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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by MB on July 10, 2003, at 10:58:54
I've been reading mixed "reviews" (reviews? that kinda sounds weird in reference to a medication, but anyway) about this drug. The side effects seem to be almost as bad as SSRI side effects, and it doesn't seem to control the ADHD as well as the stims. Plus, it takes weeks to work, where stims take minutes. Do you think this medication will sorta "replace" stim use for ADHD the way SSRIs have sorta "replaced" benzo use for anxiety? (ps. I know benzos are still widely used, but usually not until after an SSRI failure and the sawing off of one's own left leg).
I'm thinking about how well benzos work for anxiety. Also, they work in minutes. I don't think SSRIs work as well, they take weeks to kick in. Still, SSRIs are prescribed more often for anxiety than benzos (at least it appears so from the complaints that abound on this board about the difficulty in obtaining prescriptions for these medications). I don't think this difficulty is predicated on the SSRIs' greater effectiveness against anxiety, I think it has to do with the liability fears that doctors have regarding the prescription of scheduled medications. Doctors use "tolorance" and "dose escalation" as excuses, but these aren't issues when treating anxity/panic. They're only issues when treating insomnia (and then, only sometimes). The excuses are just fear based (my conspiracy-theorist opinion).
Do you think the same thing is going to happen with Strattera? Will stims be "pushed aside".
What is the motive behind my concern? Hidden agenda? Well, I have to admit: I *like* stims. Adderall was the only medication that made me feel better *enough*, whatever "enough" means. I guess "enough" means that I didn't wonder how much longer I could hold out before topping myself. I spend a lot of time thinking, "well if it gets bad enough, I could probably get back on stims." It would be hard, because I *did* escalate the dose, which is a no-no, and I'm sure a doc would be reluctant to represcribe. However, once I got off the SSRI I was taking with the Adderall, I was able to drop my Adderal dose back down to normal (I think I was trying to counter the SSRI induced apathy by increasing my Adderall dosage). So, there might be an addictivity issue where this drug and I are concerned, but I favor it to suicidality and intractable, lethargic apathy (SSRI). Getting back on stims (if I have to) has been a trump card I've held onto. But now here comes Strattera, and I fear that the stims will go bye-bye.
I probably sound like a total drug addict, but I don't care anymore. After 15 years of this crud, I just want to feel better. I'm sure some of you understand.
MB
Posted by blondegirl47 on July 10, 2003, at 12:39:17
In reply to Do You Think Strattera Will Take Over Stim Use?, posted by MB on July 10, 2003, at 10:58:54
I talked with my pdoc about this...he said that most of his patience that were on stimulant didn't do well with stratterra alone. He hasn't really had alot of success with straterra so far. In my humble opinion I don't see it phasing out anything. I couldn't tolerate the sleepyness or the weight gain from it.
Blondegirl
Posted by Jack Smith on July 10, 2003, at 13:09:11
In reply to Do You Think Strattera Will Take Over Stim Use?, posted by MB on July 10, 2003, at 10:58:54
Were you using Adderrall mainly for depression? When you were using it with an ssri, did it negate the lethargic apathy???
JACK
Posted by Zenclearer on July 10, 2003, at 18:45:56
In reply to Re: Do You Think Strattera Will Take Over Stim Use » MB, posted by Jack Smith on July 10, 2003, at 13:09:11
I don't think -- therapeutically -- straterra will outshine stims.
But I do think some docs, for adults, will begin using it exclusively first line. In other words, they won't offer adults stims as a first treatment.
Posted by Viridis on July 11, 2003, at 2:50:43
In reply to Do You Think Strattera Will Take Over Stim Use?, posted by MB on July 10, 2003, at 10:58:54
I think the drug co. that makes Strattera would like it to replace stimulants, but (and my pdoc agrees) the best combination for many is Strattera plus a pstim. I take it along with Adderall, and the two work well together. So, for now at least, I'm staying on both. Strattera had an immediate calming/focusing effect for me (even though it's supposed to take a while to kick in) but then this is typical for me -- generally I can tell within a few days whether a med is appropriate for me or not. The ones that have been bad stayed bad no matter how long I used them, and the ones that work well did so from the start.
Posted by MB on July 11, 2003, at 21:29:29
In reply to Re: Do You Think Strattera Will Take Over Stim Use » MB, posted by Jack Smith on July 10, 2003, at 13:09:11
> Were you using Adderrall mainly for depression? When you were using it with an ssri, did it negate the lethargic apathy???
