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Dr. Bob is Robert Hsiung, MD,
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Posted by AS Mom on March 31, 2003, at 12:24:29
In reply to Re: Straterra - Back to Ritalin SR-Libby, posted by snowflake on March 31, 2003, at 10:58:13
I have taken both of my children off Strattera and am using Concerta for them again. They are much happier, in control, and much more self-confident.
Posted by rickgee on March 31, 2003, at 14:18:10
In reply to Re: Straterra - Back to Ritalin SR-Libby, posted by AS Mom on March 31, 2003, at 12:24:29
Hello All, I just read all of the threads from the first of the year and want to thank all for input. I am a 58 year old male who has ADHD forever. I have also suffered from mild depression which I think is related to above. I just ended a withdrawal period on Effexor (thank God that's over) From all I have read I think that Straterra may be the one. However since I'm going to be my doc's guinea pig, I think we should start slow. Maybe 18mg day to start. I will post as I get going.
Posted by blondegirl47 on March 31, 2003, at 14:22:51
In reply to Going To Start Straterra This Week, posted by rickgee on March 31, 2003, at 14:18:10
Hi rickgee, I think that is what my doc started me on. The sample pack is 18 for 4 days, then 25 for 2 weeks. I can't remember what the next dose size is. Good luck with it. I am glad my doc didn't take my other meds away at the same time, Stattera makes me kind of tired.
Posted by rickgee on March 31, 2003, at 14:36:37
In reply to Re: Going To Start Straterra This Week » rickgee, posted by blondegirl47 on March 31, 2003, at 14:22:51
How long have you been taking it. I wasn't taking any stim's. Tried Ritalin a few years ago didn't do much. I have a fairly stong tolerance for drugs, so hopefully not too many side effects.The effexor was OK, but if I had known how it was to get off, I would have asked for something else. It was nice to see that Straterra has some effect on depression too.
Posted by blondegirl47 on March 31, 2003, at 14:40:27
In reply to Re: Going To Start Straterra This Week, posted by rickgee on March 31, 2003, at 14:35:57
Today makes 2 weeks. I am struggling with the grumpy's that come and go. Also, have intermitent problem with wanting to binge. Fried foods and sweets. I have read that this goes away, so I am going to give it a month. Hope that part goes away soon.
I take it at night before bed because it seems to make me tired. Not everyone gets tired from it though.
Posted by blondegirl47 on March 31, 2003, at 14:41:38
In reply to Re: Going To Start Straterra This Week, posted by rickgee on March 31, 2003, at 14:36:37
Rickgee...I think you are double posting :)
Posted by teacherkris on March 31, 2003, at 15:57:52
In reply to Re: Going To Start Straterra This Week » rickgee, posted by blondegirl47 on March 31, 2003, at 14:41:38
Good luck on starting! I started at 10mg and my doc raised it by 10 each week as follows:
week 1: 10 mg am
week 2: 10 mg am and 10 mg afternoon
week 3: 20 mg am and 10 mg afternoon
week 4: 20 mg am and 20 mg afternoon
week 5: 40 mg am (no increase in total dosage)
week 6: 40 mg am and 20 mg afternoon
week 7: 40 mg am and 40 mg afternoon (this is where I am now)
Just an FYI I found that most pharmacies don't stock the 10 mg size and had to order it. I was irritated with my doctor at first for the slow start up but I'm glad as each time my dose went up I had some mild side effects but they always went away after the first day or so.Good luck and let us know how it goes!
Posted by babs on March 31, 2003, at 19:20:32
In reply to Re: Going To Start Straterra This Week, posted by teacherkris on March 31, 2003, at 15:57:52
I currently take adderall and my pdoc wants me to switch to straterra. I'm wondering about a few things- one, has anyone lost weight on it? Due to my other meds I've gained a whopping 60 pounds and the adderall hasn't helped at all. Also, when I first started adderall I noticed a decrease in my caffeine and nicotine consumption (I smoke and drink diet Coke like a fiend) but unfortunately that effect wore off a long time ago (I think the adderall is losing its effectiveness overall anyway). Has anyone noticed a decrease in caffeine/nicotine use since starting straterra? I would LOVE to hear that was one of the side effects.
Posted by teacherkris on March 31, 2003, at 19:26:24
In reply to Re: straterra, weight, caffeine and nicotine, posted by babs on March 31, 2003, at 19:20:32
Smoking and drinking caffeine are both ways to self-medicate. I used to do both before starting Ritalin about five years ago. Now if my meds are right and I do drink caffeine I get jittery as it just ups my level of stimulant in my body. As I mentioned in a previous post I've lost 15 pounds since starting strattera about six weeks ago. :-) I'm still on some Concerta though so I haven't tried drinking diet coke with it yet. My hope is the opposite of yours, that by going on Strattera and off Concerta/stimulants I WILL be able to drink Diet Coke again, along with taking Exederin and Sudafed that both have stimulants in them. We'll see what happens!
