![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 606 to 630 of 1242. Go back in thread:
Posted by oops...trythatbutton on May 18, 2003, at 8:09:42
In reply to Re: Straterra - No other takers? » zenclear, posted by kdg on May 18, 2003, at 0:44:50
Yes...though I don't recall myself throwing thing. Actually I think it is the opposite with sugar. ADHDer tends to have a low/slow glucose uptake in the brain so having sugar has a calming effect. A lot of mild ADHDer tends to self medicate with coffee and/or chocolate which would help if it was mild ADHD.
The Strattera is ok with children. The key is to get the right dosage. You could check the Strattera website.
Strattera takes time and should be started at the lowest dose from my own experience
Posted by snowflake on May 18, 2003, at 14:08:53
In reply to Re: Straterra - No other takers? » kdg, posted by oops...trythatbutton on May 18, 2003, at 8:09:42
My 11 year old was put on Strattera with disasterous results. After being on Adderall XR which helped, his doctor wanted to try this new med, Strattera. It didn't help his ADD and he was acting the way you describe your son as acting now. My son's ADD is the inattentive, not hyper type. After wasting 8 weeks, he even noticed how different he was feeling and acting. We stopped immediately and he's back on Adderall XR. I'm sure there are success stories, but it seems, in my opinion that the majority are with adults.
Posted by teacherkris on May 18, 2003, at 14:14:59
In reply to Re: Straterra - No other takers?, posted by snowflake on May 18, 2003, at 14:08:53
This thread seems to be focused heavily on adults, which is the reason why I started reading it. I've found a lot of other boards and threads focused on kids with Strattera many of them success stories. So I don't think the Strattera is necessarily better for adults I think it's more a matter of who's posting. I'm a middle school teacher and have had several kids switch to strattera with great success. I also think that we need to keep in mind that most of us who come to these boards are having trouble with the meds, since those who are having no problems have no need to seek out the support and advice the boards offer. I guess my point is don't give up too quickly, true it doesn't work for some but from my own experience with it and what I've seen with my students I think it's worth the patience to give it a fair trial. Hang in there and good luck!
Posted by Mona on May 19, 2003, at 8:11:37
In reply to Straterra approval., posted by scoper on December 28, 2002, at 2:19:34
My son is 9 years of age and he was taken off the Dex cold turkey and put on Staterra 40 mg about a month ago. Since then I've seen him cry for no reason, get mad for no reason, rage, shout, yell, hit, and run away. He goes into the rages out of nowhere and then it's like you can't control him. Does anyone know what's going on? He also has shacks and nitemares....SOS from AR
Mona :)
Posted by snowflake on May 19, 2003, at 9:47:51
In reply to Re: Straterra approval., posted by Mona on May 19, 2003, at 8:11:37
Dear Mona,
Your case sounds exactly like my 11 year old son's response to Strattera. At 4 weeks we saw no improvements, his doctor asked us to wait a little longer. For us we waited 8weeks with absolutely no help for his ADD and with the exact side effects you describe. After a horrendous weekend with these types of behaviors, we stopped it immediately and went back to Adderall XR.
Posted by kashusha on May 19, 2003, at 17:53:29
In reply to Increasing to 100mg Strattera, posted by cmcdougall on May 5, 2003, at 14:05:08
> Hi All,
>
> Took 40mg for 4 days, increased to 80mg for 21 days, started 100mg last Friday. I LOVE Strattera. Still taking Lexapro and Trazodone for depression, Zonegran for migraines.
>
> This is the best I've felt in years. I tried all the stims and they were OK... This is definately better.
>
> Love and luck to you all.
> CarlyI'm on 80mg Strattera and have had no response. Nothing. I've been at this dose for about a month. Did you see improvement before taking 100mg? I see my pdoc tomorrow, and I don't think she'll go above this dose. Adderral does nothing for me, and i haven't tried anything else. I'm so overwhelmed and disorganized/distracted! I really hoped Strattera would help.
Posted by GRS on May 21, 2003, at 15:35:43
In reply to Re: Straterra approval., posted by Mona on May 19, 2003, at 8:11:37
My son has had a similar reaction and was switched from dexedrine. I have just lowered his dose to 25mg and hope this will help.
GRS> My son is 9 years of age and he was taken off the Dex cold turkey and put on Staterra 40 mg about a month ago. Since then I've seen him cry for no reason, get mad for no reason, rage, shout, yell, hit, and run away. He goes into the rages out of nowhere and then it's like you can't control him. Does anyone know what's going on? He also has shacks and nitemares....SOS from AR
>
> Mona :)
>
Posted by froggyanna on May 22, 2003, at 4:32:32
In reply to Straterra approval., posted by scoper on December 28, 2002, at 2:19:34
Hi Folks,
I apologize in advance for the length of this posting!
