Posted by 10derheart on July 25, 2007, at 1:20:42
In reply to Re: Can i ask is 40mg the standard dose for Strattera?, posted by linkadge on July 24, 2007, at 12:44:35
Hey rj,
From the info docs are provided by Lilly on Strattera:
Dosing adults:
"Dosing of children and adolescents over 70 kg body weight and adults — STRATTERA
should be initiated at a total daily dose of 40 mg and increased after a minimum of 3 days to a
target total daily dose of approximately 80 mg administered either as a single daily dose in the
morning or as evenly divided doses in the morning and late afternoon/early evening. After 2 to 4
additional weeks, the dose may be increased to a maximum of 100 mg in patients who have not
achieved an optimal response. There are no data that support increased effectiveness at higher
doses (see CLINICAL STUDIES). The maximum recommended total daily dose in children and adolescents over 70 kg and adults is 100 mg."
----------------------------------------------
...and available capsule sizes:"HOW SUPPLIED - STRATTERA (atomoxetine HCl) capsules are supplied in 10-, 18-, 25-, 40-, 60-, 80-, and 100-mg strengths."
----------------------------------------------You can read the entire document here:
http://pi.lilly.com/us/strattera-pi.pdfI have been on Strattera since Jan 2004. My pdoc at the time, though a very conservative guy with meds, chose to follow Lilly's guidance and start me on 40mgs qday. I had recently tapered off Prozac and was still rx'd MPH (generic Ritalin) IR - I think about 20-40mg qday, prn - to help 'cover' some symptoms that Stratt didn't seem to work as well for.
Prior to Stratt, my ADD was treated with Prozac 20 mg and MPH IR - anywhere from 40-80mgs qday - I usually took the full 80, though, and I probably needed more. We switched because I was developing some HTN and also because both pdoc and I wanted to give Stratt a try - not controlled substance, maybe smoother, and hopefully less effect on BP than a stimulant. I was the first and only person he'd ever prescribed it to.
I asked and he rx'd 80 mgs after about 2 months. I have been on that dose ever since. No Prozac, no Ritalin. I had a dramatic response to 40mg Strat - by that I mean in about 24-48 hours my mind cleared (for others who don't know...with ADD it often feels as if many radio/TV channels are on at once in your brain, static, can't turn down or tune out to think of, feel, do - just one thing...) chattering in the head calmed, I could organize, plan, stop fidgeting, stay on task, finish tasks....and more. Not perfect by any means - but all these symptoms improved almost immediately, so much so that I myself told pdoc I didn't need to augment with the stim any more after a few weeks.
No poop out after 3.5 years, either. I have experimented with going back down to 40, and although I still retain much of the overall, calm, 'head clearing' effect, I notice certain symptoms cropping up within a day or two - losing things, blurting, interrupting people, even some emotional lability returning (frustration) and so forth. So at 80mg it stays.
I had severe dry mouth and some bothersome headaches the first 30-60 days, then all that went away. I may have had insomnia, but I couldn't tell if the Stratt did it, as I already had that chronically anyway, due to anxiety and other issues. No long term SEs I can think of.
Rj, hope this works for you. Give it time, and be patient and work with the doc. If he wants to use the 18s and work up, so be it. Maybe ask for 40 after a short while if you don't notice any relief...I have a feeling that except in kids, 18 may not have much efficacy with most people, unless they are very sensitive. No data, just my hunch is all. If 40 does nothing, or very little, see if he'll increase to 60, then 80. But give it the usual 4-6 weeks, because for you, that may be what it takes to get the benefits. It's really amazing how a correct dose ad a long enough trial can take a med from useless to awesome....
One other thing and I'll shut up...are you still taking Prozac? Pdoc should know this, but Strat dosing needs to be adjusted down if you are.... And personally (and this is just me) I think it can be good to try Strat alone - or at least without the SSRI - to find out if it will cover both ADD and some/all of the anxiety/depression stuff. But clearly, only you and your pdoc know what's better for you, based on dx, previous response to meds and so on.
You might also check out this site...easy reading and although the docs were sponsored by Lilly, it seems quite balanced and has a ton of info - I highly recommend it to someone starting this med.
http://www.johnswank.com/Strattera.htm
I really hope you find relief - I do know what it's like to fight severe ADD symptoms without meds as I did so for years. You've been hanging in there a long time and you deserve a break :-)
Hope something here helps. You take care, and if you want any more Strattera or ADD links, let me know, I have a ton saved.
poster:10derheart
thread:771633
URL: http://www.dr-bob.org/babble/20070719/msgs/771814.html