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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by circusboy on July 25, 2006, at 17:58:51
Well, clearly I *can* stop. And I have, several times. I just miss it so much when I'm not taking it. It always starts out great, then after about five days it makes me un-social, sad... generally dysphoric.
But it's the only thing that's stopped the "itching" in my head, the confusion and paralysis in the face of minor decisions, the erratic moodiness... It's restored my capacity to write analytically, to keep a few ideas in my head at once like I could before my first major diagnosed depression nine years ago... And again, it stops the itchiness (which isn't just a metaphor).
I do worry that I've developed some sort of dependence. Last time I quit I went through five days of total lethargy and mental dullness like I don't think I'd ever experienced. But maybe that's another thread for another board.
From the older Strattera threads I've read here, it seems the Strattera-induced depression doesn't diminish over time. So I'm going to have to quit again.
I'm just not sure what to do next. My last "trial" before Strattera + Ritalin and after nortriptyline + Ritalin was just plain Ritalin, 10mg, three times a day. I seemed to be doing...fine? I can't remember now. Either way, something did make me "ask [my] doctor about Strattera," and it wasn't the commercials. I blame Racer. (Not really ;))
I mean, even when I'm doing pretty bad, I can hold a job. I've even started going back to school (one class at a time, but still), I have a couple of friends. In other words, I function fairly well. So why do I keep up the drug thing? Am I just on some level unwilling to give up a certain identity?
I know, you can't answer those questions. Still. I'm Strattera-dysphoric, and more ambivalent about meds than ever. After my bad nortriptyline experience, I was sure I was through with all of this. Maybe I should've held onto that feeling.
-cb
Posted by Phillipa on July 25, 2006, at 22:42:39
In reply to Strattera makes me depressed. Why can't I stop?, posted by circusboy on July 25, 2006, at 17:58:51
I guess call your doc and tell him you want to switch back. Love Phillipa
Posted by circusboy on July 26, 2006, at 10:35:30
In reply to Re: Strattera makes me depressed. Why can't I stop? » circusboy, posted by Phillipa on July 25, 2006, at 22:42:39
I know what I need to do. I guess I needed to whine. Maybe I should start a blog to contain my whining to one place. :)
Stupid kappa-opiate partial agonist metabolite.
Could someone please make us a better NRI? One that doesn't make you depressed (Strattera) or stupid (nortriptyline) make your heart thump out of your chest when you're trying to sleep (desipramine)?
> I guess call your doc and tell him you want to switch back. Love Phillipa
Posted by silvercoin on July 26, 2006, at 13:08:46
In reply to Re: Strattera makes me depressed » Phillipa, posted by circusboy on July 26, 2006, at 10:35:30
> I know what I need to do. I guess I needed to whine. Maybe I should start a blog to contain my whining to one place. :)
>
> Stupid kappa-opiate partial agonist metabolite.
>
> Could someone please make us a better NRI? One that doesn't make you depressed (Strattera) or stupid (nortriptyline) make your heart thump out of your chest when you're trying to sleep (desipramine)?
>
> > I guess call your doc and tell him you want to switch back. Love Phillipa
>
>I found Strattera to be annoyingly sedating in the daytime, while also giving me insomnia. Nortriptyline was intolerably sedating for me and also caused cognitive difficulties. Desipramine worked relatively well for me (as an antidepressant). I did suffer tachycardia and a number of other anticholinergic effects, but it was overall more tolerable than Strattera. I believe you would find NRI Vivactil/protriptyline to have the same or worse cardiac effects than desipramine, but for those who can tolerate this drug's severe anticholinergic effects, I think it has wonderful therapeutic properties. You could perhaps try Provigil, but this is expensive and may not work as well as Ritalin, which is a good and inexpensive ADD drug.
Todd
Posted by circusboy on July 26, 2006, at 13:28:53
In reply to Re: Strattera makes me depressed, posted by silvercoin on July 26, 2006, at 13:08:46
Todd,
Thanks for your response.... it's good to have your experiences confirmed.
Through my stuttering Strattera trials (started and stopped, tried different dosing times and amounts) I have been taking the Ritalin as well. Though generally less. Strattera seems to even out and even potentiate the Ritalin somehow -- I don't crash nearly as hard or as soon.
I've thought of mentioning Provigil to my pdoc next, but... Eh. This last six-month round of empirical trials has worn me out.
Anyone know if the amphetamines promote more norepinephrine release than methylphenidate? Maybe dex or Adderall are worth trying? But again... eh.
Maybe I should just join linkadge et. al. over on the Alternative board.
