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Dr. Bob is Robert Hsiung, MD,
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Posted by Ritchie on April 15, 2003, at 18:05:44
In reply to Atomoxetine (Straterra) weight gain » Patt, posted by paulk on April 1, 2003, at 15:11:27
i started 18 mg for 4 days then 25 mg for a week for depression, now they bumped me up to 40 mg. i am not eating at all. i have lost an entire size in 2 weeks. still having trouble eating plus i get the funky headache in the afternoon but i also have high blood pressure. Depression has not really been alievated as of yet but i am trying to be patient.
Posted by blondegirl47 on April 16, 2003, at 8:09:49
In reply to Re: Atomoxetine (Straterra) weight gain, posted by Ritchie on April 15, 2003, at 18:05:44
Strattera can make your blood pressure go up.
Posted by Lexxey on April 16, 2003, at 9:58:08
In reply to Re: update 80 mg 1x day, posted by Patt on April 15, 2003, at 16:33:24
Well I went ahead and went to 100mg...60 in am and 40 at 3-4 and it made a big difference. I finally felt improvement in attention and appetite decrease...yea!!!
My doc thought I might need to so he gave me a sample pack of 14 60mg. The research said that many folks need this amt to get anything out of it. The first day I felt wiped out for 2 hours after taking the first dose but today was really ok at the second day. I slept ok last night but for now I am taking OTC Unisom to help.
I'd say try the 100mg before giving up...it's within the recommended amount. I am skeptakle [sp?]when folks say they notice something on 25mg or the other lower doses...none of the research says that did anything to the test group except power of suggestion. All of it says that it needs month OR TWO for maximum benefits and the lower doses during the fist period is just getting you body used to it.
And how many of us are know for our patience??? Certainly not me!!!
I see my doc next monday and I will tell him I will try this for 2 more months [since I see him every 2 months] and if I'm not any more impressed I will go back to ritalin...and do so disappointed...I really wanted this to work for me.
Posted by Lexxey on April 16, 2003, at 10:03:29
In reply to Re: Atomoxetine (Straterra) weight gain, posted by Ritchie on April 15, 2003, at 18:05:44
About the blood pressure...I started taking magnesium 4 times a day 133mg-200 each time for constipation but it really lowered my BP. Read up on it on the net. I was really inpressed. one time when I took 400mg accidently my BP went down 25% to 90/60 and it's usually 135-140/70 or so. I wonder why doctors don't try this. The info on the net was really thorough.
I wish I had your trouble eating. At 100mg I have noticed some help...I sorta feel queasey tho.
Posted by teacherkris on April 16, 2003, at 10:04:58
In reply to Re: update to 100mg, posted by Lexxey on April 16, 2003, at 9:58:08
Thanks sooo much for your post! Yesterday was rough, I've been on 80 mg just in the am for the past three days and as of yesterday I was sick of the nausea and tiredness I was getting every afternoon and was willing to give up. After reading your post I'm reminded that I need to hang in there a little longer.
I'm still on Concerta for five more days so it's hard to tell the impact in terms of ADD symptoms but I've waited too long for this drug to give up yet. As you said, we're definitely not known for our patience. I've always found it humorous that they give peopel who have trouble remembering a drug that lasts four hours and once it wears off they're supposed to remember to take another one! Now we have a great new med that takes up to two months for us to feel the impact! As my doctor keeps saying, keep your hat on (or at least in your hand). So your post is encouraging. I'll finish the week at 80 mg in just the am and if I'm still having side effects I'll ask my doc to try the 60/40 combo you're on and see how that works with side effects.
Well, I'm rambling (hmmmm meds not working ;-)) Thanks again for the post and the encouragement!
Posted by Lexxey on April 16, 2003, at 10:35:11
In reply to Re: update to 100mg » Lexxey, posted by teacherkris on April 16, 2003, at 10:04:58
wow...I can see why you are having side effects if you are taking it all at once...try dividing it like I do...we can do that...there is no reason to take it all at once. I think you will feel better. Try first one at 8-9 and second at 3-4. That worked fine with me....unless all you have ar 80mg pills...in that case I would call the doc and get 40mg due to the side effects.
This stuff really does make us feel weird but I notice that in a fee days the body gets used to it and it's not so bad.
