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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1202 to 1226 of 1242. Go back in thread:
Posted by Cheraw on March 24, 2004, at 6:44:55
In reply to Re: Adults on Straterra » New2Meds, posted by spoc on March 21, 2004, at 12:57:15
Hello again everyone,
Well, two weeks have passed since starting the big "S" and I can't say I'm really any better. The side-effects have diminished quite a bit (thank God!) and I am sleeping. I am focusing a little better, but it's not like it's a wonder drug.I agree with the dosage info. My doc started me on 40mg per day and then wanted me to double it to 80mg after four days. I didn't do it because I knew I couldn't handle it. 40mg were making me crazy already! I also changed my time of day taking it. Before I took it at bedtime, now I take it first thing in the morning. That in itself seems to have made a difference for me. And not to offend, but since the topic is "male issues", I am happy to report that "wood" has returned. Orgasms are still a bit strange, but not like at the beginning.
> I didn't look into anything about the "standing" of the website I copied the following from, but the info on it seemed worth investigating. Note that the site author certainly shoots from the hip, which I like if credible too! He and his friend are patients at the Amen Clinic (haven't read the whole site, and don't know if he claims that all or part of his info derives from there). The site is called crazymeds.org:
> -------
> DOSAGE: ...This is where people get completely hosed with Strattera. This med can work wonders for more people if they and their doctors would just have some goddamn patience!!! The initial dosage is 18-25 mg. Got that? 18-25mg. Not 40mg. Not 60mg. 18-25mg. Unfortunately some bean counter in the bowels of Eli Lilly's accounting department determined that it was more profitable to restrict the size and number of 18mg and 25mg sample packs (only four capsules in each now), and let some people just fail with this med. So most of the sample packs sent out now are only 40mg capsules. It's more profitable for Lilly if Strattera doesn't work for everyone it could work for!! Isn't that crazy? Even the Amen Clinic where Mouse and I are treated gets very few of the 18mg and 25mg sample packs, and only because they treat kids! And they're in real tight with their Eli Lilly sales rep! Anyway, the highest an adult should start at is 25mg a day and just stay there for at least two weeks. Wait at least that long before going up to 40mg, and then only if it's going to make a big difference, not a small difference. Here's why - if you don't have enough norepinephrine to reuptake, Strattera starts going after MAO. And not in a good way, like an MAOI would. That is why people will feel wiped out when they take these outrageously high starting dosages. Then if they go back down to the previous dosage, they still feel crappy and give up. Well, it takes about two weeks to get over taking too much Strattera. Once again, have some freaking patience. Anyway, once you get past the 25mg a day barrier, dosages are as follows: 36-40 mg a day, 50 mg a day, 60 mg a day, 80 mg a day, 100 mg a day. Doses are usually divided between morning and afternoon, but some people get drowsy with Strattera, while others get hyper, so the dosing can be really flexible. I take my 40mg all in the morning.
>
> DAYS TO REACH A STEADY STATE: For all of the extensive pharmacokinetic testing Lilly did and data they published in Strattera's PI, far better than that done for most meds, they neglected to actually publish the steady state figures! I truly commend Lilly for its research. From reading the PI sheet you can tell they went above and beyond to get good data on any dosing differences required based on age, gender, ethnicity, taking Strattera with meals and trying to determine the difference between normal and poor metabolizers of the medication. However it looks like we've got information overload! With Strattera's wacky double metabolism (see half-life below) and identification of the poor metabolizer population, the numbers may be too variable to pin down a steady state. I couldn't find any number for it anywhere else.
>
> ========
> > When I first started Straterra, the first few dats were very intense. I was told by my doctor to take 40mg for seven days and increase to 80mg. I guess my ADD was kicking in, because I ended up taking 80 mg for seven days and then decreasing to 40 mg...after a week on the 40mg dose, I went to my Dr. The Dr. was holding back a laugh I could tell but I suggested I try a 60mg dose and see how that worked. > > Needless to say, when I initially started with the 80mg dose for a week I had several side affects.
>
>
Posted by micro on March 24, 2004, at 8:58:11
In reply to Re: Male Issues, posted by Cheraw on March 24, 2004, at 6:44:55
> Hello again everyone,
> Well, two weeks have passed since starting the big "S" and I can't say I'm really any better. The side-effects have diminished quite a bit (thank God!) and I am sleeping. I am focusing a little better, but it's not like it's a wonder drug.