-cb
Posted by jealibeanz on July 29, 2006, at 10:17:11
In reply to Re: Strattera makes me depressed » silvercoin, posted by circusboy on July 26, 2006, at 13:28:53
Strattera can cause depression? How so? Is this common? It was once intended to be an AD and is still considered by some to be one, just not recognized by the FDA as such.
Maybe I should consider stopping my Strattera if it may be adding to my depression. I also have horrible insomnia and anxiety,(so I'm taking Lunesta and Xanax) which I know it doesn't help with.
I remember having a huge burst in energy, motivation, and concentration when I first began it 5 months ago. That has since subsided. I couldn't sleep for the first 2 weeks and suspected it added to anxiety, but since I'm prone to both, it's hard to tell.
I'm in college and need to study a lot.I just worry that stopping will make me tired, lathargic, and unmotivated. I just worry that stopping will make me tired, lathargic, and unmotivated. Part of me wonders if increasing the dose would help, while the other part wants to go off completely.
Posted by circusboy on July 29, 2006, at 15:28:52
In reply to Re: Strattera makes me depressed, posted by jealibeanz on July 29, 2006, at 10:17:11
Judging from the Strattera threads on this board, it seems pretty common. Wasn't enough to keep me from trying it, though. :P
It seems Strattera's primary metabolite, 4-hydroxyatomoxetine, is a partial agonist at the kappa opiate receptor. This can lead to some pain relief (I did have fewer headaches on it, though that could be a noradrenergic effect) and ... dysphoria. Zeugma says it better than I could in this great post from a few years ago:
http://www.dr-bob.org/babble/20040821/msgs/380862.htmlI have an initial burst of concentration and energy when I (re)start Strattera, too. Within a week, though, I have even less energy than before I started, and my motivation has disappeared -- mostly due to an onset of serious anhedonia. Nothing seems worth doing. People seem like too much effort. I don't remember who it was, but someone around here said that he quit Strattera for financial reasons and before too long his friends were remarking on how he was optimistic again. It sort of scared him that the drug had had that kind of subtle but significant effect on his personality.
I (obviously) have some concentration issues as well, and a history of depression. We'll see what happens next semester, but I'm finding Ritalin alone (+ a few supplements) to be an adequate, if imperfect, remedy.
-cb
Posted by jealibeanz on July 29, 2006, at 16:27:36
In reply to Re: Strattera makes me depressed » jealibeanz, posted by circusboy on July 29, 2006, at 15:28:52
How do you feel when you stop taking it? I have finals for the next 2 weeks, so I'm not sure I should D/C yet if it will make me tired. I doubt I'd have major discontinuation symptoms since I've quit all AD's cold turkey, including Paxil and Effexor which are supposed to be the worst.
Posted by alohashirt on July 29, 2006, at 20:52:46
In reply to Strattera makes me depressed. Why can't I stop?, posted by circusboy on July 25, 2006, at 17:58:51
I took Strattera for a year for inattentive ADHD. It had some effect on my distraction. At the same time I slowly became sad. I remember wondering if I had always wondered about dire fatalistic accidents. Because of a vacation and an insurance hiccup I stopped Strattera for two weeks and felt a surge of optimism and energy that continued. The scary part was that I didn't have the insight to realize the effects of this medecine as they slowly occurred.
Never again.
Posted by circusboy on July 29, 2006, at 21:31:04
In reply to My scary Strattera experience, posted by alohashirt on July 29, 2006, at 20:52:46
From my last post:
>I don't remember who it was, but someone around here said that he quit Strattera for financial reasons and before too long his friends were remarking on how he was optimistic again. It sort of scared him that the drug had had that kind of subtle but significant effect on his personality.
>Hey, so it was you! Thank you for that post, the original one... if you hadn't written it, it might've been months more before I listened to myself about what Strattera was doing to me.
The more subtle effects of these drugs are what frighten me more than anything. I appreciate the TCA's for this reason: at least they lay it all out up front. The side-effects of the SSRIs (including Effexor) and Strattera are insidious.
-cb
Posted by circusboy on July 29, 2006, at 21:59:54
In reply to Re: Strattera makes me depressed, posted by jealibeanz on July 29, 2006, at 16:27:36
> How do you feel when you stop taking it? I have finals for the next 2 weeks, so I'm not sure I should D/C yet if it will make me tired. I doubt I'd have major discontinuation symptoms since I've quit all AD's cold turkey, including Paxil and >Effexor which are supposed to be the worst.
I was lucky with Effexor, too... For me, Zoloft withdrawal was the worst. Interestingly, I have felt mild withdrawal ~1 week after quitting Prozac. Anyway.
