![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 692 to 716 of 1242. Go back in thread:
Posted by gouda on June 5, 2003, at 12:39:45
In reply to Re: Q A to Froggyanna: CPAP and sleep apnea?, posted by froggyanna on June 3, 2003, at 14:19:30
Sorry for the delay in reply, Strattera @ the new dosage of 25 mg (originally on 18 mg) is just knocking me out!
I sleep well since I take 25 mg 2-3 hours b4 bedtime.
In the morning, I feel more motivated, getting things done, and thinking up more to-do things for my to-do list.
However, I have to take another 5 hour nap in the afternoon! This totally sucks!
So I am currently on my "awake" window, so I thought I'd better reply to you before I conk out again.
> Has anything helped you with that? I've done it for as far back as I can remember, and I have never found anything that would help me stop. Nails, skin, stray hairs, anything "protruding" gets an unreasonable amount of attention, and I go into paroxysms of desperate attempts to remove the offending "object." It's only just this past week that I came to the startling understanding that this could be related to my ADD, or perhaps even be OCD. I've always been embarrassed by it. I tend to be a perfectionist on top of the procrastination. In computer terms, that would mean having an outrageous urge to put every single pixel in line (which I have done quite a bit as a sometimes graphic designer). Of course, that's only when I'm not ripping at my fingernails! But it's funny.... you'd think I'd want to have perfect manicures every day, but no, I rip my fingers to shreds. It's got something to do with the feeling of it, and getting rid of those extra bits of skin, a release of tension, perhaps. Anyone else have any insight into this?
I have no insight, but I can totally relate to your tendencies! I too love ripping and shaving my fingernails, totally disguisting, but I just can't help it. When I am tense, working on a deadline, I also feel this incessant need to find any imperfection in my hair, scratching my scalp, pulling out stray hairs that are sticking out, pulling out the one wavy hair in my sea of straight hair. Totally neurotic and counter productive! It totally drives me crazy! I have been diagnosed with "obsessive compulsive traits", and my pdoc wants to increase my SSRI (Celexa) from 20 mg - 40 mg "to counteract my OCD". So maybe you might wanna check that out for yourself and take a OCD "Yale-Brown Obsessive Compulsive Test". Don't worry, you're norm for an OCD person ... hehe.
Also, right now my knee is bouncing up and down like crazy, and I really wish this agitation would go away.
>I've got a different tick, when I am awaken during sleep, I will kick my leg in frustration, even though I am still partially sleeply. Weird!
I don't have the jittery knee though like you.
> Hey, that's three questions. But OK. First, though, I "ruled out sleep apnea" as the cause of my ADD. Is that what you meant? Cuz I can't rule it out of my life! I've definitely got it!
>Yep, sorry, yup that is what I meant to ask. I too want to find out the cause of my ADD.
Personally, I think my ADD is cause by (a) sleep disorder (b) genetics (c) head injuries as a toddler who was very accident prone.
> I'm new to this ADD stuff, too. I haven't heard that all ADDers necessarily have sleep disorders. But my psychiatrist told me that many people in his practice who don't have SERIOUS APNEA have sometimes been able to rid themselves of ADD-like behavior through the reduction of snoring. Because even mild snoring means that you are not sleeping optimally. And if you are not sleeping optimally, then you are more prone to going through your days fuzzy, distracted, etc. So that's why he initially prescribed buspirone for me -- to see if it relieves my snoring/apnea and thus relieves my ADD-like behavior (assuming I DON'T have ADD). I was skeptical, though (but excited that it might be that simple!). Alas, it has not really done anything to stop my apnea, or even the snoring. So dang it, I must have ADD!
>Thanks for your extensive description of your sleep apnea. Your snoring sounds just like my dad and grandmother! And they definitely might have ADD, although never diagnosed.
> To get a sleep study, you usually need to go to a dedicated clinic or hospital department. Most big cities have a "Sleep Disorders" clinic of some kind. Another doctor generally refers you but there's no reason you couldn't suggest it to your doctor first. It's an overnight stay and they really wire you up. They measure your breathing, your heart, your brainwaves, and your leg muscles. That's what I know about, at least -- there could be other things. Some people have Restless Legs Syndrome, where your limbs jerk around, so they want to include that in the picture. And they videotape the whole night in all your glory! Usually, if you've given them enough data to go on during the first half of the night, they wake you up and put you on a CPAP mask. Then they titrate the air pressure for the rest of the night to find just the right pressure that keeps your airway open without causing other kinds of discomfort.
>Wow, I think I would like to consider this ... I just mentioned earlier that I've been doing the leg whapping thing at night. Hmm, what is the cost of taking part in a sleep disorder treatment? I would need to budget for this.
CPAP! Dang, that was funny! Wow, it sounds so complicated!
> SOMEthing has definitely reduced my appetite, but I noticed that even with the buspirone and Straterra. I'm just glad that this is happening, because I have been binge eating for years on Prozac and Zoloft. I now need to lose about 150 pounds. As for staying calm and focused, what dose are you taking? I've just finished 5 days at 100mg 2x/day and tomorrow I start on 5 days at 150mg 2x/day. I will then go to 200mg 2x/day if I'm "not impressed," as the pdoc says. Did you gradually increase like this?Yes, I started on 100 mg 1x/day for about a month, then increased to 150 mg 1x/day for another month ... I never got to 200 mg, b/c I really disliked the experience (but this should not dissuade you; most people have good experiences with Wellbutrin)
I haven't had any of the "tingley" things you mention -- I hope I can avoid that by going slow. But I also haven't noticed any improvement yet in my agitation or the urge to rip flesh. I can't stop shaking my leg or picking. And did you say that "extreme calm" was one of your CONS? How so?
>Yes, you should be patient with Wellbutrin, I didn't have any benefits until 3 weeks.