>
> I agree with the dosage info. My doc started me on 40mg per day and then wanted me to double it to 80mg after four days. I didn't do it because I knew I couldn't handle it. 40mg were making me crazy already! I also changed my time of day taking it. Before I took it at bedtime, now I take it first thing in the morning. That in itself seems to have made a difference for me. And not to offend, but since the topic is "male issues", I am happy to report that "wood" has returned. Orgasms are still a bit strange, but not like at the beginning.
>
>
> > I didn't look into anything about the "standing" of the website I copied the following from, but the info on it seemed worth investigating. Note that the site author certainly shoots from the hip, which I like if credible too! He and his friend are patients at the Amen Clinic (haven't read the whole site, and don't know if he claims that all or part of his info derives from there). The site is called crazymeds.org:
> > -------
> > DOSAGE: ...This is where people get completely hosed with Strattera. This med can work wonders for more people if they and their doctors would just have some goddamn patience!!! The initial dosage is 18-25 mg. Got that? 18-25mg. Not 40mg. Not 60mg. 18-25mg. Unfortunately some bean counter in the bowels of Eli Lilly's accounting department determined that it was more profitable to restrict the size and number of 18mg and 25mg sample packs (only four capsules in each now), and let some people just fail with this med. So most of the sample packs sent out now are only 40mg capsules. It's more profitable for Lilly if Strattera doesn't work for everyone it could work for!! Isn't that crazy? Even the Amen Clinic where Mouse and I are treated gets very few of the 18mg and 25mg sample packs, and only because they treat kids! And they're in real tight with their Eli Lilly sales rep! Anyway, the highest an adult should start at is 25mg a day and just stay there for at least two weeks. Wait at least that long before going up to 40mg, and then only if it's going to make a big difference, not a small difference. Here's why - if you don't have enough norepinephrine to reuptake, Strattera starts going after MAO. And not in a good way, like an MAOI would. That is why people will feel wiped out when they take these outrageously high starting dosages. Then if they go back down to the previous dosage, they still feel crappy and give up. Well, it takes about two weeks to get over taking too much Strattera. Once again, have some freaking patience. Anyway, once you get past the 25mg a day barrier, dosages are as follows: 36-40 mg a day, 50 mg a day, 60 mg a day, 80 mg a day, 100 mg a day. Doses are usually divided between morning and afternoon, but some people get drowsy with Strattera, while others get hyper, so the dosing can be really flexible. I take my 40mg all in the morning.
> >
> > DAYS TO REACH A STEADY STATE: For all of the extensive pharmacokinetic testing Lilly did and data they published in Strattera's PI, far better than that done for most meds, they neglected to actually publish the steady state figures! I truly commend Lilly for its research. From reading the PI sheet you can tell they went above and beyond to get good data on any dosing differences required based on age, gender, ethnicity, taking Strattera with meals and trying to determine the difference between normal and poor metabolizers of the medication. However it looks like we've got information overload! With Strattera's wacky double metabolism (see half-life below) and identification of the poor metabolizer population, the numbers may be too variable to pin down a steady state. I couldn't find any number for it anywhere else.
> >
> > ========
> > > When I first started Straterra, the first few dats were very intense. I was told by my doctor to take 40mg for seven days and increase to 80mg. I guess my ADD was kicking in, because I ended up taking 80 mg for seven days and then decreasing to 40 mg...after a week on the 40mg dose, I went to my Dr. The Dr. was holding back a laugh I could tell but I suggested I try a 60mg dose and see how that worked. > > Needless to say, when I initially started with the 80mg dose for a week I had several side affects.
> >
> >
>
>
Hello, For those of you that have pdocs inappropriately rxing straterra, Have them rx you 18mg caps and titrate very slowly. Also, consider bedtime dosing to help with the side effects as drowsiness is very common. If you are on multiple meds drowsiness my not occur depending on the mix. Regards, Micro
Posted by Viridis on March 25, 2004, at 2:19:41
In reply to Adult Male on Straterra, posted by New2Meds on March 21, 2004, at 10:07:11
I'm an adult male with ADD who took Strattera for about 6 months. Initially it was promising, and improved my mood quite a lot (and concentration a bit). It DEFINITELY requires a slow increase in dosage (based on my experience); initially it caused mild nausea, muscle aches, and dry mouth, but these problems did fade out with time.
