Posted by The Bean on October 22, 2003, at 18:06:42
In reply to Straterra approval., posted by scoper on December 28, 2002, at 2:19:34
Hello all,
Wanted to post my experience with Strattera - as it has been very positive overall - albeit difficult to get to the optimal dosage. I preface all of this with the fact that I have THE BEST "team" to work with, and I do so at a facility that specializes in treating both adults and kids with ADD/ADHD. I see my PhD Doc (therapist) at this facility every 4-6 weeks and my MD Doc (Family Practice Physician) a minimum of 4x a year. They are VERY good about listening to my experiences and allow me flexibility to "tinker" slightly with my meds. I see them more often if were "tinkering" a lot - like adding new things to the mix - and have seen one or the other of my docs every 3 weeks through the process of "testing" Strattera. I also attend some of the things the facility offers, like Tai Chi classes and educational seminars presenting research in the field.
I was diagnosed with ADD - Inattentive Type about 5 years ago as an adult, at age 37. Have tried a million different combinations of things . . . but I'm currently taking 75mg Adderall XR in the morning after breakfast and recently (8 weeks ago) added Strattera to the mix and am delighted with the results! We've settled on a low dosage of 10 mg a day and I take it at bedtime. I wake up more alert, and sleep about 1 hour longer than I did with just Adderall XR alone, so I'm now getting a decent 6.5 hours a night. Usually a much higher dose of Strattera is recommended, but that didn't work for me. I'll give you the whole history of drugs and you can see if it's helpful to you!
Ritalin made me anxious (like for no reason I wanted to bang my head against the table because I somehow felt that might help) and creepy (like I wanted to crawl out of my skin). Because of THAT experience, I never wanted to try Concerta.
We next tried Adderall, which was good, but didn't last long enough. Started Adderall 40mg in the am and Ritalin 20mg in the afternoon for about 2 years. Adderall's 1/2 life kept me awake too long at night, and for some reason, when I started the day with Adderall and took the Ritalin later in the day, I didn't get the "anxious/paranoid" feeling I had taking Ritalin alone.
Started on Adderall XR when it came out and it was REALLY great for several years, but over the whole 5 years on medication, I've lost about 15-20 lbs (I am NEVER hungry and have to set my Palm Pilot to beep and remind me to eat - and I do - 6 small meals a day!) and after I got down to about 110 lbs (I'm only 4'11", so it's not as thin as it sounds!) the Adderall XR began to make me feel edgy and impatient all the time. It was MUCH worse in the week before my menstrual cycle.
We tried adding 2 different anti-depressants to help with the "mood dysregulation" and depression issues around my cycle. Effexor, which was great at first, but seemed to build up in my system and I got progressively sleepier and more sluggish the longer I took it. Then Wellbutrin - and on the Wellbutrin, I didn't sleep for 4 days straight, got MORE depressed and actually felt suicidal. I stopped the Wellbutrin at that point : - )
So we tried Dextrostat, thinking it might take that "edge" off, and it did, but I never felt like I had the mental clarity I got with the Adderall XR, and it didn't change the "hell week" experience before my period all that much, so went back to Adderall XR and we added the support of Celexa tablets. Taking Celexa all the time though was too much (it makes me VERY sleepy - even at low dosages) similar to the Effexor issue. So my MD doc suggested we try LIQUID Celexa which I now take 1/2 tsp of ONLY the 10 days before my period is supposed to start. I've taken as much as 1 tsp at times too. I just count 19 days from the start of my last cycle, as I have a 29 day cycle and start taking it. At that dosage it is technically not at a "therapeutic" level - so it supposedly wouldn't have any effect - but it TOTALLY evens out the "witch" behavior and crying hysteria that I used to have, so - conclude what you will!
Six weeks ago, we decided to try Straterra, since I was still feeling the "edgy" with Adderall XR, but had decided to live with it! I was to begin with 18 mgs, and was supposed to increase the Strattera while decreasing the Adderall XR. I was advised NOT to cold turkey on the stimulant, but to ramp up the Strattera and ramp down the stim.
The FIRST DAY on 18 mgs and my full dose of Adderall XR was AMAZING!! I had the 3 most productive, happy and "smart" days I've had in 20 years. Then, I started the ramp up/down process and it went to hell in a handbasket! 24 mgs of Strattera and 75 of Adderall and I was MEAN. 24 mgs of Strattera and 50 of Adderall and I was fuzzy and slow. 40 mgs of Strattera and 50 mgs of Adderall and I was sluggish and "dopey" - like I feel on antihistamines (like I can't put two sentences together, am clumsy and tired, etc.) 60 mgs Strattera and 50 of Adderall was even worse for the sluggish/dopey feeling, so we stopped the Strattera to start over again and get feeling of the 3 good days back. It took about 3 days for all the effects of the Strattera to clear my system.
Starting over, after a week at 18 Strattera/75 Adderall, I was not sleeping well and was very impatient and snippy. We tried it without adding Celexa for those 10 days before my period the first time around and that was a BIG MISTAKE! Dropped the dosage to 18 mgs every other night before bed and found that day 1 was still edgy, but on day 2 was not, AND I still had the increased clarity from before. I added Celexa this time for the 10 days in my cycle and it was great - except I think I need to keep taking Celexa all the way through my cycle. Stopping on the day my flow starts seemed to trigger a migraine (too fast a drop in my Seratonin level, I suspect!) next month a new adventure!
Three days ago, I started taking 10 mgs Strattera at bedtime, and so far, so good!! My PhD doc tells me I'm a "statistical outlayer" (which I suppose is a polite way to say that I'm a wierdo) but apparently using Strattera this way is not the "norm" - but nothing I've ever tried is, so I'm just delighted to have what feels like a great combination (at least for now!)
Hope this helps someone!
The Bean
poster:The Bean
thread:133458
URL: http://www.dr-bob.org/babble/20031021/msgs/272028.html