Extreme calm meaning I kinda felt unnerved about how calm I was when tackling whatever I was doing. It was almost like I had no emotional component whatsoever. "A Just Do It" w/o the kick-butt attitude. Very weird!
> > Fifth, Strattera at night: ... I've been taking it 2-3 hours before
> > my bedtime, and it's been great to help me "fall asleep"
> Maybe I'll try that. Maybe I could take it with my second dose of Wellbutrin for the day. I like to make these things as easy to remember as possible! But it would be hard to do that if I were to get a normal 8-5 job -- the hours wouldn't work. Right now I'm still not sleeping regular hours. My go-to-bed and wake-up times are all over the map. I hope that these meds can help me to regulate that some.
>I hope so for you too! Sounds like you're on lots of meds, so it will require a good pdoc to sort all your symptoms out.
> > Sixth, Strattera and irritability: Same problem as you, if not worse.
> Rats. OK, that's two of us then who are hoping that this will wear off. Anyone else got some encouraging reports? Did any of you have irritability initially but it eventually went away? ADDled minds want to know!! :-)
>
> If you've bothered to read this far, thank you -- I appreciate the space to write like this. I don't mean to be a blowhard, but there is so much about all of this that is fascinating to me, and writing helps me to understand it better.
>
> Cheers,
> froggyanna
>Glad to hear from you! Yes, I'm just trying to deal with meds too without a job, so I think our discussions are the best form of therapy. Look forward to hearing from you again, and hang in there!
Posted by paulk on June 5, 2003, at 15:44:40
In reply to Re: Straterra at night ? Other questions..... » froggyanna, posted by MomofBoys on June 5, 2003, at 9:47:19
Sure sounds like they should come out with an exteded release version of Strattera
Posted by bookgurl99 on June 5, 2003, at 16:34:45
In reply to Atomoxetine (Straterra) veterans » MomofBoys, posted by paulk on June 5, 2003, at 15:44:40
Isn't Straterra basically an ER drug? It's not supposed to be a stim.
Posted by MomofBoys on June 6, 2003, at 9:03:10
In reply to Re: Anyone taking Strattera with SSRI's like Lexap, posted by Mike Oxsbig on June 3, 2003, at 12:23:41
When I went to the doc yesterday, she started me on Lexapro 10 mg to add to my Strattera of which I take 80 mg at bedtime. She also added 20 mg of Strattera in the morning. I feel like I've lost the initial energy I felt when I started taking Strattera at night...I would have restless sleep but wake up and just go-go-go! If I took the Strattera in the morning i was dead tired to the world.
I hope this change helps some. If not, stimulants are in my future, or so she says. We will see.....
Posted by froggyanna on June 7, 2003, at 10:52:57
In reply to Re: Straterra at night ? Other questions..... » froggyanna, posted by MomofBoys on June 5, 2003, at 9:47:19
Hi Mom! :-)> So my questions are:
> >
> > 1. Has anyone else been advised to take Straterra at night? If so, is that decreasing your daytime sleepiness?
>
> YES! It has decreased my daytime sleepiness for a limited time. I wake up just a raring to go, get lots of work done (i work at home) and then by noonish I do have the sleepiness, for which my doc is thinking of adding Ritalin and I will find out today. The Strattera has been incredibly helpful to me so I would like to continue on this but the sleepiness does hold me back a bit.
I'm glad to hear that someone else is taking it at night. I haven't yet decided if it takes care of my sleepiness all day.... Since I'm unemployed, my days are pretty unscheduled, so I'm not as aware of whether sleepiness "intrudes" or not. I'd like to know if your doc decided to prescribe the Ritalin, what dosage and when -- all that.
> > 2. If you increased your dosage slowly, did you avoid the tiredness? The agitation? The irritability?
>
> I started at 40 and went to 80 where I am today. Tired YES. Agitated NO. Irritable NO. But if something sparks my temper, yes I am agitated and irritable. Is it me or the Strattera? Don't know.The past two days I have been a LOT less cranky. I don't know if it's getting used to the Straterra or the fact that I reduced my dosage of buspiron from 60mg to 45, which I also take at night....
> > 3. Would there be any benefit to taking part of the dose before bed and part in the morning?
>
> I am going to ask this myself today when I go to the doc about splitting my dose to day/night instead of just one dose at night.What did the doc say?
> > 4. How many days did you go before increasing?
>
> 40 for six weeks or so then 80.Ah... so you didn't start with 10 and go up every three days like some people do. But you did stay at 40 for quite awhile. Why did you increase? Was it pooping out? Or did it take that long for the side effects to subside?
> > 5. Was it a month or more before you started experiencing any real effect on your ADD symptoms? Are you MAINTAINING those effects?
>
> My effects on ADD were almost immediate. I could organize, get things done. It was amazing to me.
That's astounding! Even at 40mg? I'm not sure I've read anyone else on here say that the effect was that dramatic. Well, it's having NO effect on ADD for me. My doc said I could eventually go up to 120mg. I wonder if weight has anything to do about it? Is this a drug that you can take more of the heavier you are?
> Hope that I could be of help with my experience. But I will find out more from my doc today.Yes! It's good to compare notes. Thanks! And please let me know what you and the doc decided!
froggyanna
Posted by froggyanna on June 7, 2003, at 12:08:54
In reply to Re: Q A to Froggyanna: CPAP and sleep apnea?, posted by gouda on June 5, 2003, at 12:39:45
> Sorry for the delay in reply, Strattera @ the new dosage of 25 mg (originally on 18 mg) is just knocking me out! I sleep well since I take 25 mg 2-3 hours b4 bedtime. In the morning, I feel more motivated, getting things done, and thinking up more to-do things for my to-do list. However, I have to take another 5 hour nap in the afternoon! This totally sucks! So I am currently on my "awake" window, so I thought I'd better reply to you before I conk out again.