Posted by Proud2B-ADD on March 31, 2003, at 20:25:09
In reply to Re: straterra, weight, caffeine and nicotine, posted by babs on March 31, 2003, at 19:20:32
I've been on Strattera for 2 1/2 weeks. I've been a light smoker (2-3 cigarettes a day) for about 4 months before starting Strattera. Even though I didn't smoke very much, I found it hard to kick those few a day.
Since I've started taking Strattera, I've lost my craving. However, I've noticed that I still crave a cigarette when I drink, but on a day to day basis, I've kicked the habit!
Posted by babs on March 31, 2003, at 21:02:15
In reply to Re: straterra, weight, caffeine and nicotine, posted by teacherkris on March 31, 2003, at 19:26:24
that's great that you lost fifteen pounds! Did Ritalin have a similar effect on you? For your sake, I hope you cn drink diet Coke again. For my sake, I hope the straterra cuts down on the craving!
Posted by Msanjelpie on April 1, 2003, at 7:40:52
In reply to Re: Straterra - Back to Ritalin SR-Libby, posted by AS Mom on March 31, 2003, at 12:24:29
AS Mom: Why did you take both of your children off Strattera and switch to Concerta for them again. Why did you take them off the Concerta in the first place... How did the Strattera make them act...
THANKS - Jeannie
Posted by blondegirl47 on April 1, 2003, at 8:15:12
In reply to Re: straterra, weight, caffeine and nicotine, posted by babs on March 31, 2003, at 19:20:32
Hi Babs
I have slowed up on caffiene because it seems to mess with my adderall absorption. Also makes me more shakey. My pdoc is letting me take strattera with my adderall. If you go off adderall cold turkey and switch to strattera alone you won't be able to tell what strattera is doing because you will be crashing from no adderall.
From what I have read, once strattera kicks in (about a month) you might lose some weight. This is day 15 for me and I have been having intermintent binges. You may also experience some grouchies and a little dizzyness.
Make sure your pdoc gives you the samples that start out at 18mg and move up gradual. Good luck
Posted by Patt on April 1, 2003, at 10:15:07
In reply to Re: straterra, weight, caffeine and nicotine, posted by blondegirl47 on April 1, 2003, at 8:15:12
I am only at Day 5 on the Straterra 40 mg/day, but so far I'm starving. I did not take a stimulant medication prior to the Straterra, so didn't have to worry about withdrawal. I wake up during the night with my stomach growling, I'm so hungry. I've gained about 2 lbs. in the 5 days, so I'm hoping this passes. If not, I'll definitely have to stop! I drink regular and/or diet coke with the medication, and drink about 2 cups coffe each day & don't seem to have any problems with the caffeine.
Posted by blondegirl47 on April 1, 2003, at 10:25:38
In reply to Re: straterra, weight, caffeine and nicotine, posted by Patt on April 1, 2003, at 10:15:07
Hi Patt, seems like the doc started you out on quite a high dose. I started out at 18, for 4 days then 25 for 14 days. I agree about being hungry I take it before bed and sometimes I will wake up about 3:30 or 4 hungry. Yesterday I lost all control and ate everything in site. I still want to eat today, but I am in better control of it.
Strattera isn't a stimulant so it shouldn't be effected by caffiene. Although Strattera will make your blood pressure go up. I hope our hungry's go away soon!
Posted by paulk on April 1, 2003, at 15:11:27
In reply to Re: straterra, weight, caffeine and nicotine, posted by Patt on April 1, 2003, at 10:15:07
I've had problems with weight gain also - it seems that in the evening when it wears off I get rebound appetite. I’ve gained 5 lbs in the last month. I’m wondering if splitting the dosage and taking it every 12 hours would help.
Sure wish they had thought of a slow release – I bet it would solve other side effects as well.
Posted by blondegirl47 on April 1, 2003, at 15:19:49
In reply to Atomoxetine (Straterra) weight gain » Patt, posted by paulk on April 1, 2003, at 15:11:27
I have read where people are taking it twice a day. Since it makes me sleepy, I am happy to only take it once a day. I hope your weight gain stops, as well as mine. :)
Posted by LibbyH on April 1, 2003, at 15:43:19
In reply to Re: Straterra - Back to Ritalin SR spinning » LibbyH, posted by not exactly on March 29, 2003, at 18:17:14
> Sorry, but I am completely confused by your message.