I have looked at many of the messages about Straterra on this board, but there's no way that I'll be able to read them all! But I'm very glad that I found this and I hope to learn a lot. If it happens that I ask a question that has already been addressed here, perhaps someone could kindly direct me to the conversation where that question is covered. Otherwise, I thought that, like several other people here, this might be a good place to keep a record of my experience, perhaps help others, and benefit from the collective experience!
I am starting Straterra tomorrow, 40 mg. Actually, it's today, since it's 1:00 am! So I'll start a few hours from now. I'm a 51-year-old woman who is just discovering I have ADD. I went to a psychiatrist a few weeks ago to get a diagnosis, and it was confirmed. He also recommended an internist I could go to, because I am new to my area and have a number of different health issues. Luckily, I went to that doctor last week and found him to be a great match for me! That in itself is a major accomplishment -- to find a doc that you can trust and feel comfortable with!
Anyway, the psychiatrist (is that what people mean here when they use the term "pdoc"?) took my history and we discussed the fact that I also have sleep apnea and am hypothyroid. Both of those problems can exacerbate the ADD. I am going to work with the internist to get the thyroid meds fine-tuned, because I believe that I'm not taking the right amount/kind of thyroid right now. As for the sleep apnea, I use CPAP and that has been fairly successful. But this pdoc (I hope that's the right term!) has done a lot of work with Buspar. His research and clinical experience have shown that Buspar can be highly effective in reducing both snoring and apnea. He suggested that I start taking Buspar for a few weeks, see if that helps with the snoring and/or the ADD symptoms, and if I still need help with the ADD, to add either Ritalin or Adderall to the mix.
So I've been gradually increasing the dosage of Buspar over the past couple of weeks, but I haven't yet tested whether I can go without the CPAP. I did try to go without it one night at the beginning, and my husband told me that the gasping apnea had been reduced but I was still snoring pretty badly. I put the mask back on! Since increasing the dosage I haven't tried it again yet, but I will!
I'm up to 45mg of Buspar. Both the internist and the pdoc said that I could comfortably go to 60mg and maybe even higher. For me, the reason to be taking Buspar is specifically for the sleep apnea. So if, after testing it out again, I see continued improvement, I will probably keep increasing the dosage to see if the snorning is even more reduced. I have been snoring loudly since I was a skinny teenager, so being an overweight middle-ager is NOT the cause. I was evaluated for surgery for apnea (decided not to do it) and that doc told me that I have an unusually narrow air passage, so that's the cause. I guess the Buspar has properties that help to maintain muscle tone of the airway during sleep. I think that's fascinating!
When I went to the internist, he suggested that I get all the thyroid blood work done and I'm waiting for those results. He also suggested an overnight sleep study because I haven't had one in years. That will be a good way to find out if the Buspar is having an effect. Additionally, he told me that because I have some possible heart risks, he thought that it might be a better idea to try Straterra before going with the stimulants. I called the psychiatrist and told him this and he commented that a lot of internists are "unnecessarily afraid" of the effects of stimulants (he and the internist are friends). But he said if I wanted to try Straterra he had no objections. He said that he's had 15 people on it -- 5 of them love it and 10 of them hated it.
Despite the odds, I've decided to give the least objectionable substance a chance (least objectionable, at least, to my mind). The pdoc said that my target dosage should be 120mg, and to start out at 40.
By the way, I'm going ahead with this, because the Buspar appears to be having very little effect on my ADD symptoms.
Now.... in addition, I have been taking ssri's for years for depression. First Prozac for about 6 or 7 years, and now Zoloft for about 5. I have found a very stable state in regards to depression by taking 100mg/day of Zoloft. Like a lot of people, I think, I thought my ONLY problem was depression. Well, after several years of learning what it feels like to be, or not to be, depressed, and yet still having problems with attention and work performance, I recently "discovered" ADD.
What a revelation! Now I can finally put all the pieces together and see my life clearly, all the way back to little-girlhood! The overwhelming sense of futility over not being able to achieve goals, accomplish things that other people seemed to find so easy, and put my life in order. The extreme shyness, the sensitivity, the anger, the impulsivity, the aimlessness.....despite being very intelligent! I dropped out of high school, I have taken college courses but have never gotten a degree, and at 51 I still don't know what I want to be when I grow up! Despite some career success, I have been unemployed for over a year and a half now and I'm afraid to jump back in! I've been afraid to put myself back into those corporate situations that are so alien to a person with ADD; afraid to make myself vulnerable yet again to the constant sense of not performing as well as I should, despite my best efforts, and always being late to work!!
So, in summary: I currently take 100mg of Zoloft and 0.2mg of Levoxyl (thyroid) in the morning, and 45mg of Buspar at bedtime (will increase to 60mg tomorrow). I also take some allergy meds (Zyrtec, Flonase, Advair), but I don't think they pertain to this discussion. I will be adding 40mg of Straterra to the mix.