LOL... Wow, it's doing a lot to you, even at "such a small" dose. I'm at 40mg, and aside from the queasiness and dizzyness that I experienced at first, I can't say that it has had any appreciable effect on me at all. I DID have one good burst of motivation one morning very early on. But this is a drug that is supposed to take a while to work on you. So I wonder why it's working the opposite way on me?
So you don't take it right at bedtime but 2-3 hours before.... I think that I am doing a little of both. Some nights I take it right when I'm ready to fall asleep, but other nights it turns out that I *think* I'm going to bed and then I don't. Something catches my attention and then I'm not ready to sleep any more. Then I can stay up for another 2-3 hours! Being unemployed allows that to happen, but I have to say: Even when I was (trying to) work a regular job, my sleep schedule was all over the map. I know that's not good, but I have *always* been like that!
MomofBoys said that she was considering adding Ritalin in the afternoons to keep her from feeling sleepy. Have you thought of that?
> > Anyone else have any insight into this [skin picking and other ugly stuff]?
>
> I have no insight, but I can totally relate to your tendencies! <snip> I have been diagnosed with "obsessive compulsive traits", and my pdoc wants to increase my SSRI (Celexa) from 20 mg - 40 mg "to counteract my OCD". So maybe you might wanna check that out for yourself and take a OCD "Yale-Brown Obsessive Compulsive Test". Don't worry, you're norm for an OCD person ... hehe.Yeah, THANKS! :-) I have never thought of myself as OCD, but I suppose it's possible. I'm in the process of adding WellbutrinSR to my recipe and eliminating Zoloft. "W" is supposed to help with this kind of thing, and it also goes by the name Zyban to help people stop smoking. Same stuff. My doctor gave me a paper to read that says it helps with other nasty little habits as well....
I'm not familiar with Celexa. Do you take it for depression?
> > Also, right now my knee is bouncing up and down like crazy, and I really wish this agitation would go away.
>
> I've got a different tick, when I am awaken during sleep, I will kick my leg in frustration, even though I am still partially sleeply. Weird! I don't have the jittery knee though like you.Lucky. I'm still doing it. I can stop it, but I have to consciously force myself. I become aware that I'm doing it long after it has started.
> Personally, I think my ADD is caused by (a) sleep disorder (b) genetics (c) head injuries as a toddler who was very accident prone.Yes, genetics has a LOT to do with it, they say! I don't know if either of my parents or any of my brothers has it. No one was ever diagnosed. I suspect that some of them do, but we just never thought about it. We somehow just muddled through, for better or worse. In my Dad's case, he was diagnosed with schizophrenia in the early 60s, when he was in his 40s. That was like the Dark Ages of mental illness care. My parents got divorced and he went away. As a young adult, I reconnected with him, and he had a fairly successful life, happily remarried, and not suffering financially. So it was impossible to think of him as mentally ill. But there is SO MUCH detail about all that that I have no knowledge of. These were the days when you didn't talk to your kids about these kinds of things. And I have just never been able to talk in depth with either of my parents about it all. We've skirted around the issues, but never really hashed it all out. So my parents are kind of a mystery.....
> > [long discussion of sleep study]
>
> Wow, I think I would like to consider this ... I just mentioned earlier that I've been doing the leg whapping thing at night. Hmm, what is the cost of taking part in a sleep disorder treatment? I would need to budget for this.Well..... I am praying that my insurance will cover most of it, because I don't have this much spare change!! For me, it was $2,135. That's just the study. CPAP machines can cost anywhere from $200-$600 (I'm guessing) but you can also rent them. Once you do the study and your doctor gets the results, you usually have to go to a third-party medical device supplier with a prescription for your air pressure. Those companies have people who are trained to set the machine correctly, train you how to use it, and get whatever headgear you're using fitted properly for you.
> CPAP! Dang, that was funny! Wow, it sounds so complicated!Well, some people never get used to it. I've gotten used to it, and after awhile it's second nature....
> [Wellbutrin] Yes, I started on 100 mg 1x/day for about a month, then increased to 150 mg 1x/day for another month ... I never got to 200 mg, b/c I really disliked the experience (but this should not dissuade you; most people have good experiences with Wellbutrin). Yes, you should be patient with Wellbutrin, I didn't have any benefits until 3 weeks.Please remind me: Did you say you are not taking it any more?
> Extreme calm meaning I kinda felt unnerved about how calm I was when tackling whatever I was doing. It was almost like I had no emotional component whatsoever. "A Just Do It" w/o the kick-butt attitude. Very weird!I'm still learning about what Wellbutrin is supposed to do, so I don't know if it's an SSRI or not. But the SSRIs are known, I think, for putting people into that "detached" state. For me, that has been a blessing. I took Prozac for years, and now Zoloft. Not being at the MERCY of my emotions has been liberating. And in a spiritual sense, detachment is something you strive for! It doesn't mean that you are a zombie. You have your feelings. But they don't rule you. I like feeling like that.
> > > Fifth, Strattera at night: ... I've been taking it 2-3 hours before my bedtime, and it's been great to help me "fall asleep"
>
> > Maybe I'll try that.I did try that, and it seems to be working well for me. I have much less trouble with sleepiness in the day now.
> > > Sixth, Strattera and irritability: Same problem as you, if not worse.
> >
> > Rats. OK, that's two of us then who are hoping that this will wear off. Anyone else got some encouraging reports? Did any of you have irritability initially but it eventually went away? ADDled minds want to know!! :-)When I wrote that, I thought it was the Straterra. But now I think it might be the buspirone I'm taking. I just reduced the dosage from 60mg to 45, and the irritability is GONE!
