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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by SLS on August 21, 2003, at 10:29:07
Hi.
I began taking Strattera over six weeks ago to treat severe bipolar depression. I experienced a brief partial remission during the second week that has since disappeared. Has anyone had success with Strattera for depression without ADD/ADHD? What dosage? How long did it take for it to begin working? Any input would be greatly appreciated.
- Scott
Posted by SLS on August 22, 2003, at 7:46:56
In reply to Strattera for depression. Any success stories?, posted by SLS on August 21, 2003, at 10:29:07
> Hi.
>
> I began taking Strattera over six weeks ago to treat severe bipolar depression. I experienced a brief partial remission during the second week that has since disappeared. Has anyone had success with Strattera for depression without ADD/ADHD? What dosage? How long did it take for it to begin working? Any input would be greatly appreciated.
Has anyone tried it without success? What dosages did you investigate?
- Scott
Posted by SLS on August 22, 2003, at 16:07:30
In reply to Strattera for depression. Any failure stories?, posted by SLS on August 22, 2003, at 7:46:56
?
:-)
Posted by fallsfall on August 22, 2003, at 17:18:13
In reply to Strattera for anything. Any stories at all? :-), posted by SLS on August 22, 2003, at 16:07:30
Hi Scott,
I've been taking Strattera since February. I have depression. I also take Lithium, Prozac and Provigil. When I started with the Strattera I did an experiment that showed that the Strattera was much more effective if I was also taking Provigil. The two gave me energy, initiative and motivation. They were also really good at reducing suicidal ideation. If I recall it was helpful really quickly (less than a week?).
I take 80mg Strattera. Since I also take Prozac, I'm one of those people who should need less Strattera (because the Prozac makes it more potent?). I don't remember a drop in the effect, but there were a lot of very stressful things going on at the time and it is possible that I totally missed something important.
How much are you taking? What else are you taking?
Posted by zeugma on August 22, 2003, at 20:42:28
In reply to Strattera for anything. Any stories at all? :-), posted by SLS on August 22, 2003, at 16:07:30
> ?
>
> :-)
Hi Scott, I suppose I have some "new Strattera stories." Been feeling a lot better regarding ADHD symptoms. Increased motivation, attention span, received praise at work for working more efficiently. Strattera has definitely been 'additive' with regard to the TCA. It hasn't interefered with sleep, as my my pdoc was concerned about.On the other hand, it hasn't done a thing for my social phobia. I find that while Strattera and TCA do not worsen anxiety, they don't help it either- particularly social phobia. The clarity Strattera brings changes the nature of the anxiety somewhat- I become exquisitely aware of exactly WHY I'm becoming anxious as the process unfolds, and this should be a good thing, but it's an 'awareness' that resembles the pain from a throbbing nerve in an especially sensitive place.
To me, this means that the Strattera's been doing doing its job, and so is the TCA (I'm sleeping, waking up OK, not depressed). I'm going to see if I can try Klonopin for the social anxiety. I have seen more evidence of efficacy in severe social phobia for that drug of anything short of a MAOI.
Maybe you could describe your experiences with Strattera in more detail? You had said your depression was also of the 'deactivated' kind. Do you also get severe anxiety? Does the Strattera worsen or improve sleep and eating patterns? or do anything to improve motivation? Have you tried any psychotherapeutic or cognitive approaches? Are there comorbidities (e.g, social phobia, panic disorder, OCD, etc.)?
Posted by SLS on August 23, 2003, at 7:59:44
In reply to new adventures on Strattera » SLS, posted by zeugma on August 22, 2003, at 20:42:28
Hi Z.
> Been feeling a lot better regarding ADHD symptoms. Increased motivation, attention span, received praise at work for working more efficiently.
That must feel wonderful. What a tremendous change this must be for you.
> Strattera has definitely been 'additive' with regard to the TCA. It hasn't interefered with sleep, as my my pdoc was concerned about.
I'm currently taking:
Lamictal 200mg
imipramine 300mg
Abilify 10mg
Strattera 80mgWhat benefits do you get from TCA?
> The clarity Strattera brings changes the nature of the anxiety somewhat- I become exquisitely aware of exactly WHY I'm becoming anxious as the process unfolds, and this should be a good thing, but it's an 'awareness' that resembles the pain from a throbbing nerve in an especially sensitive place.
Ouch. I guess whether it's a good thing or not depends on how much control you feel you have to change the circumstances surrounding the anxiety.
> I'm going to see if I can try Klonopin for the social anxiety. I have seen more evidence of efficacy in severe social phobia for that drug of anything short of a MAOI.That sounds like a good idea. Do you ever have panic attacks?
