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Re: Strattera for ADD-I?

Posted by mtdewcmu on April 30, 2011, at 14:38:38

In reply to Strattera for ADD-I?, posted by CaffeinePoet on April 30, 2011, at 13:16:23

> Hi folks,
>
> I'm 35, and I have ADD-inattentive type symptoms. I actually have hypothyroidism, and treating that with added T3 really helped but seemed to provoke Thyroid Eye Disease, so I had to stop the T3.
>

Do you have bona fide hypothyroidism that is confirmed by a mainstream endocrinologist or internist? Because the established standard of care for hypothyroidism is levothyroxine, not T3. I know there are some people outside the mainstream promoting the idea of softer forms of hypothyroidism that respond better to T3 or desiccated thyroid, but I would not mess with my metabolism on the basis of their ideas. I took one dose of Armour Thyroid years ago, and I felt great for a while, but I couldn't sleep for the next couple days.

> My biggest problem is low motivation. But I am also not getting anywhere in my career because of being late to meetings, interrupting, and procrastination. I feel that I have been overlooked as a possible ADD-I diagnosis in the past because I am fairly smart, and it took several years of failures (job loss, course failures, etc.) after reaching more complex work, for me to seek help.
>

If your attention problems were already prominent in childhood, then it could be ADD. My life followed a similar track to what you are describing, with problems already apparent in elementary school, that I was able to compensate for more or less, but becoming more intractable later in life.

> Oh yes, and I have anxiety.
>
> I have worked with a therapist for about a year now to try to overcome these symptoms behaviorally. The hypothyroidism just complicates the pictures.
>

Anxiety and mood disorders can conspire to cause attention difficulties even in the absence of ADD. But the presence of such disorders by no means rules out ADD. In fact, untreated ADD strongly predisposes one to develop secondary anxiety, mood, and substance abuse disorders. I had to suffer through years of having only my anxiety and mood disorder treated, before I got a doctor to take seriously my complaints of longstanding, severe attention problems.

> Now, after a final failure, I am moving on to medication. What do you all think about Strattera? Would you try that first, or would you try to go straight for the stimulants?

Strattera benefits fewer people with ADD than either Ritalin or amphetamine. That's not to say that it doesn't work well for those it helps (I assume), but overall it's considered much less effective than stimulants. I have heard that Adderall or Dexedrine (or Vyvanse) are most effective in adult ADD. My experience is that Dexedrine blows all the other ones away for my symptoms.

I recommend trying Wellbutrin before Strattera. All Strattera did for me was cause me to sweat more, and cause a mild subjective effect that at the end of the day didn't amount to anything. If your doctor tries to put you on Strattera before stimulants, that usually means that he either A) doesn't trust you with a controlled substance and wants to avoid it at all costs, or B) is susceptible to Lilly's marketing, because the studies have all shown that Strattera is less effective, and therefore should be a second-line treatment for ADD.


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URL: http://www.dr-bob.org/babble/20110418/msgs/984163.html