> Glad to hear from you! Yes, I'm just trying to deal with meds too without a job, so I think our discussions are the best form of therapy. Look forward to hearing from you again, and hang in there!You hang in there, too, gouda! Are you currently LOOKING for a job, or are you in a holding pattern, like me?
Cheers,
froggyanna
Posted by MomofBoys on June 8, 2003, at 17:26:21
In reply to Re: Straterra at night ? Other questions....., posted by froggyanna on June 7, 2003, at 10:52:57
>
> Hi Mom! :-)
>
> > So my questions are:
> > >
> > > 1. Has anyone else been advised to take Straterra at night? If so, is that decreasing your daytime sleepiness?
> >
> > YES! It has decreased my daytime sleepiness for a limited time. I wake up just a raring to go, get lots of work done (i work at home) and then by noonish I do have the sleepiness, for which my doc is thinking of adding Ritalin and I will find out today. The Strattera has been incredibly helpful to me so I would like to continue on this but the sleepiness does hold me back a bit.
>
> I'm glad to hear that someone else is taking it at night. I haven't yet decided if it takes care of my sleepiness all day.... Since I'm unemployed, my days are pretty unscheduled, so I'm not as aware of whether sleepiness "intrudes" or not. I'd like to know if your doc decided to prescribe the Ritalin, what dosage and when -- all that.SHE DID NOT START ME ON RITALIN. WHAT SHE DID CHANGE WAS ADDING 25 MG OF STRATTERA IN THE MORNING ALONG WITH LEXAPRO 10 MG. ONCE AGAIN, I AM EXTREMELY TIRED WITH THE STRATTERA IN THE MORNING. ITS DRIVING ME CRAZY. I HATE BEING SLEEPY DURING THE DAY.
>
>
> > > 2. If you increased your dosage slowly, did you avoid the tiredness? The agitation? The irritability?
> >
> > I started at 40 and went to 80 where I am today. Tired YES. Agitated NO. Irritable NO. But if something sparks my temper, yes I am agitated and irritable. Is it me or the Strattera? Don't know.
>
> The past two days I have been a LOT less cranky. I don't know if it's getting used to the Straterra or the fact that I reduced my dosage of buspiron from 60mg to 45, which I also take at night....
>
>
> > > 3. Would there be any benefit to taking part of the dose before bed and part in the morning?
> >
> > I am going to ask this myself today when I go to the doc about splitting my dose to day/night instead of just one dose at night.
>
> What did the doc say?SHE ADDED 25 MG IN THE MORNING (SO I AM ON A TOTAL OF 105 MG). THE SLEEPINESS IS NOT A GOOD THING WITH ME.
>
>
> > > 4. How many days did you go before increasing?
> >
> > 40 for six weeks or so then 80.
>
> Ah... so you didn't start with 10 and go up every three days like some people do. But you did stay at 40 for quite awhile. Why did you increase? Was it pooping out? Or did it take that long for the side effects to subside?I DIDN'T INCREASE AFTER A WEEK LIKE I WAS SUPPOSED TO...I WENT ON VACATION RIGHT AWAY AND DIDN'T THINK IT WAS WORKING UNTIL I CAME HOME THREE WEEKS LATER AND NOTICED THE DIFFERENCE WITH 40 MG. IT WAS JUST ME AND THE FEAR OF INCREASING. BUT NOW THAT I HAVE BEEN ON THIS DOSE FOR AWHILE, I DON'T FEEL THE ENERGY THAT I FIRST HAD. I AM FEELING DISAPPOINTED THESE DAYS WITH THE STRATTERA. I DON'T KNOW WHAT THE DEAL IS. I DO GO BACK TO SEE MY DOC IN ABOUT 10 DAYS TO SEE WHAT THE LEXAPRO HELPED. AFTER FOUR DAYS OF IT, I DON'T SEE ANY CHANGES AT ALL, BUT WITH THE INCREASE OF 25 MG OF STRATTERA IN THE DAYTIME, I AM SO TIRED! I THINK I WILL START TAKING IT AT NIGHT WITH THE REST OF MY DOSE.
>
>
> > > 5. Was it a month or more before you started experiencing any real effect on your ADD symptoms? Are you MAINTAINING those effects?
> >
> > My effects on ADD were almost immediate. I could organize, get things done. It was amazing to me.
>
> That's astounding! Even at 40mg? I'm not sure I've read anyone else on here say that the effect was that dramatic. Well, it's having NO effect on ADD for me. My doc said I could eventually go up to 120mg. I wonder if weight has anything to do about it? Is this a drug that you can take more of the heavier you are?YES, I HEARD THAT 120 MG IS LIKE THE NORM. I KNOW BECAUSE OF CHILDREN, IT IS A WEIGHT/DOSE DETERMINATION...NOT SURE IF ITS THE SAME WITH ADULTS THO....
Posted by Lasagne on June 9, 2003, at 18:17:29
In reply to Re: Straterra - patience involved, posted by Nat'sMom on January 17, 2003, at 12:27:40
> My 14y/o son has been taking Ritalin for about 4 years with minimal success. Adderall was too strong for him. His child psychiatrist jsut started him on Wellbutrin (150mg bid) about 10 days ago at my prompting. I became aware of symptoms that looked like depression - extreme irritability, tearfulness etc. Does anyone have info on Straterra with kids?
My 10 year old son just began taking Strattera about 2 months ago. He also currently takes Celexa 30mgs daily and Metadate(slow acting Ritalin) 20 mgs. daily. At first the Strattera had amazing results. It was the first time my son functioned tolerably in the mornings. The initial therapeutic result diminished over time, but he is still much more manageable in the mornings than he used to be.