I'm going to get some L-tyrosine that is supposed to help with dopamine production and maybe that will help my spastic coordination problem. Dopamine affects the movement and it was helped by Ritalin.
Posted by paulk on April 16, 2003, at 10:44:45
In reply to Re: update to 100mg, posted by Lexxey on April 16, 2003, at 9:58:08
>I am skeptakle [sp?]when folks say they notice something on 25mg or the other lower doses...none of the research says that did anything to the test group except power of suggestion. All of it says that it needs month OR TWO for maximum benefits and the lower doses during the fist period is just getting you body used to it.
From the Drug monograph:
"A fraction of the population (about 7% of Caucasians and 2% of African Americans) are
poor metabolizers (PMs) of CYP2D6 metabolized drugs. These individuals have reduced activity
in this pathway resulting in 10-fold higher AUCs, 5-fold higher peak plasma concentrations, and
slower elimination (plasma half-life of about 24 hours) of atomoxetine compared with people
with normal activity [extensive metabolizers (EMs)]."That means that for poor metabolizers it is like taking 5 TIMES as much medicine. Not everyone is the same. our metobolic differences are probably more varied thatn our faces - and we don't all look alike. How do you think you would have fared if your doctor started you out on 300mg/day? That would have been equivelent to a poor metabolizer taking 60mg.
Beign a poor metabalizer has the upside of saving money. The message is not that everyone should take a low dosage, but until you know how well you metabolize the med you should start slowly.
Posted by teacherkris on April 16, 2003, at 11:30:40
In reply to Atomoxetine (Straterra) dsage » Lexxey, posted by paulk on April 16, 2003, at 10:44:45
I see what you're saying about poor metabolizers but look at the percentages you also posted those are fairly low. I agree with what Lexxy's saying in that we've had a lot of people on the board who seem to feel that they're getting great benefits from 25 mg or less and I too am skeptical about that based on the double-blind drug trials. I think it is always hard to tell with something like ADHD, where symptoms often worsen and improve without any rhyme or reason even without meds, whether the meds are really working. I know Concerta worked great for me but there were those days when I felt like I hadn't even taken it, and others when I'd forget to take it and think that I had. Basically I'm just saying what I say to parents at the training workshops I do "ADD is consistently inconsistent." So I think the caveat is to be careful if you're at a dose that is lower than that which is even considered therapeutic for a child to watch and make sure it lasts.
That being said I think both Lexxy and I would agree with starting slowly. If you've read my previous posts, I've been slowly increasing for the last two months and have finally made it to 80 mg. I'm very glad my doctor made me go up only 10 mg per week as I read about people who started much more quickly, had horrible side effects and quit.
Finally, Lexxy, I agree about taking it twice a day. I had been taking 40/40 in the am and again at 3 but had whined to my doctor that I only wanted to take meds once a day :-) so he said to go ahead and try it! As you say, we all know by now that the side effects seem to lessen as the days pass so I'm going to hang in for the rest of the week and then go back to 40/40 until I see my doc and ask for 60/40 for a trial without the Concerta.
We'll see what happens. Thank you all for being here and all the support and shared experiences. This board has been a lifesaver!
Posted by Lexxey on April 16, 2003, at 12:06:30
In reply to Re: Atomoxetine (Straterra) dsage, posted by teacherkris on April 16, 2003, at 11:30:40
Having to do with the slow metabolizers...I'm not sure I grasp the explanation but maybe other folks are smarter than I am and do. If a person isn't metabolizing a drug how would it be available in the body to induce an effect? It seems like they would notice little or no effects. I have heard of drug sensitive folks who need less but this drug takes a while to do the work it's supposed to do. I didn't invent the info on it...only repeat it. And I never called anyone a liar or anything.
I'm skeptical [thanks TKris, for the right spelling] about a whole lot of things. I'm just not real easily influenced and there must be a lot of folks who also do a lot of research into how these drugs work in our bodies or there wouldn't be so many folks on the net!!! For something to stick in my head I have to read a lot about it and internalize the info...took me a while to finish college...what a pain! Wish I'd had Ritalin then.