I will aim to provide updates here like a lot of folks have been doing. I'm sorry again for the length of this -- just wanted to introduce myself and provide as clear a picture as I can at the start of the experiment. I sure do hope that I can begin to turn my life around!
froggyanna
Posted by bookgurl99 on May 22, 2003, at 8:08:30
In reply to Glad To Find This Group -- Starting Straterra, posted by froggyanna on May 22, 2003, at 4:32:32
Froggy,
Your symptoms blow me away, as I'm only 27 and am also hypothyroid. My psychiatrist wants me to be tested for sleep apnea. (I snore a lot.) I've just gotten off Zoloft after a year.(BTW, the zoloft made it _much_ harder to concentrate.) And -- since becoming hypothyroid -- I'm developing symptoms of ADD.
To be honest, from my perspective, these symptoms almost all boil down to the thyroid, as thyroid can exacerbate weight gain (hence sleep apnea) and memory problems. Otherwise, how would I, a health-conscious 27-year-old, be having the same symptoms as a 51-year-old?
When I tried Straterra recently, it made me very sleepy the first 2 days and very talkative the last day. I didn't like the feeling of being out of balance, and stopped.
My next step is to see my dr. next week and plead my case for Cytomel (t3) to be added to my thyroid regime. Several studies and anecdotal reports show that people feel greatly improved in terms of cognition and mood when they have t3 added to the mix. Lots of doctors are scared of t3 as it can increase one's chances of getting osteoporosis. But I say, if it's my brain versus my skeleton, my brain is a higher priority.
You might want to work on trying out t3, or getting your girl hormones checked out before hopping to more drugs. That's just my suggestion.
I'm really glad you found good new doctors. That is one of the best things just for feeling good about your care.
books
Posted by paulk on May 22, 2003, at 8:24:04
In reply to Glad To Find This Group -- Starting Straterra, posted by froggyanna on May 22, 2003, at 4:32:32
It just doesn’t seem responsible to start any med before your thyroid tests are back. It's just the humble opinion of a doctor’s kid, but if you turn out to be hypothyroid a combination of synthroid and Ctomel may be all you need. To start the med before the test results are in confounds the variables.
There is a lot of pressure for a doctor to make their patient happy, by sending them home with a prescription, but I think it would have been wise to have such a patient wait the two days it takes to get the test result back.
The thyroid test is much more objective and accurate than a psychological test.
Posted by bookgurl99 on May 22, 2003, at 12:34:02
In reply to Atomoxetine (Straterra) » froggyanna, posted by paulk on May 22, 2003, at 8:24:04
> The thyroid test is much more objective and accurate than a psychological test.
>
I have to say I totally agree with this statement. About a year and a half ago, I rapidly went from quick-brained youth to slow-brained depression and sluggishness. In addition, I developed severe migraines and started gaining weight. One neurologist tried to diagnose me with ADD and labeled my migraine symptoms (we did not know they were migraines at the time) as symptoms of health-related OCD.I rejected the ADD dx as I had never had it previous to that time; I think that's the clue about these things -- did the symptoms come on suddenly or have they always been there? A true developmental disorder like ADD should at least have _some_ symptoms in youth.
And while I _do_ have anxiety, it has never been about health concerns. I developed health concerns after untreated hypothyroidism caused health problems. It's a laugh, isn't it?
Looking back at it, I'm surprised that nobody ran a test to see how my t4/t3 levels were at the time. I guess sometimes you have to be your own dr.
Posted by cmcdougall on May 22, 2003, at 13:07:04
In reply to Re: Increasing to 100mg Strattera--Carly, posted by kashusha on May 19, 2003, at 17:53:29
> I'm on 80mg Strattera and have had no response. Nothing. I've been at this dose for about a month. Did you see improvement before taking 100mg? I see my pdoc tomorrow, and I don't think she'll go above this dose. Adderral does nothing for me, and i haven't tried anything else. I'm so overwhelmed and disorganized/distracted! I really hoped Strattera would help.
>Well, I wouldn't say I saw real improvement. It was more of a DIFFERENCE. I am more able to get started on projects, and more able to keep going on them. I am not a chatterbox anymore like the stims made me, although I think I will have to take a little bit of adderal again just to help me concentrate better. I am definately more organized. The difference has been subtle and ongoing... Don't give up.
Love and luck,
Carly
Posted by bookgurl99 on May 22, 2003, at 14:46:06
In reply to Straterra approval., posted by scoper on December 28, 2002, at 2:19:34
I've been thinking over some behavior of mine the past couple of weeks. And I'm realizing that I was talkative, but also short-tempered and perhaps somewhat impulsive on Straterra. I found myself swearing at work during annoying situations, for example. What gives? What mechanism would explain this?
books
Posted by froggyanna on May 22, 2003, at 16:11:19
In reply to Re: Glad To Find This Group -- Starting Straterra » froggyanna, posted by bookgurl99 on May 22, 2003, at 8:08:30
Hi Books!