My son first started at 20 mgs. of Strattera and then increased after 4 days to 40 mgs. After about a week or so of trying this it became apparent that he didn't have the focus to function well with school work and was still hyper. Our doctor then suggested that we give him 40 mgs. in the morning and then 25 mgs in the afternoon, for a total of 65 mgs. This still did not do the trick completely. He then told me that some doctors are combining a stimulant with the Strattera. So that is what we tried next. Now he takes 40 mgs. of Strattera in the morning in combination with 20 mgs. of Metadate. This seems to give him good control until about 3:30 in the afternoon. He still struggles with focusing with homework, but increasing the Metadate to 40 mgs. had an adverse effect on his mood, so we have stuck with 20 mgs. of Metadate to get him through the school year and then we will do some experimenting this summer to find a better med. option for him.
Posted by Lasagne on June 9, 2003, at 18:42:37
In reply to Buspar and meds for ADD, posted by Barbie57 on March 11, 2003, at 8:24:24
> My doc and I are trying to figure out how to best medicate anxiety and ADD. I have taken Buspar for four years and it has improved my quality of life tremendously, but it doesn't help with ADD distraction and lack of follow through. I'm currently taking Metadate ER and like the mental results but seem to have tightness in chest and some physical agitation with it. One tack we're trying is to divide up my Buspar throughout the day so that it seems to coincide with the timerelease of the Metadate. I wonder about Straterra since I read that it has some anti-anxiety effects as well. Anyone have experience with Buspar and Straterra? Or related experiences treating anxiety and ADD?
response: I have taken BuSpar for a while now for anxiety. I also take Prozac. I was recently diagnosed with ADD at age 33. My doctor started me on Strattera. I take 80 mgs at bedtime. I have found this medication to be very relaxing. At first I didn't know what to think. It was the first time that I had felt that calm in my whole life. It made my brain function at the right speed instead of always going and going. I have now been on the medication for a month and I am getting past the side-effects of dry-mouth, nausea, itching of the scalp, and daytime tiredness. The medication has also helped me to lose some weight, especially in the beginning it had good appetite control for me. Although I had thought the Buspar had improved my life greatly, I now am finding that the combination of Strattera and Buspar very refreshing. I don't get nearly as uptight as I used to. I can focus through my daily routine and do what I need to do without feeling like my chest is tightening up with stress. I also like how the Strattera helps me sleep. I wake up feeling so much better now.
Posted by Gale Fox on June 10, 2003, at 8:06:02
In reply to Re: Keep the Strattera updates coming!, posted by froggyanna on June 1, 2003, at 15:26:08
A word about Wellbutrin & Strattera and appetite/weight loss. One of the side effects of Wellbutrin is weight loss. I lost 30 lbs in 4.5 months on Wellbutrin (that was the 30 lbs I'd gained on Paxil over the past 6 years).
My pdoc tells me that appetite supression is one of the side effects of Strattera, and I'd have to ssay that's been true for me also. So I suggest monitoring your weight and food intake if you're on one or both of these meds. (I'm currently taking 80 mg Strattera & 100 mg Wellbutrin)
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
>
Posted by Gale Fox on June 10, 2003, at 8:23:15
In reply to Straterra at night ? Other questions....., posted by froggyanna on June 2, 2003, at 16:52:39
See my responses below. I'm taking Strattera for depression (80 mg) and 100 mg Wellbutrin.
So my questions are:
>
> 1. Has anyone else been advised to take Straterra at night? If so, is that decreasing your daytime sleepiness?I take 40 mg in the moring & 40 mg in the afternoon - one of several unpleasant side effects for me was insomnia.
2. If you increased your dosage slowly, did you avoid the tiredness? The agitation? The irritability?
I wish my doctor had been willing to strat me out on 10 mg. I did go up slowly, had good effects at 25 mg after a month, but then lost them as we withdrew Wellbutrin. Increasing the dosage and adding the Wellbutrin back in have helped, but I'm not seeing the dramatic improvement I saw (& felt) in February.
3. Would there be any benefit to taking part of the dose before bed and part in the morning?
I think the benefit of splitting the dosage is that you get Strattera in your system more consistently over time.
> 4. How many days did you go before increasing?
I have to go at least a week, sometimes longer because of two side effects I have - increase in a benign tremor (exacerbated by Wellbutrin), insomnia (Also exacerbated by Wellbutrin). Currently I'm postponing going up to 100 mg Strattera because of constipation. I'm told my body will adjust to the med, but meanwhile I'm taking something for the constipation as well.
5. Was it a month or more before you started experiencing any real effect on your ADD symptoms? Are you MAINTAINING those effects?
>
I'm tking for depression, not ADD. But yes, it was 3-4 weeks before I felt and effect. It was dramatic, but then dropped off - Now that I'm up to 80 mg, I'm trying to give it a 6 week trial.> Those are only some of my questions, actually. I'm just so eager to get my head straightened out that I'm feeling impatient, even though I KNOW that I have to give it time. I suppose that if someone had actually stabilized on Straterra they might not still be hanging around this discussion forum. But I sure would like to hear some real success stories. I am "afraid" to start taking the stimulants... at least not until I've done all I can without them.
>
> Thank you VERY much for any and all advice you can offer!
>
> froggyanna
>
Posted by Gale Fox on June 10, 2003, at 8:35:07
In reply to Re: Urgent question about Strattera for depression, posted by tanafofana on June 2, 2003, at 10:29:47
I find it incredible that you were able to start at 40 mg, let alone go up to 80 so quickly, because my experience has been so full of side effects & I've had to increase very slowly.
I saw great effect after about a month at 25 mg, but then we withdrew Wellbutrin & my mood and activity level dropped dramatically. I'm now up to 80 mg of Strattera and am also taking 100 mg of Wellbutrin, but though I've improved some, its not been as noticeable as the first month, so I'm disappointed - no, make that angry - I've been playing with meds for 9 months and still haven't got anything effective. I'm trying to stay with the Strattera til I've been on it for 6 weeks.