So Lilly's got a study saying that people can quit Strattera no sweat. I'm not so sure. The first two times I quit Strattera I found myself in a blinkingly anergic state where I didn't even have the energy to *try* to think. Conversations (not that they're ever effortless for me!) were nearly impossible. The last time I quit, I added in two 500mg l-tyrosine capsules before breakfast. This softened the landing significantly. I felt pretty much back to normal within two days.
I don't think it would be irrational to hang onto the Strattera until you're done with exams, however. I didn't d/c until my last class was over.
-cb
Posted by linkadge on July 31, 2006, at 18:42:55
In reply to Re: Strattera makes me depressed » jealibeanz, posted by circusboy on July 29, 2006, at 21:59:54
Activation of the noradrenergic is involved in the recolection of memories with emotional content.
Linkadge
Posted by jealibeanz on July 31, 2006, at 19:53:17
In reply to Re: Strattera makes me depressed, posted by linkadge on July 31, 2006, at 18:42:55
Does that mean increased depression?
Posted by jealibeanz on August 3, 2006, at 15:37:50
In reply to Re: Strattera makes me depressed, posted by jealibeanz on July 31, 2006, at 19:53:17
OK, maybe it does... I just took my Straterra after stopping for 5 days. I was desperate to see if maybe it would reduce the insomnia and anxiety/depressiosn. Now can't stop crying (big problem since I have class in a few minutes). Could also be due to the weeks for 2 hours sleep/night and major stress. Ughhh... don't know what to do, but obviously I shouldn't be playing with this on my own.
Posted by jealibeanz on August 5, 2006, at 12:45:53
In reply to Re: Strattera makes me depressed » jealibeanz, posted by circusboy on July 29, 2006, at 15:28:52
Does the increase in available NE result in decreased Serontonin levels? Would this be the reason for depression?
Posted by SLS on August 7, 2006, at 9:54:01
In reply to Re: Strattera makes me depressed, posted by jealibeanz on August 5, 2006, at 12:45:53
> Does the increase in available NE result in decreased Serontonin levels? Would this be the reason for depression?
I don't know, but sometimes it doesn't make sense to play neuroscientist. Not even the best of them is likely to be able to answer your question with certainty. For me, reboxetine, another NE reuptake inhibitor, made me significantly more depressed. Yet, desipramine has helped me. Can you see a pattern here? Of course not. You have done the right thing. Trial and error has demonstrated to you that Strattera is not the right drug for you for reasons that are not yet understood. I would not generalize your experience with Strattera and say that all NE reuptake inhibitors will be bad for you. Some people do well with reboxetine.
Good luck.
- Scott
Posted by jealibeanz on August 7, 2006, at 10:28:28
In reply to Re: Strattera makes me depressed, posted by SLS on August 7, 2006, at 9:54:01
What is reboxetine?
I never noticed the increased depression unil I started and stopped Straterra. I was mildly depressed when I started it and had a lot of anxiety, so it would have been hard to pinpoint anything. I guess I need to tell my doctor about the straterra experiment I did on myself while depesperate to help my insomnia.
I feel a little silly because I know very well I should be starting and stopping meds like that. Maybe the increase in depression is just from the fact that my brain chemicals got seriously out of balance when I abruptly when on and off. I know that it did help with concentration when I first began it, but really not sure that it does anymore.
And, unfortunately due to my lack of sleep, anxiety, and depression, my concentration and study habits are just not up to par. I've done fairly well so far, but bombed a couple exams at school. There's not much leeway. I might get kicked out. I was considering leaving anyway, but not for academic reasons. Sucks when you have to give up a former passion. :(
Posted by mentallybill on August 11, 2006, at 10:59:51
In reply to Re: Strattera makes me depressed, posted by silvercoin on July 26, 2006, at 13:08:46
I became extremely depressed when I was taking Strattera and became suicidal. This stuff is the worst med I have probably ever taken, but I guess it works for some people.
Posted by jealibeanz on August 11, 2006, at 11:44:06
In reply to Re: Strattera makes me depressed, posted by mentallybill on August 11, 2006, at 10:59:51
Have you found an alternative to Straterra?
Posted by KayeBaby on August 11, 2006, at 20:41:23
In reply to Strattera makes me depressed. Why can't I stop?, posted by circusboy on July 25, 2006, at 17:58:51
I had trouble with strattera too.
Worked ok for a time (couple of months)
Then it turned on me. I felt ill and also like a zombie. Whites of my eyes yellowed.I thought this link might be of interest.
It is about adverse reactions and possible wrongdoing by We Lie.....er I mean Eli Lilly.http://www.injurytalk.com/t4696-Strattera.html
Kaye
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