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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Aurore on October 28, 2003, at 21:59:35
I started Strattera a week and a half ago and am noticing very little difference in myself. I know I'm supposed to wait three weeks or so but so many people have reported noticing a difference within a few days or a week.
I am 22 and finally had myself diagnosed when my husband and I realized that I had some issues that were seriously impairing my life and our relationship. Major problems are distractibility, fatigue, lack of motivation, unable to settle down to sleep early/unable to wake up in the morning, restlessness as in unable to sit for long periods (hate going to movies), inability to complete projects or chores, disorganization. Most syptoms have been present since childhood. Also depression and social anxiety, but until I get the add treated I consider those side effects. It's depressing to feel like such a loser and difficult to face people when you have no self-confidence and expect yourself to always let others down. I also have racing-mind issues and easily zone out when others are talking to me. Tell me the most exciting story you can think of and still, next thing I know I'm thinking about the black hole theory (or something equally unimportant and generally spacey) and what did you just say??
The issues that concern me most are the fatigue, lack of motivation, and my inability to focus/think clearly. I just feel like I want to sit and do nothing all day, and it's like I have to have an inner battle with myself to get anything done. Even then, I'll walk to the room where the chore needs to be done and forget entirely what I'm there to do and end up aimlessly surfing the web or something. My concern is that I have felt a physical sense that the strattera is working on me, as in slight dizzyness, feeling somewhat keyed up, etc, but so far I feel lazier than ever if anything, and my mind seems to work only slightly better. My husband says that I seem less emotionally unstable lately, and my sleep has been more regular/early, but otherwise he hasn't seen any changes. I'm afraid that because these meds are made for adHd, and I have add-without-the-H, that they might have a completely undesirable sedating effect on me. I took 25mg of Strattera from Mon-Fri and 50mg from Sat-today and will continue on 50 as far as I know (I am 120 lbs).
If I still feel this way when I go back to the doctor in a few weeks what should I consider? Supplement the Strattera with stimulants, maybe? My mother dated a man long long ago who abused Ritalin, and after her stories I am loathe to take it (or maybe I'm kidding myself and the Strattera is really just as bad).
I like to be prepared with the facts when I go to the doc because it IS a low-income clinic and those doctors always seem in a hurry to get done with you and you then have to wait three more weeks if the meds aren't right. So any and all suggestions and related experiences are very much appreciated.
Thanks!
Aurore
Posted by tensor on October 29, 2003, at 1:53:03
In reply to Strattera may not be right - what now? Supplement?, posted by Aurore on October 28, 2003, at 21:59:35
Hi,
I can only speak for myself, but all meds i've tried i have always could tell if they are going to work or not within a week.
when i read your post, i recognize myself. Always fouling myself thinking: tomorrow(the BIG day when everything will be different), i will do all the homework and go training(as i've promised my instructor hundreds of times), but it ends either in the bed or in front of my computer. lack of motivation, anxiety, soc phobia, thousands of thoughts in your mind when you have to focus on one. this is particulary troublesome for me because i study.
i find benzos like klonopin pretty good to handle this because it slows down my overspeeded brain and it is also working for social phopia, but it might be depressant, as you can read in my post a few rows down. xanax might be an alt.
I've tried a med that is pretty similar to strattera, which is edronax(reboxetine), they are both strong noradrenaline inhibitors. I didn't do much for me, it antidepressed me for a month but boosted the focus problem. So, basically im in the same boat as you are.
Have you tried any SSRI´s? Wellbutrin(buproion) could be a choice, it´s used to treat ADD and depression. Tofranil(imipramine) could also be a chioce to consider.Best luck, and please lemme know what your pdoc prescribed you :)
/tensor
Posted by loolot on October 29, 2003, at 10:36:09
In reply to Strattera may not be right - what now? Supplement?, posted by Aurore on October 28, 2003, at 21:59:35
Hi there!
Your symptoms sound similar to my own. I have always been tired, never could concentrate well, and depressed.
I am on straterra now as an adjunct to Wellbutrin, and I havent found it to be much help, either, although I am sticking it out.
If I were you I would stress the depression and the need for energy to your docs more, and my sense is that wellbutrin may be the perfect med for you. Unlike the SSRIs, wellbutrin works by upping your dopamine and norepinephrine (straterra only does norepinephrine) so it gives you energy and brightens the mood w/o yucky side effects.
When I first started wellbutrin I felt really good in a normal way for once. I actually wanted to do things and socialize and I had energy and was able to concentrate more easily.
Focus on the depression first and then do ADD second if something like wellbutrin doesnt work.
Some of the ADD symtoms may be part of the depression and fatigue.
Posted by Alexs on October 29, 2003, at 14:08:39
In reply to Strattera may not be right - what now? Supplement?, posted by Aurore on October 28, 2003, at 21:59:35
First of all you have to give the Strattera time to do it's thing, about as long as an antidepressant, 4-6 weeks depending on how long it takes you to get to the recommended dose. Which maybe higher than 50mg.
>distractability, fatigue, lack of motivation...