> Otherwise, how would I, a health-conscious
> 27-year-old, be having the same symptoms as
> a 51-year-old?Well, y'know, the thing is: looking back on my life, I was developing these problems even back then, if not already experiencing them. I snored heavily as a teenager. I was ALWAYS tired. I certainly experienced many symptoms (I know now) of ADD. I had my first baby at 27. Before that, I underwent several years of diet and other therapies for hypoglycemia. I lost severe amounts of weight on a low-carb diet. It was actually almost a NO-carb diet! When I became pregnant, I gradually started re-introducing potatoes and breads to my diet, without a problem. Over the years, because of several life changes (including divorce), I gradually lost my "will" to follow a strict diet and became a junk-food couch potato. Then I "discovered" my depression, or at least I discovered treatment for it. Then I became caught up in the fight to earn a decent living as a single mother. With everything going on to deal with, nutrition took a back seat in my priorities. Through many other changes, I eventually went through menopause, and then I lost my last job, and that's when the symptoms of ADD seemed to become the most prominent problem, and that's where I am now.
> Your symptoms blow me away, as I'm only 27
> and am also hypothyroid. My psychiatrist wants
> me to be tested for sleep apnea. (I snore a
> lot.) I've just gotten off Zoloft after a year
> (BTW, the zoloft made it _much_ harder to
> concentrate.) And -- since becoming
> hypothyroid -- I'm developing symptoms of ADD.Good for your doctor for recognizing the possibility of sleep apnea. I would be very interested to hear how that goes for you if you decide to do it. Also, I would ask him or her about the use of Buspar (I take buspirone, the generic, actually) in reducing and/or eliminating the apnea. My particular doc has done a LOT of clinical work with it, and I would be glad to give you his name. The jury is still out as to whether it is really useful for me or not. I have my sleep study Monday night. They will "measure" me for half the night, and if I need the CPAP treatment they will titrate the correct air pressure the rest of the night. I'll let you know how that goes.
As for the zoloft.... my problems with depression were quite severe throughout my life. I am now able to tell exactly when my brain is going there, and it goes there if I'm not on medication for a few days. Because of that, I'm not as aware of any direct effect it might have on my ability to concentrate. I'm just so grateful that I don't "go there" anymore!
> To be honest, from my perspective, these
> symptoms almost all boil down to the thyroid,
> as thyroid can exacerbate weight gain (hence
> sleep apnea) and memory problems.You may very possibly be right. A good friend of mine recently told me about the importance of T3, and my internist told me that T3 tends to be the "kicker" for people to boost them over to really optimal functioning. I'll see him again in a couple of weeks and we'll discuss the results of my blood tests then.
What I know about myself and the possibility that it's the unbalanced thyroid that is causing the ADD is this: I know now that I had ADD as a kid. I was VERY bright in school, so as a sweet little girl, of course, I was overlooked. That sweet little girl became a sullen, lonely, pathologically shy teenager as a result of my parents' divorce, deaths in the family, etc. I had one shoplifting experience as a 19-year-old, and I could never figure out why I did it. I know now that it was sheer impulse with no reason. It was the ADD. I came "this close" to being arrested, but was not. This was after dropping out of high school because I just couldn't deal with it. I could not figure out why it was so difficult for me to just get by. All I knew was that I couldn't function in the social situations, I couldn't concentrate on the school work, and my mother and the counselors at school were absolutely useless to me. I slipped through the cracks. I was very angry. My mother used to use psychiatric treatment as a threat instead of as a loving solution to my problems. I remember her saying to me, "If you don't shape up, I'm going to take you to a psychiatrist!" I have no way of knowing at this point whether my thyroid was unbalanced at that time.
Through sheer grace, and being an optimist at the very core of my personality, and despite my anger, I managed to grow a very interesting, loving, fulfilling life through the maturation process. Lots of ups and downs but overall pretty good. I forgave my parents. I raised two great daughters and they have moved successfully through the college experience. One graduated with honors from the University of Southern California and the other will be spending her junior year in Japan as a student at Lewis and Clark College in Oregon. I just always had this underlying sense of never being able to achieve anything great FOR MYSELF. Too many ideas and no results. Too many struggles with job performance.
> When I tried Straterra recently, it made me
> very sleepy the first 2 days and very talkative
> the last day. I didn't like the feeling of
> being out of balance, and stopped.From the messages I've read on here, it appears that it's a good idea to give the drug a couple of weeks to see if it has a positive impact on the ADD or if the side effects settle down. But I definitely know how you feel in not wanting to wait it out. At this point, I don't know how it'll turn out for me. As I write this, it has been approximately 2 hours since my very first dose of 40mg, along with my other meds, on an empty stomach. I've been sitting for most of the time. I am experiencing a very slight sense of queasiness, not too drastic. I am also experiencing a slight sense of dizzyness, but again, it's only subtle. These are feelings that I sometimes have *without* medication!
