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Questions about Strattera (and Fluanxol)

Posted by NKP on July 10, 2020, at 8:38:43

I am currently on the following psychiatric medicines (I feel bad for taking three different medicines):

* Zoloft 50 mg / day (since April)
* Fluanxol 0.5 mg / day (since April)
* Strattera 25 mg / day (since May)

I have a few questions:

1. Can the Fluanxol interfere with the action of the Strattera? Fluanxol is a dopamine antagonist (although I am under the impression that it actually acts as a dopamine agonist at low doses?). Strattera is classed as a norepinephrine reuptake inhibitor, but to my knowledge, it also increases dopamine in some parts of the brain.

2. Does it even make sense to take such a low dose of Strattera? Has anyone else found benefit from such a low dose? I've seen literature that suggests that Strattera doses lower than the target dose of 80 mg / day may still be effective. There are also anecdotes on YouTube and Reddit of folks who seem to have done well on such lower doses. I can't say that I've experienced a dramatic effect from the Strattera, but then, it is said that Strattera is a medicine that is "compared", not "felt", in the sense that you don't "feel" it from day to day, but rather, you notice its effects when you "compare" your functioning, say, six months into treatment, to how you were before treatment.

3. Is there such a thing as a "second wave" of side-effects from Strattera? There are many anecdotes on YouTube and Reddit from folks who say that Strattera took months to start working. I'm wondering if it can also happen, months into the treatment, that one suddenly experiences new side-effects? I ask because this last week I am suddenly experiencing headaches every day, a problem that I never had before.


To give some context, I was never formally diagnosed as having ADHD. In the past I had a few episodes of depression, for which I was treated by a psychiatrist, and used the following combinations of medicines during different episodes, listed in decreasing order of effectiveness:

* Zoloft + Fluanxol
* Zoloft alone
* Cymbalta
* Wellbutrin

In April I went to my family doctor to ask that I be put back on Zoloft and Fluanxol, because even though I didn't feel sad as such, I kept having thoughts about killing myself. He acquiesced. As I described some of my symptoms to him (e.g. forgetfulness, distractability, and procrastination), he said that it sounded a bit like ADHD and suggested that I try Strattera. But the "diagnosis" was very casual and superficial.

So I'm not even sure if I have ADHD. When I read the Wikipedia article on ADHD, I concluded that I did not have the condition. My wife however came to the conclusion, after having read the same article, that I do have ADHD. I also watched YouTube videos by folks with ADHD and I could identify with much of it, hence why I decided to give the Strattera a try a month after my family doctor first suggested it.


I'm also uncomfortable using the Fluanxol for fear of getting metabolic problems, tardive dyskinesia, or gynecomastia. However, the Fluanxol "quietens" my mind (almost like cutting out the background static) in a way that makes it easier for me to concentrate on things, and it also makes me calmer (I'm a naturally irritable person and I have a short temper to the extent of it almost causing problems at work).




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