>
> JACKI was using the Adderall for ADD. I was on Prozac for depression and OCD, but the akathisia was so bad that I switched to Serzone. I was on Neurontin for irritibility and rage attacks, and I was put on clonazepam for akathisia when I started the Prozac (they kept me on it even when I switched to Serzone). Anyway, I never could tolerate more than 25mg Serzone. I did well with the Neurontin and the clonazepam. The Adderall was like a miracle drug. I felt like someone had finally turned the lights on. Life seemed fun, I enjoyed talking to people, life was no longer overwhelming, etc. But I built a tolerance to it quickly, and the antidepressant effects waned. I was allowed to take 50mg a day, but by the end, I was taking 100mg trying to maintain that non-depressed state. Finally I said, "screw it" to the Serzone and just quit taking it. I reduced my Neurontin also. I found that without the Serzone, I needed much less Adderall, and it started working again at lower doses. *However*, I had run out of my prescription in half the time I was supposed to, and I got scared. I didn't want to tell the doc how much I had been taking, so I cancelled all my appointments in a hasty moment, and went off all my meds cold turkey.
It was bad (clonazepam, Adderall, and Neurontin all stopped at once).The Adderall has been the only med prescribed that has made me feel "well", but I have to admit that 100mg/day is considered abuse, and I am scared to go back on it.
Anyway, after I quit all my meds, the depression was so bad, that I started abusing morphine and ended up in treatment. So...now I'm in a 12-step program, living sober, and am scared as hell to go back to Adderall because the truth is, I am an easily addicted person.
However, if it got down to having to decide between suicide or taking Adderall, I would take the Adderall.
BUT, to answer your question, YES, the Adderall obliterated the apathy from the serotonergic meds.
MB
Posted by MB on July 11, 2003, at 21:33:17
In reply to Re: Do You Think Strattera Will Take Over Stim Use » Jack Smith, posted by MB on July 11, 2003, at 21:29:29
> BUT, to answer your question, YES, the Adderall obliterated the apathy from the serotonergic meds.
>
> MBWell, it did so until I built a tolerance and had to increase the dose. Until then, it obliterated the serotonin induced apathy.
MB
Posted by CC67 on July 12, 2003, at 5:25:21
In reply to Do You Think Strattera Will Take Over Stim Use?, posted by MB on July 10, 2003, at 10:58:54
I do not believe strattera will take over stimulant use.
I took it for about 4 months with adderall and it
did not work will in thee end,I quit taking it.
I maintain my adderall dose even after .
Adderall has worked the best for me ,and has always been in the mix.
Strattera was just something I was trying to augment the adderall.
Posted by jay beck on July 12, 2003, at 23:49:09
In reply to Re: Do You Think Strattera Will Take Over Stim Use?, posted by CC67 on July 12, 2003, at 5:25:21
strattera is the FDA/DEAs miracle to the wide spread abuse of script pstims. so yes there is a hidden agenda. there is no question that the governement wants to medicly rid of all abuasble substances. they want drugs that don't give highs only fix certain problems. like SSRIs for anciety to stop widespread abuse of benzos. its very unfair to all who sufffer from any mental disorder. ADD/anxiety or even pain. pstims will always be around like benzos are always around, but eventually all abusable meds will be even more difficult to get a hold of. its discusting how big brother constantly harasses us for getting propper help.
Posted by Viridis on July 13, 2003, at 2:26:06
In reply to Re: Do You Think Strattera Will Take Over Stim Use?, posted by jay beck on July 12, 2003, at 23:49:09
I wonder how "widespread" pstim abuse really is. I take mine (Adderall) exactly as directed and would never divert it to anyone. The same is true for benzos. I don't abuse my prescribed meds (wouldn't enjoy that anyway) and suspect the vast majority of users are the same.
Strattera is also helpful for ADD, but I love the focus that Adderall provides. I wish the government would just relax and let us take our meds in peace. I know my pdoc is exasperated about the hoops he has to jump through to prescribe scheduled meds -- he's very conscientious and watches for signs of abuse, and I expect that most pdocs are the same.
I'm getting pretty sick of the fear the government agencies instill in so many doctors -- just let them do their work and heal those of us who need it. I seriously doubt that many pstim or benzo users would waste their valuable prescriptions by sharing them with others. I think it has more to do with the powerful lobby the drug cos. have to encourage use of still-under-patent drugs, which of course are bigger money makers.
Of course, this ties in with the goals of our current administration, who above all want to maximize corporate profits regardless of the health of consumers.
This is the end of the thread.
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