It remains to be seen if I stick with the Straterra, if I stick with the Buspar, if I add T3 to the mix, or if I don't need to sleep with a CPAP machine any more. To be perfectly honest, THAT is one of my fervent hopes in this! My apnea is severe enough that that might not be possible, but I sure would love not to have to do that.
One last thought: thanks for the good wishes. Being unemployed, health insurance is a real problem for me. I have it, but it's meager. I will have to make a decision between health care and food at some point. My husband's employment does not provide me with insurance and we are in the process of selling our house to move to something less expensive, due to my inability to look for and find work. I told him that since I discovered that I have ADD, I am going to have to deal with it and get treatment for it before I throw myself into the ring again for the last few years of my working life. I really am hoping that this is a new beginning for me!!
Regards,
froggyanna
Posted by froggyanna on May 22, 2003, at 16:37:17
In reply to Atomoxetine (Straterra) » froggyanna, posted by paulk on May 22, 2003, at 8:24:04
> It just doesn’t seem responsible to start any
> med before your thyroid tests are back. It's
> just the humble opinion of a doctor’s kid, but
> if you turn out to be hypothyroid a combination
> of synthroid and Ctomel may be all you need. To
> start the med before the test results are in
> confounds the variables.You'll have to read my response to Books to see that I have had ADD for most of my life AND I have been taking thyroid medication for years. I am fairly certain that being hypothyroid exacerbates the condition, but it does not *cause* it. Perhaps the addition of Cytomel will be very helpful for me -- I'll see the doctor in a couple of weeks to discuss the results.
> There is a lot of pressure for a doctor to make
> their patient happy, by sending them home with
> a prescription, but I think it would have been
> wise to have such a patient wait the two days
> it takes to get the test result back.Believe me..... I am NOT the kind of patient who just wants to be "happy"!! I am very thoughtful and deliberate about considering what kinds of substances I put into my body. I have also spent a lifetime looking deeply into my experiences and trying to learn as much as I can. I think you need to be a little more cautious in jumping to conclusions and assuming that someone who posts here has not done their homework.
> The thyroid test is much more objective and
> accurate than a psychological test.Perhaps, but human beings are very complex and what works for one may not work for another. I appreciate your concern, but it's misplaced. As I said in my message to Books, the outcome of this all remains to be seen, and hey, if it turns out that I don't need to take anything except Levoxyl and Cytomel in order to overcome years of frustration and lack of achievement, then I'll be happy about that!
Regards,
froggyanna
Posted by bookgurl99 on May 22, 2003, at 16:42:04
In reply to Re: Glad To Find This Group -- Starting Straterra, posted by froggyanna on May 22, 2003, at 16:11:19
Hey froggy,
how cool that your dr. called T3 a 'kicker.' very neat. i wonder if my docs have been more resistant to putting me on it because i'm young?
it's nice that the add dx might be able to help you figure out how to solve the puzzle of yourself in some way. at least it can help you to forgive yourself for disappointing yourself in some ways -- and give you new hope for the future.
i notice from your posts that you're a very evocative and detailed writer. have you ever done any writing? it seems to me that once you have your health concerns battened down, you are going to take off and make a great employee for someone (or even yourself).
books
Posted by froggyanna on May 22, 2003, at 17:11:31
In reply to Re: Glad To Find This Group -- Starting Straterra » froggyanna, posted by bookgurl99 on May 22, 2003, at 16:42:04
> Hey froggy,
>
> how cool that your dr. called T3 a 'kicker.'
> very neat. i wonder if my docs have been more
> resistant to putting me on it because i'm
> young?Hey Books,
Yeah, I really liked his explanation of that! :-) It really spoke to me, man!! :-) It certainly makes me eager to try it, especially since a friend of mine was also so enthusiastic about its effect on her. As for why age would be an issue in prescribing it, my personal opinion is that it probably has more to do with lack of awareness. I saw a doctor last year who I thought would be really great from his description on his website. He is affiliated with a "holistic" group and I thought this would be a great place to get "holistic" treatment. Wrong. He showed very little interest in my thyroid treatment and from looking at my records, he never even tested me for T3! He actually showed very little interest in ME, as well. My symptoms went from bad to worse, and because of money worries, I am only now attempting to get medical help again. So there's a doctor for whom age did not appear to be an issue. My NEW doctor has a sense of humor, he shares his own experiences with medicines, and he seems up on the latest treatments. We really hit it off, and sometimes I think THAT is more important than medicine!
> it's nice that the add dx might be able to help
> you figure out how to solve the puzzle of
> yourself in some way. at least it can help you
> to forgive yourself for disappointing yourself
> in some ways -- and give you new hope for the
> future.Yeah!! I have had years of psychological counseling and I have also engaged in regular mediTAtion. I hope to be able to get to the root of this problem and yeah, renew my hope for the next phase of my life!