I eventually got up to 80 mg, and it seemed OK for a while. Then all the positive effects disappeared, and I had the very weird side effect of slurring my words frequently and sometimes being incapable of speaking at all. A few others have reported this. I cut back to 40 mg and this improved somewhat, but since I saw no benefits, I discontinued it. I had no withdrawal, and all side effects stopped within a couple of days.
I never noticed any sexual problems, but it was just too weird for me. When I discussed this with my pdoc he said it's not appropriate for me, and seemed rather concerned in general about prescribing it based on my experiences.
It was good at first, but for me at least, I find Adderall vastly better for ADD and antidepressant effects. Strattera could be great for others, but I recommend gradual dosage increases (not more than 25 mg every couple of weeks) and close attention to side effects.
Posted by nana-int on March 30, 2004, at 11:11:46
In reply to Straterra approval., posted by scoper on December 28, 2002, at 2:19:34
grandson 8 yrs. old having good results but fights about taking each am. i know it can be taken am or pm but what are results if taken later in the day. says it upsets his stomach in am, but will take in pm.
Posted by stellajones on April 24, 2004, at 16:07:46
In reply to Anything Good to Say about Strattera?, posted by Susannah on May 28, 2003, at 16:11:27
> Does anyone have anything positive to say about treating ADHD children with Strattera? My 9 year old daughter has been taking Adderall XR 10mg/day for about a year now and I have not seen any improvement. Before Adderall XR she took regular Adderall (15mg/day bid) for about 2 years and that worked much better; however our doc insisted that we switch to a once a day formula. She took Ritalin once, very briefly, but had an increased heart rate from med and was promptly taken off. She is already very small and thin for her age, she is only 50lbs. She has trouble falling asleep at night ans is subsequently tired and irritable in the mornings.
>
> Her therapist thinks she will do better on Strattera because he claims she is "sad" as well and this med should treat both ADHD and her sadness. I'm taking her to the psychiatrist on Monday and I am going to ask him to switch her meds. I have read boards similiar to this and only see bad things. Does anyone have anything good to say or has anyone or their child had a positive experience with Strattera?
>
> My daughter has a relatively mild cause of ADHD, more inattentive than hyperactive although her symptoms can change in response to social situations, school, ect.
>
> Any information would be greatly appreciated.> Have you considered any alternative treatment?
Studies have shown that many children and adults with ADD have low levels of essential fatty acids.There are EFA oil blends for children and adults specifically marketed for focus and attention problems-ADD, that are available in most health food stores.Heres an article that describes some of the creative genius many ADD'ers posess >http://www.erinelster.com/Articles/add_article_3_00.html
Posted by Dr. Bob on April 26, 2004, at 3:40:54
In reply to Re: Anything Good to Say about Strattera?, posted by stellajones on April 24, 2004, at 16:07:46
> Have you considered any alternative treatment?
Sorry if it's confusing, but I'd like follow-ups about alternative treatment to be redirected to Psycho-Babble Alternative. Here's a link:
http://www.dr-bob.org/babble/alter/20040418/msgs/340067.html
Thanks,
Bob
Posted by Cattzo on June 4, 2004, at 23:19:12
In reply to Re: Strattera 2+ months, posted by ciejae on April 27, 2003, at 8:04:29
Wow...deja vu! I have been on Wellbutrin for the past three weeks for Depression and minor ADD. However, upon checking up with my doc today he suggested I try Strattera. I left the office with a sample pack containing four 25mg tabs and 14 50mg tabs. I took a 25mg tab after getting home, and i have to say it made me really tired. It was strange because when it was first coming on I got a sort of head rush, became a little dizzy, then the dizzyness turned into a strong desire to take a nap. =oP Anyway, the reason i'm responding to your post is because of how you mentioned disliking being a passenger when driving and how you had a fear of flying...I too, do not like being a passenger, nor do I like flying, and I guess I just wanted to see if you were still on strattera and if it was still working for you, how long it took for it to work, etc. My plan is to stop taking the Wellbutrin in order to give the Strattera a fair shot, as i've also had the misfortune to learn that mixing Strattera and Wellbutrin is a no-no. Any comment would be much appreciated. Thanks in advance. =o)
Posted by WAKI on July 11, 2004, at 18:56:33
In reply to Re: Strattera 2+ months » ciejae, posted by Cattzo on June 4, 2004, at 23:19:12
Hi,
Thanks for replying to this oldewr message, hopefully we can start a 2004 series of posts on this subject.I'm 43 yo male. I have depression and adhd.