Distractability was my main problem and Strattera difinetly helped with that, I would say about as well as Methylphenidate(Ritalin). NE Norepinephirine is supposed to help with motivation. It sounds like you have some syptoms of depression also, you may want to add an antidepressant down the line. I had side effects from Strattera most noteably fatigue which eventually went away. also my appetite lessened, it never got back to normal, been about 9 months now. Your doctor won't add on stimulants until you have been on strattera for a long enough period of time.
As far as worrying about Ritalin being addictive I think it all depends on the person taking it. I had no problem getting off it, go very slowly. If your looking to get high your probably going to end up abusing it. If your wondering why I switched from Ritalin to Srattera it was because I was having a problem with agitation and stimulants are known to cause agitation. Well I still have it but I'm glad I switched if for no other reason than being able to get refills on my scripts.
Posted by MamaB on October 30, 2003, at 5:12:16
In reply to Re: Strattera may not be right - what now? Supplem » Aurore, posted by loolot on October 29, 2003, at 10:36:09
>
Hi,
I have found the Wellbutrin to be very helpful, even over the long haul. I had to stop comparing everything to Ritalin because nither the Wellbutrin or the Strattera (almost three weeks on Strattera) work as "sharply", for lack of a better word. I read somewhere that it took at least one individual at least three months on Strattera to have any effect. MamaHi there!
> Your symptoms sound similar to my own. I have always been tired, never could concentrate well, and depressed.
> I am on straterra now as an adjunct to Wellbutrin, and I havent found it to be much help, either, although I am sticking it out.
> If I were you I would stress the depression and the need for energy to your docs more, and my sense is that wellbutrin may be the perfect med for you. Unlike the SSRIs, wellbutrin works by upping your dopamine and norepinephrine (straterra only does norepinephrine) so it gives you energy and brightens the mood w/o yucky side effects.
> When I first started wellbutrin I felt really good in a normal way for once. I actually wanted to do things and socialize and I had energy and was able to concentrate more easily.
> Focus on the depression first and then do ADD second if something like wellbutrin doesnt work.
> Some of the ADD symtoms may be part of the depression and fatigue.
>
>
>
Posted by Mid- Life Crisis on October 30, 2003, at 13:04:07
In reply to Strattera may not be right - what now? Supplement?, posted by Aurore on October 28, 2003, at 21:59:35
You really should give the Strattera more time, especially if you aren't having unbearable side effects from it. I have been on it for about a month now, going from 25 mg. to 60, and it has only been in the last few days that I could tell it was definitely working as far as helping with focus and motivation. I have ADHD (combined type) but it is also very sedating for me, so what I do is take it an hour before bedtime, and it definitely helps me sleep. It helps me get going the next a.m., and I am just now noticing that I'm becoming more productive in the daytime.(And Lilly, the manufacturer of Strattera says the adults in their trials all got 80 mg., regardless of weight. However, I really wonder whether lower weight adults need this much, as they also state that no improvement was seen in kids/adolescents when they gave more than 1.2 mg. per Kg. of weight.) At any rate, why don't you try it for at least a month or so to see if you're at least headed in the right direction. If you aren't, you can always try Ritalin or Adderall, which take no time to be effective. However, if you don't like them or cannot tolerate them--I cannot--you might then have to give Strattera a longer try and start all over again anyway. (Or have to try yet another med. that takes 5-6 weeks to build up in your system.) Like you, I was very discouraged with Strattera at first, but am glad I kept taking it. Good luck!
Posted by Snowie on November 4, 2003, at 20:05:35
In reply to Re: Strattera may not be right - what now? Supplement?, posted by Mid- Life Crisis on October 30, 2003, at 13:04:07
MLC,
My pdoc thinks I *may* have ADD, so I tried the lowest doses of Adderall XR, then Ritalin XR, and noticed a difference, but had to stop because of extreme nervousness and anxiety. I was finally given the 4 25 mg. dose of Strattera and then 40 mg. I don't know if it's doing anything but it's not hurting me either. If anything, I seem to be having a very easy time staying on my diet. I may try taking it at night just to see if it helps me function better the next day. Thanks for that suggestion.
Snowie
> You really should give the Strattera more time, especially if you aren't having unbearable side effects from it. I have been on it for about a month now, going from 25 mg. to 60, and it has only been in the last few days that I could tell it was definitely working as far as helping with focus and motivation. I have ADHD (combined type) but it is also very sedating for me, so what I do is take it an hour before bedtime, and it definitely helps me sleep. It helps me get going the next a.m., and I am just now noticing that I'm becoming more productive in the daytime.(And Lilly, the manufacturer of Strattera says the adults in their trials all got 80 mg., regardless of weight. However, I really wonder whether lower weight adults need this much, as they also state that no improvement was seen in kids/adolescents when they gave more than 1.2 mg. per Kg. of weight.) At any rate, why don't you try it for at least a month or so to see if you're at least headed in the right direction. If you aren't, you can always try Ritalin or Adderall, which take no time to be effective. However, if you don't like them or cannot tolerate them--I cannot--you might then have to give Strattera a longer try and start all over again anyway. (Or have to try yet another med. that takes 5-6 weeks to build up in your system.) Like you, I was very discouraged with Strattera at first, but am glad I kept taking it. Good luck!
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