I was the one who also said that I noticed a difference in my handwriting and typing right off...just a few days after starting it and I knew that wasn't expected....but that's all I got from it until now....and actually I feel better today than I have in a whole long time...yea!!! Again!!!
Posted by paulk on April 16, 2003, at 12:28:27
In reply to Re: Atomoxetine (Straterra) dsage, posted by Lexxey on April 16, 2003, at 12:06:30
> Having to do with the slow metabolizers...I'm not sure I grasp the explanation but maybe other folks are smarter than I am and do. If a person isn't metabolizing a drug how would it be available in the body to induce an effect? It seems like they would notice little or no effects. I have heard of drug sensitive folks who need less but this drug takes a while to do the work it's supposed to do.
Once the drug is in your system it does not stay forever. Most drugs get borken-down(metabolized) into simpler parts that mostly have no effect.If someone is a poor metabalizer, the drug stays around longer and build up to higher levels.
The big point is that people don't know how well they metabalize, so it is a good idea to start slow so that they won't reach too high a level.
The trade off is that it will take longer to get a good reaction for normal metabolizers as they slowly increase the dosage. On the other hand if people start off at a higher doseage and get a lot of side-effects, these people often won't even try again at a lower dosage.
Posted by fallsfall on April 16, 2003, at 13:33:18
In reply to Atomoxetine (Straterra) dosage » Lexxey, posted by paulk on April 16, 2003, at 12:28:27
People who take Prozac (and Paxil, I think) are also slow metabolizers. I take Prozac, but I had to go to 80mg of Straterra to have any impact on my depression (and it is quite effective). I take all 80mg in the morning because if I take it at night, I can't sleep (even with the Sonata I take for the insomnia due to the Prozac...). The side effects do seem to keep going down over time (10 weeks for me, I think).
Posted by Lexxey on April 16, 2003, at 15:03:57
In reply to Atomoxetine (Straterra) dosage » Lexxey, posted by paulk on April 16, 2003, at 12:28:27
thanks...I think I see what you are getting at. I only know about what I have read and how this drug affects me and that is keeping me busy enough.
Posted by fairnymph on April 16, 2003, at 23:51:52
In reply to Re: Strattera headaches and coffee, posted by Lexxey on April 11, 2003, at 12:54:32
When I was taking reboxetine, a drug that works in the same way as strattera/reboxetine, I found that drinking coffee gave me bad headahces! I had to give up coffee basically.
> See if those headaches take place after drinking coffee. I sent the post on the throbbing feeling about an hour after my first dose and I had decided that it's due to coffee and strattera. It's not recommended but I'm not ready to give up my one cup in the am....it just smells like morning.
>
> I have always been able to sleep on coffee and even ritalin...lots of ADHD folks can.
Posted by PuraVida on April 17, 2003, at 1:46:26
In reply to Re: Atomoxetine (Straterra) dsage, posted by Lexxey on April 16, 2003, at 12:06:30
Lexxey,
The whole metabolizing thing is like the rest of what we are dealing with - looking for answers through science, and no one knows for sure. I did look it up "on the net" and basically there are a lot of guesses on how and why it is that people react differently at different times, but we do. Some of the research I saw said that people could react differently from week to week, or month to month. I know from experience that I can react differently depending on circumstances - I don't need a monograph to tell me that. Have you ever had just one drink and felt really tipsy, when usually it takes two to feel the same way? You're not less smart than anyone else is - listen to your body and intuition - do what feels right.
PV
> Having to do with the slow metabolizers...I'm not sure I grasp the explanation but maybe other folks are smarter than I am and do.
Posted by Hattree on April 17, 2003, at 9:42:10
In reply to Re: Metabolizing » Lexxey, posted by PuraVida on April 17, 2003, at 1:46:26
I'm one of those slow metabolizers--I used to take prozac for a few days and be covered for a month. Tiny bits of some drugs do it for me when standard doses just make me feel bad. (Not so others. Immediate action meds seem to be different.)
I'm on day 3 of Strattera for the second time around. Gave up the first time because I couldn't sort out the Strattera effects from stimulant withdrawal. I feel alternately sedated and then energetic and nicely focused...possibly at onset it sedates me and then the more positive effect kicks in (including appetite supression). Sleep is definitely weird, though.
