Posted by froggyanna on June 1, 2003, at 15:26:08
In reply to Keep the Strattera updates coming! (nm), posted by Hattree on May 30, 2003, at 10:38:47
I started taking 40mg Straterra on May 22, so that's 10 days. I had a few side effects (slight queasiness, slight dizzyness) but they wore off in a couple of days. I actually got a slight little "high" the first day, but that went away after about two hours. In the afternoons, I experienced severe tiredness. Being unemployed, I could nap through that.
I have also been taking Zoloft, various dosages for several years. Right now I am at 100mg and that seems to keep the tendency to depression very nicely alleviated. And I am taking .2mg Levoxyl for Hashimoto's hypothyroidism for about a year now (Synthroid for many years before that).
Before starting the Straterra, after my first visit with a psychiatrist for the treatment of ADD, I started out with Buspar (buspirone) on April 30, so that's about a month now. The doc has experience with using buspirone to treat snoring and sleep apnea, thus allowing for better sleep and the possible reduction of ADD symptoms due to better-quality sleep. I don't think that it is improving my snoring at all -- I continue to sleep with a CPAP machine (continuous positive airway pressure). And since I have been fairly successfully using CPAP for many years, and supposedly sleeping well because of it, and I still struggle with symtpoms of ADD, I've concluded that sleep apnea (in my case) is NOT the trigger for my ADD.
But I'm still taking the Buspar, because I think it is working well with the Straterra in helping me to get a little more "regulated." That started even before the Straterra. I've noticed a slight increase in my ability to get going in the morning and a greater willingness to just DO the routine little things that one has to do every day that I typically argue with myself about (about whether I really want to do them or not). A lot of that weary emotionality about doing things seems to be fading. And that's a good thing! Oh yes, and I've finished reading two books!! I've almost never finished a book in my LIFE!
But I'm still feeling unwilling to tackle some larger projects and chores that are waiting for me. I still feel procrastination and scatteredness as a major element in my days, and that's what I want to change. At this point, it's crucial, because I need to find a job. We are selling our house (if someone will buy it!) because we want to find something more affordable -- my lack of income has become a crisis. Because of being laid off three times in 5 years, and because ADD has always caused me extreme strain in performing well at work, I think I've got a mild version of post-traumatic stress disorder! I need to find some kind of support, whether it's medical or ADD coaching or both, to get me to focus in on preparing a resume and preparing to go back out into the world. At this moment, I can hardly even begin to think about that.
Because I'm a believer that being hypothyroid can exacerbate ADD symptoms, I have been waiting to add any more Straterra until I can find out from my internist about the results of my latest thyroid tests. I've just recently found out that I may be missing the crucial T3 -- I'm only taking a T4 drug. I will be seeing that doctor June 10 for a complete physical and discussion of my test results. I think that getting my thyroid functioning well will go a long way toward offsetting some of the side effects of the psychoactive drugs (like tiredness).
In the meantime..... I just saw my psychiatrist for the second time on May 29. I told him that I noticed a distinct drop in my appetite after starting the buspirone and continuing with adding the Straterra. He said that because of that, I might want to consider substituting Wellbutrin as my antidepressant instead of Zoloft. He said that it has less of a chance of increasing your appetite than Zoloft does (and I have really struggled with binge eating since taking antidepressants). He said that Wellbutrin will help to reinforce the appetite-reducing qualities of the buspirone and Straterra. Plus, it might keep me from participating in my lifelong habit of ripping my fingernails! He also suggested that I take Straterra at night instead of in the morning to help stave off the afternoon tiredness (apparently studies have shown that it stays in your system for about 25 hours).
So, in summary:
0.2mg Levoxyl in morning;
100mg Zoloft in morning;
60mg buspirone at night;
40mg Straterra at night;
Add and gradually increase Wellbutrin, 100-200mg twice a day over 10 days;
Try eliminating Zoloft after this;
Add T3 thyroid treatment, possibly Cytomel;
Depending on effect of thyroid treatment, increase Straterra to 120mg max.That's my current "recipe," and I feel like I am on the right path. I'm noticing gradual improvement in my functioning and the side effects are not unmanageable. I am looking very favorably right now on Straterra, by itself and in combination with other medications.
GOOD LUCK TO ALL OF YOU!
froggyanna
poster:froggyanna
thread:133458
URL: http://www.dr-bob.org/babble/20030530/msgs/230612.html