> i notice from your posts that you're a very
> evocative and detailed writer. have you ever
> done any writing? it seems to me that once you
> have your health concerns battened down, you
> are going to take off and make a great employee
> for someone (or even yourself).Thank you, Books! I have worked for years as a production editor in technical publications. I do enjoy writing, but I would not want to be a technical writer. I am looking for a new path. I have actually always wanted to be self employed, but because of the problems with ADD (that I didn't even know about until recently), I have never had the "will" and the focus to commit to something like that. I am thinking about retaining the services of an ADD Coach, at least occasionally while I get on my feet and can't afford too much help, and I even joked with someone that I would write a book called "How my ADD Coach Helped Me To Write This Book"!
I've always been involved, career-wise, in some aspect of publishing, first as a typesetter, and later as a production editor. As a kid, I had my own little rubber stamp "press." I've taken courses in web design. I just have never been able to focus and pull anything together for myself. I sure wish I could start over again, and maybe that's what the ADD drugs will help me do, whether it's the Straterra, or a stimulant, or even getting my thyroid in balance. Thanks again for your kind words....
Regards,
froggy
Posted by comorbid? on May 22, 2003, at 22:03:18
In reply to Re: Mirapex » PuraVida, posted by Magpie on April 8, 2003, at 2:48:59
Hi PV and Magpie
I was surfing along, looking for info about Strattera - atomoxetine - and ran across your thread. My doctor mentioned Stattera to me today and suggested I look into it, give it some consideration, to see what I thought. I have attention issues and he thought it possible that it might help. Yes, he and I have a pretty trusting relationship. I tell him what I do, and he lays out the info.
In my case, the current diagnosis is childhood-onset bipolar, type 2, seasonal, with rapid (ultra-ultra-rapid) cycling. I'm a 42-year old male, and have had the symptoms since early childhood (or as far back as I can remember; hard to say when exactly). I originally sought treatment for depression, about 10 years ago, and was on SSRIs (zoloft and prozac) for almost eight years, and two doctors.
I went back to school three years ago, to finish the BA I'd never completed. During the time I was in school, I had terrible problems with my mood, and a range of ADHD symptoms. I had hoped that my bad study habits would be a thing of the past, but the problem was still there.
I finally sought psychiatric help. Psychometric testing revealed ADHD, Inattention subtype, with hyperactive features; I met all nine criteria for attention deficit, and four out of nine for hyperactivity.
But, referring back to the above, my new psychiatrist refused to prescribe stimulants, because he felt they might induce mania. This despite the fact that I have only experienced hypomania, never full-blown mania, and never psychosis. Needless to say, I found this frustrating.
For the past year, I've been prescribed Lamictal - lamotrigine - an anti-convulsant that anecdotal evidence suggests may be useful in mood stabilization. At the time that he prescribed this drug, my doc also took me off Prozac, which he said might exacerbate my rapid mood-cycling (I appear to have a very unstable serotonin level, affected strongly by light exposure, alcohol, marijuana, you name it).
The Lamictal has been very helpful in relieving my physical symptoms - akathisia - chronic stress-induced back spasm, restlessness, and an internal situation that's hard to describe but feels like my guts are clenched. Very helpful; these problems are mostly gone.
However, it has not had any great influence on my mood swings; last autumn, which season is usually my worst due to falling light levels, was absolutely horrible, my worst in a decade. I was at wits' end with the mood swings and did some crazy things that I regret. In previous years the Prozac had somewhat helped with this, by keeping my mood from going too low, and without it I was going from hypomania to severe depression daily, sometimes twice and three times a day. Profoundly disruptive, hugely anxiety-generating. I don't want to go through that again.
So, to address my daily (and longer, light-induced mood swings), my doctor has prescribed Zyprexa - olanzapine. I'm at only 5mg/day, and although it REALLY sandbagged me at first, it now seems to have smoothed out my mood on a 24-hour scale.
I still have light-variablity induced mood swings, such that a few sunny days in a row will leave me feeling quite confident, expansive, handsome, whatever, and a few cludy days will cause me to feel low, ugly, etc, with the intervening periods characterized by anxiety. This may perhaps be moderated by an increased dosage of Zyprexa, which is the next thing we're going to try. If that doesn't do it, tapering off the Lamictal and starting on Depakote - divalproate - may be the autumn option, though with all the tests this is very expensive and I can't afford it until I'm in grad school and fully insured.
Finally, and to get back to my original point, it's not at all clear whether my ADHD symptoms are simply part of my bipolar symptom cluster, or if the ADHD and bipolar disorder are separate and comorbid. For this reason, the use of stimulants, even something as "safe" as Strattera, may be contraindicated, but on the other hand may be perfectly alright... it's a crap shoot!