Posted by Lasagne on June 10, 2003, at 10:36:44
In reply to Re: Straterra at night ? Other questions....., posted by Gale Fox on June 10, 2003, at 8:23:15
I have been taking Strattera for about 4 weeks now. At first I did the regimine of 40 mgs.once in the morning and then 40 mgs. once in the late afternoon. I found this made me so spacey and tired during the day. I felt like I was living in a big fog.
Then my doctor told me to just take all of my Strattera 80 mgs. total in the evening. I take it around 7 p.m. and it really helps me to relax to get a good nights sleep. Then I wake up in the morning and feel good. I don't feel a huge urge to go back to bed after getting my children off to school like I used to. Once I get moving it seems like I can get things accomplished and keep going until my normal naptime at noon. I have also found that I am capable of taking shorter naps than before. Before I didn't feel good if I didn't lay down for 1 1/2 to 2 hours daily, but now if I lay down for just an hour I can still function through the afternoon and evening routine with my children.
I am also finding it easier to do the routine things that need to be done daily. I still have a tough time doing the big projects that require organization, but I have been told that I can't expect ADD/ADHD treatment to completely resolve all my issues. Right now I am trying to stay focused on the little improvements that happen daily. Before starting the Strattera I was in a depressive slump and now I finally feel like I am pulling out of it.
I also take Prozac 60 mgs. daily and Buspar 30 mgs. daily.
The Buspar really helped alleviate my anxiety symptoms, but the addition of Strattera improved my anxiety even more. I don't worry as much as I used to about things that I have absolutely no control over.
My doctor had actually been treating me for depression and anxiety for years, then after all of my boys were diagnosed with ADHD, he mentioned that I should make a special appointment to have him do a ADD/ADHD evaluation on me. That is the point where he started me on the Strattera. He thinks that coping with my ADD/ADHD symptoms for 33 years was the source of my depression and anxiety. I am now reading books about adult ADHD and am finding the whole thing enlightening. Many things are beginning to make sense for me.
Posted by Lasagne on June 10, 2003, at 10:48:18
In reply to Re: Keep the Strattera updates coming!-appetite, posted by Gale Fox on June 10, 2003, at 8:06:02
I have been taking Strattera for a month now. I began with 40mgs for the first 4 days and then increased to 80 mgs. after that.
In the beginning my weight dropped down about 5 lbs. After about 3 weeks I began to get more of an appetite back with a slight difference. If I overeat at all I feel sick to my stomach. I also still get an on and off feeling of nausea, which I find is a huge appetite control mechanism for me. My weight has gone up a few pounds since the initial weight loss, but I am still happy about the progress I have made. Prior to the Strattera I tried excercise and a better diet, yet I could not get my weight down below 160 lbs. This is the first time in a long time that I have noticed that I have lost inches and I am also below 160 lbs.
Posted by Viridis on June 10, 2003, at 20:26:41
In reply to Re: Keep the Strattera updates coming!-appetite, posted by Lasagne on June 10, 2003, at 10:48:18
I've been using low-dose Adderall for quite a while now (10 mg/day), and I find it helpful for ADD and depression. However, I'd like to try Strattera, and my pdoc is keen on this too. I'm wondering if others here have taken Strattera and Adderall (or another stimulant) simultaneously.
I've seen comments elsewhere that suggest one stay with Adderall (or Ritalin etc.), at least while the Strattera is kicking in, while others say to discontinue the stimulant before starting Strattera. In the Strattera prescribing info, there's no contraindication listed for amphetamines etc.
I plan to start the Strattera cautiously, at a low dose, since I'm sensitive to certain meds (Wellbutrin and SSRIs). I'm just wondering if anyone has used Adderall and related meds together with Strattera, how they made the transition, and so on. I'd like to have some feedback so that I discuss this in an informed way with my pdoc, who's very reasonable and open-minded, but also somewhat cautious. He doesn't mind mixing meds (within reason), and listens to what I say, but I'd like to be sure I know what I'm talking about.
Thanks in advance!
Posted by Lasagne on June 11, 2003, at 12:21:29
In reply to Re: Straterra at night ? Other questions..... » froggyanna, posted by MomofBoys on June 5, 2003, at 9:47:19
To: Mom of Boys
I too am raising 3 boys,ages 10, 7, and 4. They all have ADHD.
Do your boys have ADHD too?
How old were you when you were diagnosed?
I am 33 and after years of being treated for depression and anxiety, the doctor did an evaluation on me and now he thinks that I have suffered from ADD my whole life, which is why I have struggled so much with depression, etc. He started me on Strattera about a month or so ago. I am slowly noticing improvements but nothing as spectacular as you have noted. Have you ever done regular stimulant treatment or is Strattera your first try too?
I am interesting in having another woman with my same experience to swap stories with. Lately I have had to make sense of my new diagnosis and educate myself on it plus cope with my ADHD boys that my ADHD husband I produced. My whole world is filled with ADHD now and so I need another woman's perspective on how they have dealt with similar emotions.
