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Re: Keep the Strattera updates coming!-appetite

Posted by Gale Fox on June 10, 2003, at 8:06:02

In reply to Re: Keep the Strattera updates coming!, posted by froggyanna on June 1, 2003, at 15:26:08

A word about Wellbutrin & Strattera and appetite/weight loss. One of the side effects of Wellbutrin is weight loss. I lost 30 lbs in 4.5 months on Wellbutrin (that was the 30 lbs I'd gained on Paxil over the past 6 years).

My pdoc tells me that appetite supression is one of the side effects of Strattera, and I'd have to ssay that's been true for me also. So I suggest monitoring your weight and food intake if you're on one or both of these meds. (I'm currently taking 80 mg Strattera & 100 mg Wellbutrin)

I started taking 40mg Straterra on May 22, so that's 10 days. I had a few side effects (slight queasiness, slight dizzyness) but they wore off in a couple of days. I actually got a slight little "high" the first day, but that went away after about two hours. In the afternoons, I experienced severe tiredness. Being unemployed, I could nap through that.
> I have also been taking Zoloft, various dosages for several years. Right now I am at 100mg and that seems to keep the tendency to depression very nicely alleviated. And I am taking .2mg Levoxyl for Hashimoto's hypothyroidism for about a year now (Synthroid for many years before that).
> Before starting the Straterra, after my first visit with a psychiatrist for the treatment of ADD, I started out with Buspar (buspirone) on April 30, so that's about a month now. The doc has experience with using buspirone to treat snoring and sleep apnea, thus allowing for better sleep and the possible reduction of ADD symptoms due to better-quality sleep. I don't think that it is improving my snoring at all -- I continue to sleep with a CPAP machine (continuous positive airway pressure). And since I have been fairly successfully using CPAP for many years, and supposedly sleeping well because of it, and I still struggle with symtpoms of ADD, I've concluded that sleep apnea (in my case) is NOT the trigger for my ADD.
> But I'm still taking the Buspar, because I think it is working well with the Straterra in helping me to get a little more "regulated." That started even before the Straterra. I've noticed a slight increase in my ability to get going in the morning and a greater willingness to just DO the routine little things that one has to do every day that I typically argue with myself about (about whether I really want to do them or not). A lot of that weary emotionality about doing things seems to be fading. And that's a good thing! Oh yes, and I've finished reading two books!! I've almost never finished a book in my LIFE!
> But I'm still feeling unwilling to tackle some larger projects and chores that are waiting for me. I still feel procrastination and scatteredness as a major element in my days, and that's what I want to change. At this point, it's crucial, because I need to find a job. We are selling our house (if someone will buy it!) because we want to find something more affordable -- my lack of income has become a crisis. Because of being laid off three times in 5 years, and because ADD has always caused me extreme strain in performing well at work, I think I've got a mild version of post-traumatic stress disorder! I need to find some kind of support, whether it's medical or ADD coaching or both, to get me to focus in on preparing a resume and preparing to go back out into the world. At this moment, I can hardly even begin to think about that.
> Because I'm a believer that being hypothyroid can exacerbate ADD symptoms, I have been waiting to add any more Straterra until I can find out from my internist about the results of my latest thyroid tests. I've just recently found out that I may be missing the crucial T3 -- I'm only taking a T4 drug. I will be seeing that doctor June 10 for a complete physical and discussion of my test results. I think that getting my thyroid functioning well will go a long way toward offsetting some of the side effects of the psychoactive drugs (like tiredness).
> In the meantime..... I just saw my psychiatrist for the second time on May 29. I told him that I noticed a distinct drop in my appetite after starting the buspirone and continuing with adding the Straterra. He said that because of that, I might want to consider substituting Wellbutrin as my antidepressant instead of Zoloft. He said that it has less of a chance of increasing your appetite than Zoloft does (and I have really struggled with binge eating since taking antidepressants). He said that Wellbutrin will help to reinforce the appetite-reducing qualities of the buspirone and Straterra. Plus, it might keep me from participating in my lifelong habit of ripping my fingernails! He also suggested that I take Straterra at night instead of in the morning to help stave off the afternoon tiredness (apparently studies have shown that it stays in your system for about 25 hours).
> So, in summary:
> 0.2mg Levoxyl in morning;
> 100mg Zoloft in morning;
> 60mg buspirone at night;
> 40mg Straterra at night;
> Add and gradually increase Wellbutrin, 100-200mg twice a day over 10 days;
> Try eliminating Zoloft after this;
> Add T3 thyroid treatment, possibly Cytomel;
> Depending on effect of thyroid treatment, increase Straterra to 120mg max.
> That's my current "recipe," and I feel like I am on the right path. I'm noticing gradual improvement in my functioning and the side effects are not unmanageable. I am looking very favorably right now on Straterra, by itself and in combination with other medications.
> froggyanna




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