After 3 years of trying every ssri, effexor, lamictal, provigal, concerta and more, Welbutrin sr and welbutrin xl
Welbutrin xl was the first drug allong with lamictal that helped me out. It changed me from a 250 lb couch potato to a 170 athlete as I was many years ago. I enjoy activities and have a desire to "get out and go"!
I just started strattera am on 2nd week. First week was a night mare. I was lathargic all week. I discontinued a anxiety relaxer I was taking before bed and woke up feeling great. So I don't know if the fatigue was a side effect of strattera or the anxiety relaxer. I'm on 80 MG of Strattera and 450 Welbutrin. I'm noticing more and more to reduce the welbutrin to not feel so speeded up. I skipped welbutrin yesterday and felt good. I took 300 today and feel hyped up. Now I took a partial anxiety relaxer to see how it works to get me to sleep.
I suspect Ill be reducing everything but the Strattera. My ADHD has not improved, but i did not feel depressed when i didnt take welbutrin.
I read an excellen article by a lady that stated if you dont try strattera for 4 weeks you are not testing it at all. I have hopes in 2 weeks.
On my own today, I bought the amino acid called L-Tyrosine, it specificly states its for the same Nuro transmitters such as Norepinephrine that we are trying to acomplish with Strattera.
I started 1000 mg per day today and am hopefull.
In summary I'm on 2nd week but hope in 2 months I will still be motivated and energized but also have a clear organized mind.
Posted by Mimi on July 11, 2004, at 20:16:47
In reply to Re: Strattera 2+ months (July 2004), posted by WAKI on July 11, 2004, at 18:56:33
Not to dis you, but I was on Strattera for months. It caused appetite loss and insomnia in me, without any concentration benefits after several days. Lots of folks do not find Strattera helpful is the news in the pdoc office.
I think Ritalin worked better for me but I lost too much weight when on that.
Mimi
Posted by Torque on July 11, 2004, at 22:04:15
In reply to Strattera Sucks! » WAKI, posted by Mimi on July 11, 2004, at 20:16:47
I have been of Strattera for about 3 weeks. 25 mgs the first 2 weeks and now 40 mgs for the third week. Overall I happen to like it. It helps tremendously with my irritability and impatiance. I feel very relaxed. On the down side it makes me very sleepy a few hours after taking it, but it does pass. I combine it with 75 mgs of effexor, which I hope to decrease further (was taking 150 mgs). Keep us posted on your progress.
Posted by utopizen on July 13, 2004, at 12:13:12
In reply to Re: I like Strattera, posted by Torque on July 11, 2004, at 22:04:15
> IOn the down side it makes me very sleepy a few hours after taking it, but it does pass. I combine it with 75 mgs of effexor, which I hope to decrease further (was taking 150 mgs). Keep us posted on your progress.
>Try PM dosing- right before bedtime. With meds, your body me find it induces sleepiness or is activating to the point of causing insomnia. Either way, sleepiness tends to go away after a couple of weeks or so with any med.
Take it at night, and you'll sleep through the negative side effects. This tends to apply with all meds that your body reacts to by inducing sleep.
Posted by Torque on July 13, 2004, at 22:06:50
In reply to Re: I like Strattera - PM DOSING AVOIDS SLEEPINESS » Torque, posted by utopizen on July 13, 2004, at 12:13:12
> > IOn the down side it makes me very sleepy a few hours after taking it, but it does pass. I combine it with 75 mgs of effexor, which I hope to decrease further (was taking 150 mgs). Keep us posted on your progress.
> >
>
> Try PM dosing- right before bedtime. With meds, your body me find it induces sleepiness or is activating to the point of causing insomnia. Either way, sleepiness tends to go away after a couple of weeks or so with any med.
>
> Take it at night, and you'll sleep through the negative side effects. This tends to apply with all meds that your body reacts to by inducing sleep.
>
Thanks. I think I will try PM dosing for a while.