'Lasagne' in California
Posted by Lasagne on June 11, 2003, at 15:13:26
In reply to Strattera AND Adderall?, posted by Viridis on June 10, 2003, at 20:26:41
Reply to below post: My son was taking 40 mgs. of Metadate (slow release Ritalin). It stopped working well after about 5 or 6 months of doing great, so our doctor suggested that we try Strattera by itself. We did this for about a month. He would get 20 mgs. twice daily. The first week things went pretty well except that he was not as focused in the afternoons. We tried playing with the dose a bit but it still didn't give him satisfactory results to make it through his school work. So our doctor suggested that we combine the Metadate with the Strattera. So now he is taking 40 mgs. of Strattera and 20 mgs. of Metadate. It does a good job of controlling his symptoms until about 3:30 in the afternoon, which means the homework time is not easy to deal with. We tried uping his dose to 40 mgs. of Metadate but it made him too moody. Now it's the beginning of summer and we are going to try something different in hopes that we can get him better stabilized to start 6th grade. Although, he has been tolerable to be around with the combination of Strattera and Metadate, he definitely isn't doing as well as I have seen him do in the past with other stimulant treatments. I would say that the best effectiveness he ever got was from the Adderall, but over time he became resistant to it. Since then we have never been able to get him back to the level of effectiveness that he had on the Adderall. All I can say is that it is worth a try to combine the Strattera with a stimulant. I have been doing this for two years straight with my son and it is just a constant trial and error process. Because children are still growing it is I think more common to have these problems finding the right treatment and maintaining it. I wish you luck.
Original message:> I've been using low-dose Adderall for quite a while now (10 mg/day), and I find it helpful for ADD and depression. However, I'd like to try Strattera, and my pdoc is keen on this too. I'm wondering if others here have taken Strattera and Adderall (or another stimulant) simultaneously.
>
> I've seen comments elsewhere that suggest one stay with Adderall (or Ritalin etc.), at least while the Strattera is kicking in, while others say to discontinue the stimulant before starting Strattera. In the Strattera prescribing info, there's no contraindication listed for amphetamines etc.
>
> I plan to start the Strattera cautiously, at a low dose, since I'm sensitive to certain meds (Wellbutrin and SSRIs). I'm just wondering if anyone has used Adderall and related meds together with Strattera, how they made the transition, and so on. I'd like to have some feedback so that I discuss this in an informed way with my pdoc, who's very reasonable and open-minded, but also somewhat cautious. He doesn't mind mixing meds (within reason), and listens to what I say, but I'd like to be sure I know what I'm talking about.
>
> Thanks in advance!
Posted by froggyanna on June 14, 2003, at 13:57:34
In reply to Re: Keep the Strattera updates coming!-appetite, posted by Gale Fox on June 10, 2003, at 8:06:02
> A word about Wellbutrin & Strattera and appetite/weight loss. One of the side effects of Wellbutrin is weight loss. I lost 30 lbs in 4.5 months on Wellbutrin (that was the 30 lbs I'd gained on Paxil over the past 6 years).
>
> My pdoc tells me that appetite supression is one of the side effects of Strattera, and I'd have to ssay that's been true for me also. So I suggest monitoring your weight and food intake if you're on one or both of these meds. (I'm currently taking 80 mg Strattera & 100 mg Wellbutrin)
Hi Gale,Yes, I'm also currently taking 80mg Straterra at night and 200mg Wellbutrin 2 times a day. 45mg buspiron at night as well. I HAVE been taking 100mg Zoloft for several years, but the pdoc has suggested that I stop taking it and see if the Wellbutrin can act as the antidepressant. I gradually increased the amount of Wellbutrin I was taking, while still taking the Zoloft. Now that I'm on 200mg 2x/day for a few days, I've stopped taking the Zoloft and we'll see how that goes.
Weight loss would NOT be a problem for me at all, since I am 5'7" and weigh about 280 pounds. I need to weigh HALF of me!! I'm really glad that I've found these meds (assuming that they turn out to be right for me in all other respects). In addition to a SIGNIFICANTLY reduced appetite, I'm seeing some gradual improvements in my ability to concentrate and move forward with tasks without much trouble. I still procrastinate, and I'm hoping I'll find a way to clear that up. Also, I'm experiencing some mild physical shakiness that feels not quite right.
Here's the big thing for me, though: I recently had some major health tests done (sleep study, bone densitometry, and stress echocardiogram). I'm 51, so my internist thought it prudent to look at all these things (I have sleep apnea - that's why the sleep study.) Also blood tests. My thyroid tests came back "normal" but we may be tweaking with that a bit (that's another thread). My densitometry test shows that I have "severe" osteoPENIA in my lower lumbar region. That's the stage before osteoporosis. And the stress test (treadmill) revealed that I have an "area of abnormality" in my heart and they suspect that not enough blood is getting there. My overall cholesterol is good, but my triglycerides are skyhigh and the HDL (good stuff) is way low. I have to have a repeat stress test, with something they put in your veins so they can see your heart in more detail. My internist tells me that if they find a blocked artery, they will probably have to put a "balloon" inside it to open it up. That was pretty shocking to hear, but he says it's not major surgery.
What made me sad is that before hearing this, I had just made up my mind to join my local Curves for Women and start getting the exercise I so desperately need. I asked the doc if I could go ahead and do this and he said NO! I have to wait until we figure out what needs to be done about my heart.
I immediately did an internet search, hoping I could find some information on "natural" ways of increasing your heart health (better late than never). For those who are interested, I found a WONDERFUL page of info about an herb called Arjuna, and I'm going to be taking this as soon as it comes in the mail: http://www.planetherbs.com/articles/Arjuna.htm
Sorry for going a little off track, but y'know, we are all these things, not just our brains....
froggyanna
Posted by EasilyDistracted on June 14, 2003, at 15:11:15
In reply to Re: Straterra- anyone using as stimulant? » Lexxey, posted by Magpie on April 7, 2003, at 12:12:10
Was diagnosed with ADD about 8 years ago. Tried all the SSRI's, Wellbutrin and Cylert to help with attention and depression. Ended up gaining about 25#'s on SSRI's...not an option for me. Then I got the bright idea to "self medicate" with meth...my bright idea landed me in drug rehab, which is where I find myself now. My counselor worried that if I didn't address my ADD I would end up "self medicating" again...So, I began Straterra Wednesday am (40mg) with very little expectation and by Wednesday afternoon my entire rehab "group" was amazed at how calm I was! {It really was quite amazing). I was able to sit quietly and listen for the whole afternoon. Prior to that it was almost physically painful for me to "just sit". Anyhow, I began taking 80mg this morning and am not having any side effects that I cannot tolerate. I just may be on to something here....
