at 18:58:09
Everyone is different, so I would suggest consulting your p-doc.
I have been tapering up on Strattera for the past 4-5 weeks. I am at 60 MG now. I notice around mid afternoon, about 2 hours before I usually take my dose, I start bouncing my legs really fast like I am about to take off. Don't know what it is, but I'm not that worried. Other then that, it works great!
Posted by aviolet on February 7, 2004, at 18:34:06
In reply to Re: Strattera for Inattentive ADD ?, posted by polarber on December 27, 2003, at 13:14:51
Hey Dreaman,
Just wondering how you were doing on Strattera. I was just diagnosed as ADD-inattentive in my last year of law school and my doctor prescribed Strattera. I was a bit disappointed because I would like to start Ritalin. I was started on a starter pack of 18mg and have now moved up to 25mg and will soon move up to 40mg. So far I haven't noticed any positive effects :-( only the common negative side effects of dry mouth and constipation. I've only been on it for a week and a half so I guess its too early to tell.
Just wondering how others with ADD inattentive were doing on Straterra?
Posted by Dreaman on February 8, 2004, at 0:39:21
In reply to Re: Strattera for Inattentive ADD ?, posted by aviolet on February 7, 2004, at 18:34:06
Hello aviolet
I have been off of the stratt for a while now. Basically what happended is that it wasn't all that effective for me. I only took it for about 5 weeks and probably not at a high enough dose (30mg). But the thing that made me decide it probably would not work out for me was a lessening of its effectiveness even when I increased the dose. The meds main positive effects were to keep me awake during the day. Also in the beginning it slightly improved my motivation, but it wasnt much help with my inability to focus and my mental sluggishness. Ritalin was much more effective for these until it pooped out. I am pretty sure my problem is my dopamine system not my neuroepinephrine(strattera works on this).
If the stratt doesnt work out and you have similar symptoms to me you might want to look into an MAOI called selegiline. It has worked reasonably well for me since I started on it. Otherwize just go with ritalin.
*Dreaman
Posted by micro on February 9, 2004, at 9:07:07
In reply to Re: Straterra working- but son still fidgets, posted by kirick on February 5, 2004, at 18:58:09
> My 6 yr. old son has been on Strattera for 5 weeks. He has just started to show some signs of improvement. I do like that he eats and does not get headaches. It has not helped with some of hyperness. He can't sit in his chair in school. Does anyone know about taking other medications for the hyperactivity?
Hello,
Please purchase the followimg texts- Healing Add By Daniel Amen M.D., Driven to Distraction by Hallowell, M.D. and Ratey, M.D. as well as Answers to Distraction by these to authors. After reading them, You will be able to help your son in many different ways. Good Reading! Regards. Micro
P.S. There are too many meds and combinations to discuss here so go to www.amenclinic.com and request a copy of Add: Guide for Primary care Physicians. It has an algorithm for the medicating of add patients. [the July issue of Primary Psychiatry vol. 5 no.7, 1998]
Posted by liquidchakra on February 11, 2004, at 14:46:59
In reply to Straterra approval., posted by scoper on December 28, 2002, at 2:19:34
I am on 25 mg on day 7 right now, and although I have gotten surprising results so far, the side effects are still somewhat annoying (Although they are slowly getting better)
I've noticed 3 distinct stages after I take the pill in the morning around 7. From about 7:15 to 9:30 I am in NA rush mode, and get rather pleasant tingles on my skin, but often a strong sense of vertigo. I am very focused on my work, and do everything methodically and slowly in this state
From about 9:30 to 12 I'm in 'Oh my god is this going to give me a heart attack' mode. Pulse is high, vertigo is replaced by a splitting sinus headache and hot flashes, as well as a seemingly irregular heartbeat. I say seemingly, as I can feel it beating oddly in my chest, but when I hold my hand over it, it is beating normally, albeit a bit stronger. Around this time I start to get rushes of anxiety, but I can tell that it is simply my NA pumping (Flight or fight anxiety is the best way to describe it)
Maybe that has to do with food, since lunch is at 12, but after 12 I feel for lack of a better word...normal. Concentration is fine, I'm not tired, and everything is just great. My ideas flow better, my anxiety is almost non existent, and an odd feeling of Zen seems to descend on me. I don’t feel any irregular heartbeats either, which is a relief.