Maybe the reason some people feel an almost immediate response is something like what commonly happens with Lamictal—an initial improvement after a few days which levels off or decreases but kicks back in when the theraputic dose is reached.
Posted by Ritchie on April 17, 2003, at 11:58:43
In reply to Re: Please keep the Strattera updates coming!, posted by carlyb on April 11, 2003, at 20:39:54
If you are having trouble sleeping on the Strattera I find that taking the 5 HTP 200 mg at night helps extremely well. It also reduces carbohydrate cravings.
Posted by Lexxey on April 17, 2003, at 14:12:49
In reply to Re: Strattera headaches and coffee, posted by fairnymph on April 16, 2003, at 23:51:52
I have skipped coffee for 2 days now and no headaches...but it doesn't taste like morning anymore. Maybe I will try decaf!!! I had 3 glasses of tea for lunch and started to feel like a sinus swelling type headache come on and switched to water.
Perhaps when I have taken this a while I will try it again. I'm also not feeling as drugged after the am 60mg dose so I guess I will stick with this for a while....until the appetite comes back anyway.
Posted by Lexxey on April 17, 2003, at 14:20:40
In reply to Re: Please keep the Strattera updates coming!, posted by Ritchie on April 17, 2003, at 11:58:43
What a great idea....I'm going to run out right now and get some...but it is expensive! Maybe I'll check the net.
Talking about buying supplements on the net...where do you folks get good prices on nutritional things? There are just so many.
Posted by Ritchie on April 17, 2003, at 14:33:20
In reply to Re:Strattera updates/good buys, posted by Lexxey on April 17, 2003, at 14:20:40
5 htp can be expensive, i buy mine at Green Earth, they are probably the most reasonable, I haven't checked the net, but it works and it is will worth the money and my physician recommends it.
Posted by Viridis on April 17, 2003, at 22:24:26
In reply to Re:Strattera updates/good buys, posted by Lexxey on April 17, 2003, at 14:20:40
I've had very good success (in terms of service and prices) with www.iherb.com
Posted by Lexxey on April 18, 2003, at 9:50:14
In reply to Re:Strattera updates/good buys--supplement sources » Lexxey, posted by Viridis on April 17, 2003, at 22:24:26
You are right about I-herb ...I spent 2 hours comparing sites for prices on the net yesterday and this place has good prices on all the stuff I was interested in and not just one...thanks a bunch!!!
Posted by dddiane on April 19, 2003, at 16:01:15
In reply to Re:Strattera updates/good buys--supplement sources, posted by Lexxey on April 18, 2003, at 9:50:14
> You are right about I-herb ...I spent 2 hours comparing sites for prices on the net yesterday and this place has good prices on all the stuff I was interested in and not just one...thanks a bunch!!!
Hi Lexxey!
Di from the Topamax board here. Hope you are doing well. I'm going to check out www.iherb.com. I buy a lot of my suppliments from Target ( dubious quality? I don't know?) because their prices seem ok, but I'll compare. How are you doing with Strattera? Has your hair loss slowed? Take care, and have a wonderful holiday.
Diane :)
Posted by labrat0017 on April 20, 2003, at 1:45:39
In reply to Re: Please keep the Strattera updates coming!, posted by Ritchie on April 17, 2003, at 11:58:43
i was on strattera for awhile and it made my depression a whole bunch worse, and i lost my appetite, and i just sort of stared at the wall all the time. i had zero enery, and could not get out of bed. anybody else find that?
Posted by Hattree on April 20, 2003, at 12:38:06
In reply to strattera, posted by labrat0017 on April 20, 2003, at 1:45:39
I'm experiencing some of the same, alas. How long did you stick with it?
> i was on strattera for awhile and it made my depression a whole bunch worse, and i lost my appetite, and i just sort of stared at the wall all the time. i had zero enery, and could not get out of bed. anybody else find that?
Posted by Ritchie on April 20, 2003, at 14:01:06
In reply to strattera, posted by labrat0017 on April 20, 2003, at 1:45:39
I am not really seeing any improvement in the depression either, my appetite is totally gone which I personally like, I have noticed the suicidal thoughts diminishing though so I am going to stick with it. Right now I am at 40g. I do get the crash and burn effect in the evenings but it hasn't interfered in my life so I can live with it.
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