Torque
Posted by so far so good on July 15, 2004, at 15:50:50
In reply to Re: I like Strattera - PM DOSING AVOIDS SLEEPINESS, posted by Torque on July 13, 2004, at 22:06:50
Age ? How long ago diagnosed with ADD? Any other ADD meds to compare stattera to(personnely speaking) ? I keep hearing sleepiness - side effect.How sleepy? Eyes closing mid-day fighting to stay awake? Or just tired feeling in general ?Any other meds being taken for other mental health issues? Any info would be greatly apprciated .
Posted by blondegirl47 on July 16, 2004, at 17:02:58
In reply to Would like info on strattera??????, posted by so far so good on July 15, 2004, at 15:50:50
My Pdoc had me take strattera at night before bed and my stimulant during the day. I slept very well on it, but it seemed to help me hyper focus on things I should be doing. It also made me hungry and I put on weight. I stopped taking it about a month after starting.
I was diagnosed about 4 or 5 years ago...
Blondegirl
Posted by WAKI on August 1, 2004, at 23:23:35
In reply to Re: I like Strattera - PM DOSING AVOIDS SLEEPINESS, posted by Torque on July 13, 2004, at 22:06:50
I tried PM dosing the last two nights and it is making a major difference. When I took 80 mg of Strattera in the morning I was fatigued. I then tried 40 mg in morning and 40 mg at night in which I felt relaxed all day. I then tried 80 mg at night and it's working really sweet. I am awake all day.
I still have some insomnia so p-doc put me on ambien for awhile. I dream like a kitten on Ambien. I also take 400 mg of lamictal at night and 300 mg of Wellbutrin during the day to energize me.
When I take strattera in morning I tend to eat more. When I take it at night it curbs my appatite nicely along with the Wellbutrin.
I am determined to try this strattera for 3 to 6 months to really give it a chance. I will suffer through the side effects so that I do not miss a potential opportunity.
I am a little discouraged with all this med taking. These message posts are keeping me motivated. It really gets "old" experimenting with meds all the time.
Posted by WAKI on August 1, 2004, at 23:30:00
In reply to Re: PM DOSING is working for me, posted by WAKI on August 1, 2004, at 23:23:35
Possibly some of you can inform me. I have ADHD in which the Wellbutrin and/or Concerta just antagonizes the ADD and makes it worse. (Rapid thoughts).
The strattera appears to slightly be helping me.
I was told Concerta is simple a longer half life version of the ritlan.
Are all the rest of the ADHD meds out there the same as concerta (speed effect), with the exception of Strattera?
Any ideas on other meds I can trial?
Thanks.
Posted by WAKI on August 1, 2004, at 23:40:56
In reply to Re: Strattera and Ritalin or Strattera only, posted by Siraris on January 15, 2004, at 11:57:46
I forgot if I told all of you, but I will mention again because this was a major "find" for me.
I was slipping into depression (the fatigue type) every 4 days when I started Strattera.
My P-doc had me chart my naps, amount of times I wake up at night and duration, and total hours of sleep.
He figured out my sleep was so disturbed that it caught up with me every 4 days. I would then nap for a few days, be re energized for about 4 days then fatigue cycle again.
Right now I am on ambien to sleep at night and I do not cycle any more.
I hope this info will help somebody out. My p-doc said some P-docs specialize in sleep alone. He said sleep science is a field that can really complicate or help ones life.
I used to be fairly proud that I can function on little sleep.
I am now a avid believer in sleep is essential to a productive day.
Posted by WAKI on August 1, 2004, at 23:46:19
In reply to Re: Would like info on strattera??????, posted by blondegirl47 on July 16, 2004, at 17:02:58
Blondechix,
I wish I could hyper focus. Whats it like? I'm 43 yo trying to score high on LSAT to get into law school. This adhd crap is really holding me back.
Are any of you dis organized, hoard things, start things and don't finish them? If your are tell me how it effects / impacts your life?
Posted by WAKI on August 2, 2004, at 0:10:43
In reply to Re: Would like info on strattera??????, posted by WAKI on August 1, 2004, at 23:46:19
I have come to the conclusion that I was not settleing like a man should with a potential wife. I was a non commital person, kept the relationship at some what a distance away.