Posted by Lasagne on June 14, 2003, at 16:04:36
In reply to new on Straterra, posted by EasilyDistracted on June 14, 2003, at 15:11:15
Hi:
I have been taking Strattera for about a month or so now. I am taking 80 mgs. daily at bedtime. I was recently diagnosed with ADHD at age 33, so I had never done any stimulant medication treatments prior to this time. And because of what I now see as a strange miracle, I stayed away from self-medicating myself, eventhough there is a huge family disposition to do so. Although, I have been taking Prozac for 10 years for depression and Buspar during the last few years for anxiety. I couldn't believe how much calmer the Strattera made me. At first it was a bit scary because I didn't realize how hyper I was before, so to start experiencing the world at what my doctor says is normal speed, it took a bit of getting used to. Now I am really enjoying this feeling. I don't fuss about so much and I can let a lot of things go that I used to get fixed on before and couldn't break the thought pattern. It is also easier for me to get through my daily routine and I find I am slowly but surely getting more organized. I am finding that with time the procrastination issues aren't as bad. I am not sure I will ever be completely rid of all of my symptoms but right now I am trying to stay positive about the improvements that have happened with this medication. The one thing I absolutely love about the Strattera is the ability to sleep. I have been a long time sufferer in the sleep dept. and now the medication relaxes my brain so I am not constantly thinking about this or that in the middle of the night. I find myself occasionally over thinking things, but I can recognize it now and somehow shut it off and move on to more productive thoughts or simply rest.
Posted by Lasagne on June 14, 2003, at 16:13:55
In reply to Re: ...Strattera updates!-appetite/heart trouble, posted by froggyanna on June 14, 2003, at 13:57:34
I have been taking Strattera for over a month now. I take 80 mgs. at bedtime. At first the appetite control was more intense and I dropped down to 155 lbs after years of trying to do so on mere excercise and healthier eating (but to no avail). I attribute this to the nausea that I felt in the beginning. After about 3 weeks on the medication I noticed my appetite increased a bit and then I put back on a few pounds. Although, I find that the medication still continues to control my appetite. If I over eat at all, then I am so uncomfortable and feel sick. The nausea seems to be decreasing with time, something I was most concerned about because I would feel it on and off all day long at first. Now I seem to be stabilizing in that department, thank heaven!
The main side effect that I still continue to struggle with is the hot flashes and sweating that started when I began the medication.
Posted by gouda on June 15, 2003, at 18:05:44
In reply to Re: Q A to Froggyanna: CPAP and sleep apnea? » gouda, posted by froggyanna on June 7, 2003, at 12:08:54
Posted by gouda on June 15, 2003, at 18:08:33
In reply to Re: new on Straterra » EasilyDistracted, posted by Lasagne on June 14, 2003, at 16:04:36
To All,
I just marvel at how almost ALL of us STRATTERA-takers are ALSO on SSRIs! Lexapro, Celexa, Wellbutrin, etc.
Does anyone know what's the significance of this ADD & DEPRESSION connection?
Gouda
Posted by zeugma on June 15, 2003, at 21:35:53
In reply to Why are so many of us ADDers also depressed?, posted by gouda on June 15, 2003, at 18:08:33
> To All,
>
> I just marvel at how almost ALL of us STRATTERA-takers are ALSO on SSRIs! Lexapro, Celexa, Wellbutrin, etc.
>
> Does anyone know what's the significance of this ADD & DEPRESSION connection?
>
> Gouda
ADHD is a lot more serious (at least the kind that I have) than a lot of people commonly supposed. It has made my entire life a shambles. Plus, it commonly comes with comorbidities, particularly the more severe varieties. If I didn't suffer from some form of endogeneous depression, I would be depressed anyway at the havoc these disorders have wreaked on my life.
Posted by reba on June 15, 2003, at 22:34:59
In reply to Strattera AND Adderall?, posted by Viridis on June 10, 2003, at 20:26:41
Ok, so here is my deal. I'm 20 years old, and i was diagnosed with ADHD in the begining of february. Since then I decided to take Strattera. I tried my hardest to keep an open mind since i had never tried any type of meds before this, and my doc didn't know much at all about it. So heres for everyone getting frusterated with Strattera; it took me almost 2 months to really notice ANYTHING! Also it was hard because never having been on any other meds i didn't know what to expect. Advise for anyone trying Strattera for the first time, hang in there, and really keep an eye on changes to yourself, they were very hard for me at first to really see myself. Another point of advise i want to give is that meds don't fix everything, you really have to learn better skills on your own or through a ADD coach type thing. I personally read everything on ADD i could get my hands on. lol. But I have been reading all your posts and i too have had side effects such as dry mouth, daytime tiredness, hot flashes, and moodiness if i dont eat enough durring the day. I also lost weight and I am not used to that AT ALL. I'm not that big to begin with so it was weird.
Ok, I have a couple questions for whoever.
1st about the day time tiredness. I take 80mg at about midnight. But I am tired from when I wake up about 10, or 11 am till almost 5:00 pm. This is a huge problem for me. I drink lots of coffee to help this and I want to find a better way to deal, weather it be changing the time I take the meds or the dose I need to take.
2nd That brings up my 2nd question of what about using stimulant meds with Strattera. i want to hear anything anyone knows about this. I have never taken any sort of ritalin or anything so I want some input please. Maybe this is what I need to not be tired in the day?
ok so I suppose this is all for now!
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