I'm taking is slowly just because of the heart problems (I was supposed to be up to 40 mg by now, but I am waiting until Sunday to do that now. Do these ever go completely away?
Posted by Ashlea on February 19, 2004, at 10:36:35
In reply to Strattera and splitting caps?, posted by Palbella on January 23, 2004, at 18:57:27
I have a 5 year old on Strattera. He can not/will not swallow the capsule so I started opening the pill and putting it in chocolate milk. I called Eli Lilly and of course they read their script and tell you that opening the pill is not advised and it was never tested that way. My doctor said their would be no problem in opening it, but that it has a very bitter taste and can cause a burning sensation in the mouth. So far, the milk seems to coat any burning and my son has not complained at all about it. I do know that my son is taking 25 mg dosage. Maybe you can request the 25 mg capsule instead of the 40 mg or 60 mg. Anyway, Good Luck...
Posted by Forest Gump on March 12, 2004, at 9:02:06
In reply to Straterra approval., posted by scoper on December 28, 2002, at 2:19:34
Okay, I started out on this medication and it really calmed me down. However, I am constipated and my libido has went into the crapper. Anyone, having problems with erections? I know this is personal but I need to know. Thanks,
Forest
Posted by Forest Gump on March 12, 2004, at 9:04:37
In reply to Re: New to Straterra, posted by dazed on February 4, 2004, at 12:00:20
I'm from Columbus area and I noticed they have a support group for adhd adults. Anyone ever been to a meeting? is it worth while?
Forest
Posted by Lightshifter on March 12, 2004, at 23:21:26
In reply to Re: Straterra approval., posted by Forest Gump on March 12, 2004, at 9:02:06
> Okay, I started out on this medication and it really calmed me down. However, I am constipated and my libido has went into the crapper. Anyone, having problems with erections? I know this is personal but I need to know. Thanks,
> ForestIn reply Forest, I can say that indeed I had erectile dysfunction issues as well as urinary retention and difficult orgasms (anorgasmia i think its called). I have backed off to taking it only a couple of times a week and it seems to have helped.. For me, Strattera works for a very long time. I can go days and still feel as if I'm on the medication... perhaps my norepinephrine depletion isn't as bad as most. Maybe when I take it too often too much backs up and causes problems.
LightShifter
Posted by Cheraw on March 14, 2004, at 20:36:00
In reply to Re: Straterra approval., posted by Forest Gump on March 12, 2004, at 9:02:06
> Okay, I started out on this medication and it really calmed me down. However, I am constipated and my libido has went into the crapper. Anyone, having problems with erections? I know this is personal but I need to know. Thanks,
> ForestForest,
I'm there with you, brother. Beyond the libido, orgasms are bizzare to say the least! Almost painful. I'm not sure this medication is worth all of the negative side effects. I haven't slept in days.
Posted by Forest Gump on March 15, 2004, at 7:58:55
In reply to Male Issues, posted by Cheraw on March 14, 2004, at 20:36:00
Okay, I'm not crazy then. Thanks for the reply. I mean this medication is great but my orgasiums are better. I may ask my doctor what he thinks I should do.
Posted by King Vultan on March 15, 2004, at 10:17:20
In reply to Male Issues, posted by Cheraw on March 14, 2004, at 20:36:00
> > Okay, I started out on this medication and it really calmed me down. However, I am constipated and my libido has went into the crapper. Anyone, having problems with erections? I know this is personal but I need to know. Thanks,
> > Forest
>
> Forest,
>
> I'm there with you, brother. Beyond the libido, orgasms are bizzare to say the least! Almost painful. I'm not sure this medication is worth all of the negative side effects. I haven't slept in days.
Based on my experiences last year with three tricyclics and Strattera, one thing I would suggest is considering adding an alpha-1 blocker, such as Hytrin or Flomax. This will tend to counteract the adrenergic agonist effects that NE reuptake inhibitors can have in the penis and prostate. My experience was that this improved erection quality and made ejaculation vastly more comfortable. You might also consider adding trazodone instead, which has a built in alpha-1 blockade and will also tend to counteract the insomnia problems you are experiencing.Beyond this, and as I've mentioned before, my experience was that desipramine had very similar therapeutic effects to Strattera and much fewer side effects. The insomnia was not nearly as bad, and desipramine also did not cause me drowsiness during the day. It was also much cheaper.
Todd
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