I have some quirks that could be irritating to a woman. I take long showers, like a cool house, disorganized and worked allot before this 1 year sabbatical I am taking. If I don't push myself I easily blow a day watch baseball ar golf on the idiot box. Sex wise a pop a Viagra and can rock her house all night. Assume several naps in 9 hours but also assume several love sessions (good long ones that wear her out)
If I my V-juice we can go to bed at 6:00 Pm on a Friday stay in bed for 3 days straight rocking her house. We only come up for air, water and food. But you have to admit 72 hours sexing on the V-juice makes any man a tarzan studd muffin?
You guys doing th V-Juice will be the talk of the womens night out. All the women in town will smile at your family jewels. The only time I go on Injured reserve status is when my unit gets so raw from the constant tight friction. At that point it's pure terror to work the unit for a good week.
I find if you use KY and some vasaline your unit wiil withstand much more sueface contact.
You can buy a case of KY off the net on a old folks medical web site. Very cheap price and will last you for ever. The KY gives you pure velocity at high speed intervle cycles. This is great when she is on top of the man while he is on back. She can effeciently squat up and down with no friction.
The vasciline is for hardcore pumping. It creates a vacuum tight seal. When your unit slips out you will hear a vacuum break and a pussy fart.
Sex is beautiful! Sex should be thr form of curency.
Imagine going to the gas station and gass is 4 dollars. Instead the customer services the attendant. The attendent will then service her boss, the boss does the VP. The VP does the Prez. The prezz does the secretary, the plant operators do the prezz wife, the janitor does the VP wife.
then they have one major orgy and live on love.
Do sound like any of you?
Posted by Dr. Bob on August 2, 2004, at 17:54:22
In reply to Does ADHD cause relationship problems?, posted by WAKI on August 2, 2004, at 0:10:43
Posted by Sebastian on August 2, 2004, at 19:23:26
In reply to Does ADHD cause relationship problems?, posted by WAKI on August 2, 2004, at 0:10:43
Sounds like me before mental illness. Does the viagra counter sexual difficulties from psyco-tropic meds.
Posted by WAKI on August 3, 2004, at 2:31:28
In reply to Re: let's stick to medication here, thanks (nm) » WAKI, posted by Dr. Bob on August 2, 2004, at 17:54:22
Wohlverstanden Fuehrer Koenig Kommandant DR BOB
Posted by Dr. Bob on August 3, 2004, at 18:04:59
In reply to Wohlverstanden Fuehrer Koenig Kommandant DR BOB, posted by WAKI on August 3, 2004, at 2:31:28
Posted by Dara on August 18, 2004, at 22:03:28
In reply to Re: I like Strattera, posted by Torque on July 11, 2004, at 22:04:15
I am a recovering drug addict who began using Welbutrin XL about 3 years ago... That has worked ok, and I have been able to take care of my kids and recieve an A.A. while on it. I kept hearing about Straterra, and my Dr. agreed to try me on it. I've been on about 3 weeks now, and I went from 18ml, to 25ml, to 40ml. I am wondering why everyone else seems to be taking 80ml? I felt real tired for about 3 days on the 18ml, but thats it. I really want this stuff to work for me, because I have alot of responsibilities, and I don't ever want to self medicate again! W/out any medication, I am like a crazy person spinning out of control... Since I have begun to try prescribed meds., I am not nearly as bad! Just still confused and forgetful. I still interrupt people alot, and my mind moves from subject to subject still too fast.(according to how other people seem to be!) Any input would be soo great!
Posted by Rio on September 13, 2004, at 13:50:09
In reply to Re: I like Strattera, posted by Dara on August 18, 2004, at 22:03:28
My son starts strattera in the morning. I am so scared for him. He has enough problems without the possibility of getting any one of the side effects mentioned by you in here. I am so tired and at the end of my rope now. I am a single mum and so take the brunt on a daily basis. I swear, I will need prozac after all this. I've given up crying myself to sleep. My son needs help, to focus, concentrate, to be able to remain in school for at least ONE whole day!...... even to speak in a quiet voice. Man, that kid is so LOUD! I often say I just wish I could remove his battery, just for ten mins! If this drug makes him worse, then I don't know what I am going to do. Yet, the recent events of Russia put the whole thing into perspective. My eyes have welled up just typing this. Like I said..... I'm just tired. Thank you for listening.
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