> Maybe you could describe your experiences with Strattera in more detail? You had said your depression was also of the 'deactivated' kind.
Yes. It is extremely anergic. When I first added Strattera to my other drugs, I gave it virtually no chance of working. Then, about three weeks into treatment, I began to respond to it in a big way. The response lasted for only a few days, with hints of improvement remaining for about a week. Now, nothing. I worked up to 120mg, but began to have problems staying awake after about two weeks. So, I have returned back to 80mg. Strattera continues to make me feel mildly "spacey", and blurs my vision, so I really don't want to be on it if it is not going to do anything positive.
> Do you also get severe anxiety? Does the Strattera worsen or improve sleep and eating patterns? or do anything to improve motivation?
During the first and second weeks, Strattera definitely reduced my appetite. I lost 5 pounds very quickly. Thereafter, it returned to normal. I don't think it has contributed at all towards weight gain. When I received an antidepressant effect from Strattera, all aspects of my depression improved, including anhedonia and motivation. It was great!
> Have you tried any psychotherapeutic or cognitive approaches?Yes, and I continue to use them whenever I feel the need. Unfortunately, my depression is so severe, that it greatly slows and impairs cognition to the point where I cannot process very much new information. Psychotherapy is not generally very productive for me. I have no real issues to deal with other than how this brain disorder has ruined my life and what I can do to minimize the damage and remain constructive.
> Are there comorbidities (e.g, social phobia, panic disorder, OCD,
etc.)?I do have some social anxiety. Depressed mood and social anxiety were prominent during the early years of my illness. As I got older, they have been replaced by anergy and cognitive dementia.
Thanks for the insightful questions and input.
- Scott
Posted by zeugma on August 23, 2003, at 19:04:07
In reply to Re: new adventures on Strattera » zeugma, posted by SLS on August 23, 2003, at 7:59:44
> Hi Z.
>
> > Been feeling a lot better regarding ADHD symptoms. Increased motivation, attention span, received praise at work for working more efficiently.
>
> That must feel wonderful. What a tremendous change this must be for you.
>
It is. I often get the dread, especially early evenings when I get home, that the 'deactivated' states will return. So I am trying to do everything in my power to stop that from happening- pursuing cognitive behavioral therapy, researching different medications, cultivating healthful activities like exercise as much as possible. I am well aware that in my 'deactivated' states, the slightest physical or mental exertion seems overwhelming.> > Strattera has definitely been 'additive' with regard to the TCA. It hasn't interefered with sleep, as my my pdoc was concerned about.
>
> I'm currently taking:
>
> Lamictal 200mg
> imipramine 300mg
> Abilify 10mg
> Strattera 80mg
>
> What benefits do you get from TCA?
I'll give you a chronological rundown (highlights only of course). I started at 20 mg a night. Immediate relief of IBS symptoms- nausea, severe abdominal pain. As I have posted elsewhere, I used to routinely miss days at work because the nausea was too severe to take public transportation. The last time that happened in fact was the day I started nortriptyline.Not long after this, I noticed an increase in emotional agitation. I quit my job during my first week on nortrip. The work problems had been brewing a long time- basically, I wanted to advance in the company, and was exremely frustrated that this wasn't possible. So I left that position. In the wake of the emotional disruption, I noticed a change for the better- my writing was getting clearer and more coherent. This was the first POSITIVE I had noticed from the TCA (besides the IBS relief), and it encouraged me to continue even though the next few months were difficult. Eventually I landed a job elsewhere in the company and that helped some.
Also, as I slowly titrated up, my sleep patterns SLOWLY improved. Chaotic sleep patterns were always a hallmark of my disorder. This was another important positive from the nortrip. I should add that the support I received from my neuropsychologist and pdoc during this time was crucial. They believed they had seen improvement from the nortriptyline and my pdoc said it was emotionally 'normalizing' me. To me, on the inside, it was like watching a glacier melt. Imperceptible change, then something comes crashing down out of nowhere. Frustrating and inspiring at once. I am glad I stuck with it. I think what helped (and still helps) is that I always felt that the nortriptyline was part of MY OWN plan to get better. There is a strong power of auto-suggestion in these things, I believe.
>
> > The clarity Strattera brings changes the nature of the anxiety somewhat- I become exquisitely aware of exactly WHY I'm becoming anxious as the process unfolds, and this should be a good thing, but it's an 'awareness' that resembles the pain from a throbbing nerve in an especially sensitive place.