Bob, sorry for the confusion. I had been taking the following combination for two years with great success for ADD & what my pdoc call Chronic Major Depression:
Daily:
Ritalin SR @ 40-60 mg depending on my work hrs.
Wellbutrin SR 300 mg
Prozac 20 mgI started waking developing sleep problems, waking early & being unable to go back to sleep. Eventually, I started sleeping 10-14 hrs. a day, but never felt rested. I pushed myself to function, but nothing was fun anymore. Then, the oddest part. I started
waking in the middle of the night with panic attacks. Couldn't breathe. The doc thought changing the antidepressant would help. He was never very crazy abous prozac with me because lack of motivation has been a constant problem since he began seeing me five years ago, so he changed the antidepressant to Lexapro. He thought since I was having panic attacks, it might be a good time to try a nonstimulant medication for my ADD, so he asked if I was willing to try Straterra too. Since it was more convenient, I jumped at the chance. So he changed me to:
Daily:
10 mg Lexapro now titrated to 20
40 mg Straterra titrated to 80
and added
.5 mg Klonopin twice daily for panicI stopped the WEllbutrin ^ Ritalin cold turkey and within two days of titrating to 80 mg of Straterra, I found myself thinking about killing myself almost constantly, always by sitting in the garage with both cars running, and always carefully planned for times when no one woudl be aroudn to find me. These were not pleas for help. It was more like I'd think, "WEll, I'm about finished with life, so I guess I'll just kill myself. It's no big deal. No one will be home for hours." SO I'd leave a little note in an envelope on the front steps for my family not to come in, to call the police, that I was int he garage & I'd go in the garage & start the cars. Then, somewhere between 15 minutes to half an hour later, it's like I'd wake up & think what the heck am I doing this for? This is insane! I finally called my doc & said, "I think I need to be in the hospital." Even there, they treated the problem like a psychological one except that he did have me evaluated by a neurologist who put me on Topomax for atypical migraines I've had my whole life & had like gangbusters in the hospital. My pdoc said he thought that would help with the suicidal impulses, but it didn't. I had a low grade migraine for severtal weeks, but that's gone now & the Topomax does seem to be helping both headaches & stablizing my moods a little.
It wasn't until two weeks later & I was still having the problem & there was no psychological reason for my level of distress that my pdoc started looking closer at my meds. He finally called in my family one at a time & me and asked each of us what we thought my single biggest problem had always been. It was unanimous, "IMPULSIVITY!" So he said the Ritalin seemed to be keeping that in check at least, so why not try going back to it & keep me on the Klonopin for panic attacks & see how that does?
So now I'm taking, daily:
40 mg Ritalin SR regardless of work hrs.
125 mg Topamax for headaches AND moods
40 mg Lexapro for depression
.5 mg Klonopin twice daily for anxietyThis week, he added
2.5 mg of Zyprexa at bedtime because my depression always seems to cause difficulty with sleep first and also because my depressions are somewhat atypical in that they have an agitated component. When I get low on energy & fatigued, I tend to push myself to continue funtioning & end up snapping at people, getitng argumentative, etc. I am not Bipolar because I've been through all the trials with those drugs and get MORE, not less agitated on them.Hoep this helps clear up why my pdoc blamed my agitation on the Straterra.
Honestly, I didn't FEEL worse on Straterra. I FELT better... clearer, more energetic, etc. than on Ritalon, but my family is telling me they are thanking GOD I'm back on Ritlin SR right now.
Thanks for asking.
Libby
Posted by LibbyH on April 1, 2003, at 15:47:16
In reply to Re: Straterra - Back to Ritalin SR-Libby » Proud2B-ADD, posted by blondegirl47 on March 31, 2003, at 9:13:44
I think that part of my problem with the agitation was quitting the Ritalin "cold turkey." I know that ADDers don't get addicted to stims in the same ways as most of the population, but it seems to me that the Ritalin acted as a calming agent on me & I could have withdrawn from that calming action just like most folks woul dhave withdrawn from its stim action. 'Course I have NO SCIENCE AT ALL to back up that claim. It's just a guess on my part. Still, I wonder if I'd done better to taper off the Ritalin.
Libby
Posted by Lexxey on April 1, 2003, at 17:07:00
In reply to Re: Straterra - Back to Ritalin SR - Bob, posted by LibbyH on April 1, 2003, at 15:43:19
when a person stops stimulants there will often be a period when they are depressed. The brain gets used to those chemicals. That's why I have always taken one month off ritalin for the almost 20 years I took it. It just makes me a little draggy for a few days. This makes sense to me and I can cope if I have to. I just drop everything I don't bump into. Clumsiness comes back and drives me nuts!!!
