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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 Whit on October 15, 2004, at 22:54:15
My wife has never been on any psychotropic drugs of any kind. She is generally a lightweight, and it doesn't take much to knock her out.
She decided recently that she needed to focus better at work, and she has had a difficult time with that for a while, but she has been able to compensate. Anyway, she started taking Strattera. The pdoc gave her 60mg tablets to take at night. At first, she dumped some of the powder out of the capsules so she would not start so high, but the past few nights she has taken the full 60mg.
At the beginning there were some mornings where she would be dizzy, but right now she is not really having any side effects.
However, she says she does not feel any differently either. It has been a little over a week. Shouldn't she be feeling something?
I have read that the therapeutic dosage is around 80mg, but she is not willing to ask the pdoc for an increase just yet, especially since she has not really noticed anything (except the fatigue and dizziness she usually slept off).
Any ideas?
Posted by JayDee on October 16, 2004, at 0:45:41
In reply to Strattera--time to work and dosage, posted by Whit on October 15, 2004, at 22:54:15
I started out on 25mg myself, taken before bed. the only thing I noticed was it made me DRUGGED and STUPID the next couple days. made my RLS really bad too. If I had taken 60mg to start I would have gone insane! The side effects quickly dissapeared(along with any good effects) I moved to 40mg, 65 mg, then 80mg. Today I had my first good experience with it (2.5 weeks in). I had been taking 40mg night 25-40mg morning, but last night I skipped my dose and took 80mg this morning. 45 minutues later, I felt 'drugged,' almost like I had taken some OxyContin! The rest of the day I was much more calm, patient, confident and was able to work more dilligently(sp?)... just like I had taken an opiate, coincidentally. But without the dumbing.
Based on this, it seems to be best when taken all at once, in the morning... or perhaps dosage spread morning/midday. Lets see if it lasts for me.
Posted by JayDee on October 16, 2004, at 0:53:56
In reply to Re: Strattera--time to work and dosage, posted by JayDee on October 16, 2004, at 0:45:41
just wanted to add, docs say that Strat takes 2-6 weeks for full effect, like antidepressants. But this never any sense to me at all. The increase of NE/DA in the prefrontal cortex should be immediate, and this is what helps with ADHD symptoms. I have a feeling the folks not seeing a benefit until several weeks in are actually getting relief from depression/anxiety, rather then ADHD.
This coen-sides with my finding that it's best taken in the morning.
Posted by Whit on October 16, 2004, at 8:19:12
In reply to Re: Strattera--time to work and dosage, posted by JayDee on October 16, 2004, at 0:53:56
The reason why it doesn't make sense is that Strattera, unlike most of the other stimulant-like meds for ADHD, works on NE and DA in the nucleus accumbens and not in the pre-frontal cortex.
Posted by zeugma on October 16, 2004, at 9:52:02
In reply to Re: Strattera--time to work and dosage, posted by Whit on October 16, 2004, at 8:19:12
response varies among individuals. I found that it literally starting working immediately- I became flushed, ravenously hungry, and it seemed like my mind cleared up immediately. my handwriting, normally awful, also trailed into unintelligibility (the only med that has helped my handwriting is Provigil). i do not believe that this was a placebo effect but you can draw your own conclusions.
-z
Posted by zeugma on October 16, 2004, at 9:57:20
In reply to Re: Strattera--time to work and dosage, posted by zeugma on October 16, 2004, at 9:52:02
i should add too that when the Ritalin was not working recently, I added Strattera back as a prn med. It worked as such, although I cannot tolerate its s/e for longer periods than a couple of days. i do not think this is typical, but may indicate something about my noradrenergic system (ie I respond better to noradrenergic than to dopaminergic meds).
-z
Posted by JayDee on October 16, 2004, at 15:16:47
In reply to Re: Strattera--time to work and dosage, posted by Whit on October 16, 2004, at 8:19:12
You've got it backwards. It DOESN'T increase DA in the nucleus accumbens, but rather only in the prefrontal cortex. This is why its a non-stimulant and non-addictive.
Anyways try it in th morning. one the sideeffects pass, it should work immediatly.
This is the end of the thread.
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