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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Dreaman on December 23, 2003, at 23:38:52
Hello,
I was wondering how all the Inattentive
ADDers (meaning main symptoms are tiredness, brain fog, really bad concentration, maybe social shyness and inhibition) have done on Strattera. So far on this thread I have not read anything specifically about how well the strattera works for Inattentives. Sometimes I get really frustrated at how much attention the people with the hyperactive component get in the literature and books while inattentives are barely mentioned. My intuition is that Inattentives as apose to Hyperactives would have a big differences in their reactions to the strattera compared to the differences that are seen with traditional stimulants. I say this because strattera works almost exclusivly on Nuero-epinephrine (spelling ?) as apposed ritalin working on both dopamine and neuroepinephrine. So I am guessing that one ADD type or the other needs neuroepinephrine more than dopamine. Am I right or am I just dreaming this all up?Anyway I was on ritalin for about 2 years before I started getting tolerant of it. Now it barely works no matter what dosage I am on. Did this happen to anyone else? In the beginning it was really a miracle drug for me, not anymore so I am looking into strattera. What I really want to know is what are the cognitive effects of the strat ie focus, concentration how do they compare with stims? Also did strattera help anyone overcome shyness or social inhibitions.
Anyone had a good drug experience for ADD w/o h other than stims?Any shared experiences would be great especially
from inattentives!
Posted by zeugma on December 24, 2003, at 6:41:08
In reply to Strattera for Inattentive ADD ?, posted by Dreaman on December 23, 2003, at 23:38:52
I think Strattera is very good for clearing brain fog. I can't compare it directly to stimulants, because I have never been able to tolerate a stimulant. My ADD is severely inattentive, and when I started on Strattera, my employers immediately noticed a difference (they didn't know I had started Strattera, of course).
The theory behind using norepinephrine reuptake inhibitors is that they will increase levels of dopamine (not just norepinephrine) in the prefrontal cortex, which is thought to be the seat of executive function. The NE reuptake mechanism actually has a higher affinity for dopamine than for norepinephrine, and in areas where there are few dopamine transporters- the PFC among them- dopamine clearance is mostly via the NE transporter. That's the theory, at least.
My experience is that Strattera works for brain fog, without being physically stimulating (it doesn't keep me up at night, but isn't particularly energizing, either).
Posted by Dreaman on December 24, 2003, at 12:20:49
In reply to Re: Strattera for Inattentive ADD ?, posted by zeugma on December 24, 2003, at 6:41:08
Zeugma thanks for the feedback. Sounds like the strat is really helping with your job performance. I just recently talked to my pdoc and she agreed that we should try Strattera. After Christmas I will go to the pharmacy and pick the pills up. My doc said that starting out with 10mg would be our best bet. I was wondering how you increased your dosage to what your on now and how long you took it to get the good cognitive effects.
I have read in alot of places that Strat sedates people. Is this maybe just the hyperactive people? I need the opposite of sedation. How has the Strat affected your socialization skills. Hows your Sleep? I sleep 12-13 hours daily when allowed. Maybe the strat would cut down on this. Do you have any depression or anxiety along with the ADD, hows that going if you do. Also did you have any cardiac side effects since you started? I am a little worried because I think the last few years on Ritalin may have screwed up my heart a little.
Sorry about all the questions but I am a little apprehensive as well as excited about starting the strattera.
Posted by zeugma on December 24, 2003, at 13:33:31
In reply to Re: Strattera for Inattentive ADD ?, posted by Dreaman on December 24, 2003, at 12:20:49
> Zeugma thanks for the feedback. Sounds like the strat is really helping with your job performance. I just recently talked to my pdoc and she agreed that we should try Strattera. After Christmas I will go to the pharmacy and pick the pills up. My doc said that starting out with 10mg would be our best bet. I was wondering how you increased your dosage to what your on now and how long you took it to get the good cognitive effects.
I started at 18 mg, went up to 25 mg after a week or so, stayed at that doseage for 2 weeks, then went up to 40, then 60, then 80 mg a day (where I currently am). I spent approx. 3 weeks at each of these dosages before reaching my current one.
>
> I have read in alot of places that Strat sedates people. Is this maybe just the hyperactive people? I need the opposite of sedation. How has the Strat affected your socialization skills. Hows your Sleep? I sleep 12-13 hours daily when allowed. Maybe the strat would cut down on this. Do you have any depression or anxiety along with the ADD, hows that going if you do. Also did you have any cardiac side effects since you started? I am a little worried because I think the last few years on Ritalin may have screwed up my heart a little.I have SEVERE, SEVERE depression along with ADD. I feel 'deactivated,' lethargic, and terribly unfocused when not on meds. I also take an antidepressant, nortriptyline, which helped with the depression, but not with the lack of alertness. Strattera helps me specifically with the 'drifting off' feeling that is typical of inattentive ADD.
Strattera doesn't interfere with my sleep at all. I was able to get by on less because I felt less sluggish overall. Unfortunately, one thing Strat has NOT helped me with is anxiety. That's not to say it won't help you- there are others on this board who have found Strat anxiolytic. Not me, though. I currently take a very low dose of clonazepam for anxiety. It helps, but I am afraid it is reversing some of the effect of the Strattera in terms of alertness and energy. I'm not sure what i am going to do about this.
My doctor checks my pulse every month. It's my understanding that if you stay on top of this, there's nothing to worry about.
z
>
> Sorry about all the questions but I am a little apprehensive as well as excited about starting the strattera.
>
Posted by dazed on December 30, 2003, at 15:25:02
In reply to Strattera for Inattentive ADD ?, posted by Dreaman on December 23, 2003, at 23:38:52
I have been recently diagnosed with ADD Inattentive. Every thing you ask about I'm it. I started with Straterra, then kept increasing dosage until after 10 weeks at max dose it did nothing, absolutely nothing. Didn't help with social anxiety or ADD, or tiredness, feeling lazy, etc. It was like taking placebo for me.
Last month started on Adderall. Still nothing. 10mg/3xday. I go back in January and suspect he will increase dose of Adderall or try something new. So far it's been a waterhall on both of these drugs. I'm hopeful that I will "see the light come on" at some point.
Also hoping to overcome social inhibitions also.
Posted by EscherDementian on December 31, 2003, at 5:45:58
In reply to Re: Strattera for Inattentive ADD ?, posted by dazed on December 30, 2003, at 15:25:02
My ADD Inat. was not affected either, until Adderall 70-80mgs and a PDoc with the courage and authority to perscribe that. I have since been able to come way down in dose regularly as i recognize what is needed (or not). Mind, regognition alone has taken over a year - but well worth it.
i am still perturbed about my time and $ wasted on a previous pmhnp who dropped and referred me out with a misdiagnosis (*glad we found that out *whew*) because i wasn't fitting into standard dosage parameters and "wasn't getting better". I've come to learn that not all pdocs know and act on something i'd assumed was in the basic psych. education: that we are all unique individuals.
Don't give up yet, dazed. The universe responds to action. Hope this helps,
Escher
> I have been recently diagnosed with ADD Inattentive. Every thing you ask about I'm it. I started with Straterra, then kept increasing dosage until after 10 weeks at max dose it did nothing, absolutely nothing. Didn't help with social anxiety or ADD, or tiredness, feeling lazy, etc. It was like taking placebo for me.
>
> Last month started on Adderall. Still nothing. 10mg/3xday. I go back in January and suspect he will increase dose of Adderall or try something new. So far it's been a waterhall on both of these drugs. I'm hopeful that I will "see the light come on" at some point.
>
> Also hoping to overcome social inhibitions also.
This is the end of the thread.
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