>
> Ouch. I guess whether it's a good thing or not depends on how much control you feel you have to change the circumstances surrounding the anxiety.
>That's a good point. During my 'deactivated' state I always felt as though I had only a tenuous control over my body and my actions. I have a stronger control now but I find it difficult to control the physiological reactions of anxiety when in the presence of others. I had a near-meltdown this week when invited to speak with some of the administartive staff. One of my superiors wound up encouraging me to take 'deep breaths' to calm myself down. As a matter of fact I have been doing breathing exercises all week as directed by my CB therapists. It helps somewhat in non-stressful circumstances, but i feel at this point that the social phobia is a disorder on the magnitude of my depression and ADHD- it has caused the loss of jobs, relationships, and professional opportunities. I believe in fact that I could fairly be said to have avoidant personality disorder. And I am tired of having lost so much to this disorder, so I am determined to get this properly treated. I have found time and again that the owner of a particular brain is the one with the most insight in how it should be properly treated.
> > I'm going to see if I can try Klonopin for the social anxiety. I have seen more evidence of efficacy in severe social phobia for that drug of anything short of a MAOI.
>
> That sounds like a good idea. Do you ever have panic attacks?I used to panic at the onset of abdominal pain/nausea- using right after finishing a meal. Also stressful social situations, like the one I described above, have caused panic.
>
> > Maybe you could describe your experiences with Strattera in more detail? You had said your depression was also of the 'deactivated' kind.
>
> Yes. It is extremely anergic. When I first added Strattera to my other drugs, I gave it virtually no chance of working. Then, about three weeks into treatment, I began to respond to it in a big way. The response lasted for only a few days, with hints of improvement remaining for about a week. Now, nothing. I worked up to 120mg, but began to have problems staying awake after about two weeks. So, I have returned back to 80mg. Strattera continues to make me feel mildly "spacey", and blurs my vision, so I really don't want to be on it if it is not going to do anything positive.
>
Of course not. Just one question- do you take the Strat all in the a.m., all in the p.m., or split? Maybe if you took it all at night the sedation would be less trouble. It's odd that Strattera has such a short half-life, but apparently a long duration of effect.
> > Do you also get severe anxiety? Does the Strattera worsen or improve sleep and eating patterns? or do anything to improve motivation?
>
> During the first and second weeks, Strattera definitely reduced my appetite. I lost 5 pounds very quickly. Thereafter, it returned to normal. I don't think it has contributed at all towards weight gain. When I received an antidepressant effect from Strattera, all aspects of my depression improved, including anhedonia and motivation. It was great!I can imagine. I have also lost a couple of pounds to the Strattera. It made me ravenously hungry the first week, then reduced my appetite. I wish Strattera could recover the magic it had for you. Have you discussed your response with your pdoc? does he or she have any ideas?
>
>
> > Have you tried any psychotherapeutic or cognitive approaches?
>
> Yes, and I continue to use them whenever I feel the need. Unfortunately, my depression is so severe, that it greatly slows and impairs cognition to the point where I cannot process very much new information. Psychotherapy is not generally very productive for me. I have no real issues to deal with other than how this brain disorder has ruined my life and what I can do to minimize the damage and remain constructive.
Your cognition seems fine on this board, at least. Maybe you're saying you have flashes of lucidity followed by brain fog? That was sort of the pattern i struggled with. I felt like I couldn't rely on my brain to do what it needed to in most circumstances. And I'm deathly afraid of that feeling, in truth.
>
> > Are there comorbidities (e.g, social phobia, panic disorder, OCD,
> etc.)?
>
> I do have some social anxiety. Depressed mood and social anxiety were prominent during the early years of my illness. As I got older, they have been replaced by anergy and cognitive dementia.
>Again- no sign of dementia here. But if that is an issue, have you researched Alzheimer's meds? My own thought, not that I know much about it. is that the so-called 'nootropics' would be bad for depressives because they are pro-cholinergic. What about deprenyl? That one actually seems more promising for neurodegenerative disorders AND depression.
> Thanks for the insightful questions and input.
>
>
> - Scott
>You're very welcome. I appreciate this opportunity to exchange experiences and thoughts.
z
>
Posted by Gale Fox on August 30, 2003, at 11:57:38
In reply to Strattera for depression. Any success stories?, posted by SLS on August 21, 2003, at 10:29:07
If it offers any encouragement, I had an extremely good response to Strattera for depression at 4 weeks, then lost it until I went up in dosage. And, unfortunately, the response wasn't as dramatic the 2nd time around. I'm currently taking 100 mg Strattera & 100 mg Wellbutrin, all in the morning.
gale
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