Posted by spoc on March 21, 2004, at 12:57:15
In reply to Re: Adult Male on Straterra, posted by New2Meds on March 21, 2004, at 10:40:09
Hi New2Meds, I am not on Strattera but at the bottom of this I have pasted some very interesting dosing comments I came across, that I was going to check out further if I ended up trying it. I am an adult female and haven't tried all that many meds of any kind either. A pdoc recently put me on Ritalin based on a conversation only, and I suspect it's not agreeing with me and may not even be the class of meds I need, or at least by themselves. I thought of Strattera since I have seen mention that for some it has an anti-depressant effect too.
I didn't look into anything about the "standing" of the website I copied the following from, but the info on it seemed worth investigating. Note that the site author certainly shoots from the hip, which I like if credible too! He and his friend are patients at the Amen Clinic (haven't read the whole site, and don't know if he claims that all or part of his info derives from there). The site is called crazymeds.org:
-------
DOSAGE: ...This is where people get completely hosed with Strattera. This med can work wonders for more people if they and their doctors would just have some goddamn patience!!! The initial dosage is 18-25 mg. Got that? 18-25mg. Not 40mg. Not 60mg. 18-25mg. Unfortunately some bean counter in the bowels of Eli Lilly's accounting department determined that it was more profitable to restrict the size and number of 18mg and 25mg sample packs (only four capsules in each now), and let some people just fail with this med. So most of the sample packs sent out now are only 40mg capsules. It's more profitable for Lilly if Strattera doesn't work for everyone it could work for!! Isn't that crazy? Even the Amen Clinic where Mouse and I are treated gets very few of the 18mg and 25mg sample packs, and only because they treat kids! And they're in real tight with their Eli Lilly sales rep! Anyway, the highest an adult should start at is 25mg a day and just stay there for at least two weeks. Wait at least that long before going up to 40mg, and then only if it's going to make a big difference, not a small difference. Here's why - if you don't have enough norepinephrine to reuptake, Strattera starts going after MAO. And not in a good way, like an MAOI would. That is why people will feel wiped out when they take these outrageously high starting dosages. Then if they go back down to the previous dosage, they still feel crappy and give up. Well, it takes about two weeks to get over taking too much Strattera. Once again, have some freaking patience. Anyway, once you get past the 25mg a day barrier, dosages are as follows: 36-40 mg a day, 50 mg a day, 60 mg a day, 80 mg a day, 100 mg a day. Doses are usually divided between morning and afternoon, but some people get drowsy with Strattera, while others get hyper, so the dosing can be really flexible. I take my 40mg all in the morning.DAYS TO REACH A STEADY STATE: For all of the extensive pharmacokinetic testing Lilly did and data they published in Strattera's PI, far better than that done for most meds, they neglected to actually publish the steady state figures! I truly commend Lilly for its research. From reading the PI sheet you can tell they went above and beyond to get good data on any dosing differences required based on age, gender, ethnicity, taking Strattera with meals and trying to determine the difference between normal and poor metabolizers of the medication. However it looks like we've got information overload! With Strattera's wacky double metabolism (see half-life below) and identification of the poor metabolizer population, the numbers may be too variable to pin down a steady state. I couldn't find any number for it anywhere else.
========
> When I first started Straterra, the first few dats were very intense. I was told by my doctor to take 40mg for seven days and increase to 80mg. I guess my ADD was kicking in, because I ended up taking 80 mg for seven days and then decreasing to 40 mg...after a week on the 40mg dose, I went to my Dr. The Dr. was holding back a laugh I could tell but I suggested I try a 60mg dose and see how that worked. > > Needless to say, when I initially started with the 80mg dose for a week I had several side affects.
poster:spoc
thread:133458
URL: http://www.dr-bob.org/babble/20040319/msgs/326701.html