What I hope you can get from this is, 1) It's hella difficult for your doctor to sort these things out, they're very complicated, and self-diagnosis, although you may "know" how you feel, is NOT a good idea, 2) there are alot of different medication strategies to work through, and patience is a MUST, 3) self-medication is ALWAYS a no-no, despite any short-term positive effects you may perceive (If you're in a bad way emotionally, just about ANYTHING may seem to give you relief, because it distracts you from your suffering. Airplane glue, alcohol, hard drugs, sex, food, coffee, cigs, exercise, you name it: They all have effects on your brain, and will change the chemistry, for better or worse....and sometimes you're so desperate for change, any change, that these things seem like possibilities), 4) TALK TO YOUR DOCTOR and be honest! And if your doctor isn't helping you, find another one. You have to participate in your treatment to make it work!I hope all this information helps you, and is not just an exercise in self-indulgence on my part.
And by the way, I asked my doc about Abilify – apipiprazole – and he said it has yet to be approved for bipolar disorder, although he did have free samples that a sales rep had left. Ah, the temptation! When I read about it, it sounded very good: A serotonin agonist and anti-agonist, meaning it would tend to stabilize the effect of serotonin on receptors in the brain, and also anecdotal evidence that suggests it may work for ADHD. Sigh. Who knows? Maybe I’ll end up trying it someday, or maybe not, if something else does a good enough job to satisfy me….
I wish you all the best, relief from your troubles and happy outcomes!
comorbid?
Posted by froggyanna on May 22, 2003, at 23:45:02
In reply to Re: Glad To Find This Group -- Starting Straterra, posted by froggyanna on May 22, 2003, at 17:11:31
First Day on Straterra: whoa!Just thought I'd drop in and "report" on my experience the first day of taking Straterra. As I wrote earlier, the first couple of hours consisted of very slight queasiness and very slight dizzyness. Soon after that, a kind of a "high" set in. I was just sitting at the computer for most of the day. Around 6pm I became quite tired and napped on the couch for about an hour and a half. I still felt a bit queasy before sleeping, but when I woke up, that was gone. Also, upon waking I felt a bit spacey. Now I'm feeling pretty much back to "normal."
I have a small pile of projects on my desk that I could have done today, but I didn't. Things like paying bills, organizing some records, etc. I had a professional Organizer come in to help me get my office straightened up before we put our house on the market, and at least I'm not feeling overwhelmed by the mess at the moment (because there is no mess). But as usual I'm putting things off, not wanting to get started, etc. I don't know if a drug can help me with that -- they say it's possible! We'll see.
I'm almost reluctant to try this again tomorrow, except that I know that people have said that the side effects subside. So I'm going to keep trying, and I'll post again tomorrow how the second day goes.
Regards,
froggyanna
Posted by froggyanna on May 23, 2003, at 9:55:23
In reply to Glad To Find This Group -- Starting Straterra, posted by froggyanna on May 22, 2003, at 4:32:32
Day 2 -- Before TakingWow.... well, that was some night! After taking Straterra for the first time yesterday, I wondered how I would sleep. Interesting! My husband is very sensitive to my movements and he frequently complains that I wake him up. I don't know if that's always because of ME or if he himself is having trouble sleeping. But anyway, in MY HEAD last night I was tossing and turning, waking up frequently and going back to sleep, and generally sleeping VERY fitfully. Not at all pleasant. At one point, I even had a really urgent diarrhea-like cramping and then it almost immediately went away. I woke up around 7:00, as he was waking, and I asked him if any of it had bothered him. He said he never noticed anything! So either he was sleeping VERY soundly or my perception of my "activity" was more in my head than in my body.
I jumped out of bed and took a shower with more than my usual amount of clarity and enthusiasm. That's pleasant. I dunno..... maybe all that discomfort is worth it to feel like this in the morning? Has anyone else had an experience like this?
Not noticing any of the "dryness" that other people have reported.
I'm going to take my second dose now (40mg). I don't look forward to the discomfort I felt yesterday, but I'm hoping that will eventually subside....
froggyanna
Posted by paulk on May 23, 2003, at 10:44:29
In reply to Re: Mirapex, posted by comorbid? on May 22, 2003, at 22:03:18
>In my case, the current diagnosis is childhood-onset bipolar, type 2, seasonal, with rapid (ultra-ultra-rapid) cycling
<snip>
>But, referring back to the above, my new psychiatrist refused to prescribe stimulants, because he felt they might induce mania. This despite the fact that I have only experienced hypomania, never full-blown mania, and never psychosis. Needless to say, I found this frustrating.
<snip>
>… it has not had any great influence on my mood swings; last autumn, which season is usually my worst due to falling light levels, was absolutely horrible, my worst in a decade
A very similar type of deal is going on with my sister’s girl. Once she got the bipolar diagnose, they wouldn’t even try her with stimulants.I think the bi-polar diagnose is a fad diagnose and unfortunately, ends up removing most of your treatment options. Deciding if a patient is hyperactive or manic is a VERY subjective determination that will get you either a bipolar or a quite different ADD diagnose.