Posted by paulk on April 1, 2003, at 17:33:57
In reply to Re: Atomoxetine (Straterra) weight gain, posted by blondegirl47 on April 1, 2003, at 15:19:49
> I have read where people are taking it twice a day. Since it makes me sleepy, I am happy to only take it once a day. I hope your weight gain stops, as well as mine. :)
Dividing the dose may make you half as sleepy twice a day. A time release version may eliminate the sleepyness altogether. I remeber how surprised I was when I took effexor and switched to the slow release - almost like a different drug.
Posted by not exactly on April 2, 2003, at 3:05:31
In reply to Re: Straterra - Back to Ritalin SR - Bob, posted by LibbyH on April 1, 2003, at 15:43:19
Libby,
I can't believe your pdoc switched you from Prozac+Wellbutrin+Ritalin to Lexapro+Strattera+Klonopin all at once! That seems completely irresponsible - no wonder you felt suicidal. I'm sure the bad reaction you had was not due to the Strattera, but rather withdrawal symptoms from quitting the Wellbutrin and Ritalin cold turkey (both should be tapered off very gradually to avoid severe rebound depression).
- Bob
Posted by AS Mom on April 2, 2003, at 8:00:52
In reply to Re: Straterra - Back to Concerta - AS Mom, posted by Msanjelpie on April 1, 2003, at 7:40:52
DD's reaction to Strattera: weepiness and extreme fatigue! She has an autoimmune disorder so we didn't want to see her more tired than she already is. Also - did not help her ADD at all. She was on Concerta for 3 years prior to trying Strattera. We will be switiching her today to Ritalin (not time-leased) so we can give her the medication only when she needs it for school. Some days she is so tired that she doesn't attend school and we don't give her medication for ADD on those days. This was another reason we stopped the Strattera. We want to be able to have the option of reducing meds when she isn't feeling well.
DS's reaction: EXTREME moodiness and hyperactivity. He also had very vivid, disturbing nightmares. Now that he's back on Concerta, he's not having the nightmares and is calm and in control. He's been on Concerta/Ritalin for 3 years prior to trying Strattera.
My son also suffers from anxiety/depression. We took him off of prozac, and we'll see the psych today to discuss other meds that might help him with anxiety. The prozac did not help his anxiety at all. He was on that for about 2 years. We were hopeful that Strattera would be able to help both ADHD and anxiety, but it didn't work for him.
Posted by LibbyH on April 2, 2003, at 12:47:41
In reply to Re: Straterra - Back to Ritalin SR » LibbyH, posted by not exactly on April 2, 2003, at 3:05:31
I've experienced the rebound depressions before and every depressive episode is a little different, but over the course of my entire life, up until this last time I could say I've had certain tendencies when depressed. This last time, the impulsiveness and suicidal impulses specifically were awful. Between suicidal impulses, I felt great. It looked a lot more like mania. It was strange enough to make me wonder if all those trials with the BIpolar drugs were a fluke & I actually had some weird type of super rapid cycling bipolar with swings every 2-3 hrs. instead of every several days, so much so that I asked my pdoc about it.
He directed me back to my history, the trials, the testing, and the fact that I had been stable for two years on a pretty high doe of some pretty stimulating meds, so he was pretty confident I wasn't Bipolar.In other words, it wasn't like I was DEPRESSED so much as BIPOLAR, so I think what was goin on must have been a combination of both the sudden withdrawal from the Ritalin (the Wellbutrin had pooped out months ago) AND the effects of the Straterra. I have been doing some reading on the drug since my experience & increased impulsivity can be a side-effect of the drug. I understand that sometimes this can settle down as one builds a tolerance, but I was in a situation where I was making active (albeit not very seriously threatening) suicide attempts. I had never seen myself behave this way. I was scaring myself, my family, and even a pdoc who has seen me through five years of awful depression. I couldn't afford to wait. I don't mean to alarm anyone, but I will be on Ritalin for as long as the FDA, my pdoc, and my health will allow. Without it, I am dangerously impulsive and thoroughly capable of destroying my life in less than a week.
Libby
Posted by not exactly on April 2, 2003, at 13:59:21
In reply to Re: Straterra - Back to Ritalin SR - Bob, posted by LibbyH on April 2, 2003, at 12:47:41
> the sudden withdrawal from the Ritalin (the Wellbutrin had pooped out months ago)
Drugs "poop out" because your body adjusts to them. This is virtually the same phenomenon as "tolerance", an aspect of addiction. Just because a drug has pooped out does not mean that you won't get a violent reaction to discontinuing it.
However, I'm willing to believe that the presence of the Strattera made the Ritalin & Wellbutrin withdrawal symptoms more severe and qualitatively different from what you may have experienced in the past.
- Bob
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