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Re: Straterra - Back to Ritalin SR - Bob

Posted by LibbyH on April 1, 2003, at 15:43:19

In reply to Re: Straterra - Back to Ritalin SR spinning LibbyH, posted by not exactly on March 29, 2003, at 18:17:14

> Sorry, but I am completely confused by your message.

Bob, sorry for the confusion. I had been taking the following combination for two years with great success for ADD & what my pdoc call Chronic Major Depression:
Ritalin SR @ 40-60 mg depending on my work hrs.
Wellbutrin SR 300 mg
Prozac 20 mg

I started waking developing sleep problems, waking early & being unable to go back to sleep. Eventually, I started sleeping 10-14 hrs. a day, but never felt rested. I pushed myself to function, but nothing was fun anymore. Then, the oddest part. I started
waking in the middle of the night with panic attacks. Couldn't breathe. The doc thought changing the antidepressant would help. He was never very crazy abous prozac with me because lack of motivation has been a constant problem since he began seeing me five years ago, so he changed the antidepressant to Lexapro. He thought since I was having panic attacks, it might be a good time to try a nonstimulant medication for my ADD, so he asked if I was willing to try Straterra too. Since it was more convenient, I jumped at the chance. So he changed me to:
10 mg Lexapro now titrated to 20
40 mg Straterra titrated to 80
and added
.5 mg Klonopin twice daily for panic

I stopped the WEllbutrin ^ Ritalin cold turkey and within two days of titrating to 80 mg of Straterra, I found myself thinking about killing myself almost constantly, always by sitting in the garage with both cars running, and always carefully planned for times when no one woudl be aroudn to find me. These were not pleas for help. It was more like I'd think, "WEll, I'm about finished with life, so I guess I'll just kill myself. It's no big deal. No one will be home for hours." SO I'd leave a little note in an envelope on the front steps for my family not to come in, to call the police, that I was int he garage & I'd go in the garage & start the cars. Then, somewhere between 15 minutes to half an hour later, it's like I'd wake up & think what the heck am I doing this for? This is insane! I finally called my doc & said, "I think I need to be in the hospital." Even there, they treated the problem like a psychological one except that he did have me evaluated by a neurologist who put me on Topomax for atypical migraines I've had my whole life & had like gangbusters in the hospital. My pdoc said he thought that would help with the suicidal impulses, but it didn't. I had a low grade migraine for severtal weeks, but that's gone now & the Topomax does seem to be helping both headaches & stablizing my moods a little.

It wasn't until two weeks later & I was still having the problem & there was no psychological reason for my level of distress that my pdoc started looking closer at my meds. He finally called in my family one at a time & me and asked each of us what we thought my single biggest problem had always been. It was unanimous, "IMPULSIVITY!" So he said the Ritalin seemed to be keeping that in check at least, so why not try going back to it & keep me on the Klonopin for panic attacks & see how that does?

So now I'm taking, daily:

40 mg Ritalin SR regardless of work hrs.
125 mg Topamax for headaches AND moods
40 mg Lexapro for depression
.5 mg Klonopin twice daily for anxiety

This week, he added
2.5 mg of Zyprexa at bedtime because my depression always seems to cause difficulty with sleep first and also because my depressions are somewhat atypical in that they have an agitated component. When I get low on energy & fatigued, I tend to push myself to continue funtioning & end up snapping at people, getitng argumentative, etc. I am not Bipolar because I've been through all the trials with those drugs and get MORE, not less agitated on them.

Hoep this helps clear up why my pdoc blamed my agitation on the Straterra.

Honestly, I didn't FEEL worse on Straterra. I FELT better... clearer, more energetic, etc. than on Ritalon, but my family is telling me they are thanking GOD I'm back on Ritlin SR right now.

Thanks for asking.




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