The fix is to go to a new doctor and tell him you want his to diagnose you BEFORE he has access to your old records.
You will most likely get a new diagnose, and if it is non bi-polar you should be able to try stimulants. (In fact I would bet if you go to 5 different doctors, you will get 5 different diagnoses!)
Your best hope to get good treatment is to be very proactive with your doctor.
Posted by ciejae on May 23, 2003, at 10:52:37
In reply to Re: Glad To Find This Group -- Starting Straterra, posted by froggyanna on May 23, 2003, at 9:55:23
I also had many side affects at the beginning (taking it 2.5 months now). I had minimal trouble sleeping, but an incredibly hard time staying awake during the day while at work. In order to function, I just drank lots and lots of coffe to counteract the sleepiness, and the lack of motivation. Gradually I needed to use less and less coffee. I also had problems with urinary retention, minor headaches,and dry mouth. Those too went away gradually. The final result?--I'm not a different person, but it has helped me in many ways. Just try and stick with it in spite of the side affects. And by the way, it really didn't start helping my ADD until about 3 weeks after starting. It's like an antidepressent, it takes a while to work.
Posted by froggyanna on May 23, 2003, at 12:10:57
In reply to Re: Glad To Find This Group -- Starting Straterra, posted by ciejae on May 23, 2003, at 10:52:37
Thanks, ciejae, I'd really like to know how you think it has helped you, specifically. What symptoms of ADD have you been able to overcome with it? Have you ever tried any of the stimulants? (I have not.) I am also hypothyroid, so I would like to avoid them if possible. After taking Straterra for awhile now and getting used to it, do you notice any side effects at all? That is, are you aware that you have taken a drug? With the others that I take (Zoloft, Levoxyl, Buspar), I just pop them in and forget about it. Can you do that now with Straterra?
I appreciate the encouragement. I'm definitely planning on sticking this out, at least until a better idea comes along....
Regards,
froggyanna
> I also had many side affects at the beginning (taking it 2.5 months now). I had minimal trouble sleeping, but an incredibly hard time staying awake during the day while at work. In order to function, I just drank lots and lots of coffe to counteract the sleepiness, and the lack of motivation. Gradually I needed to use less and less coffee. I also had problems with urinary retention, minor headaches,and dry mouth. Those too went away gradually. The final result?--I'm not a different person, but it has helped me in many ways. Just try and stick with it in spite of the side affects. And by the way, it really didn't start helping my ADD until about 3 weeks after starting. It's like an antidepressent, it takes a while to work.
Posted by ciejae on May 23, 2003, at 15:45:01
In reply to Re: Glad To Find This Group -- Starting Straterra, posted by froggyanna on May 23, 2003, at 12:10:57
I usually don't get irritated over loud or sharp noises or bright light anymore
I need less sleep now (6 instead of 8), and when I wake up, I'm fully functional and not tired and "out of it" anymore in the morning.
I not speeding through traffic cursing at people all the way anymore. I don't find it as annoying as I used to when people are holding me up in traffic, even when I might be late for something.
I'm not feeling panic over deadlines that I have to meet, or multiple tasks that I have to do in a short period of time (my job can be very stressful at times, I'm an engineer).
I'm not feeling like something terrible is going to happen (I'm usually always waiting for the worst)
I haven't been feeling the urge to go on a shopping binge (spending money has been one of the ways that I've provided myself the stimulation I needed)
I'm not worrying as much (I used to get fixed on a certain issue, and go over and over it in my head)
I don't fall asleep while watching movies anymore.
I find it easier to talk, my thoughts are flowing much easier now.
I'm becoming a better listener, people don't bore me as much as they used to.
I'm tackling difficult jobs at work for much longer periods of time than I could have ever tolerated before.
I'm getting along better with my husband and kids.
I'm not getting stressed out when I'm a passenger in a car anymore.
My phobias aren't bothering me as much (fear of heights, fear of flying, fear of being under a bridge, fear of going over a bridge……yes, I do have my issues)
I'm still messy, but I think that now I have more patience to work on it.
Also, I have no sexual side effects. I've taken anti-depressants in the past, and all of them had sexual side effects.
Posted by ciejae on May 23, 2003, at 15:58:02
In reply to Re: Glad To Find This Group -- Starting Straterra, posted by froggyanna on May 23, 2003, at 12:10:57
I forgot to say that I've never tried any stimulants. I never realized I was ADD until I started reading about it on the internet. Then I realized that me and both my daughters had the same symptoms. I went back to my old psychiatrist (who did one of the studies on Strattera before it was approved)and he looked in my records. He said that way back when I was seeing him before, he thought I had ADD (I thought it was depression) and he was treating me with anti-depressents that were for depression as well as ADD (I think it may have been Wellbutrin or Paxil, it's been so long-10 years now). After about 6 months of success with this drug, I'm going to tell my daughters about it. I don't want to let anyone in my family know about it right now. For instance, when I've taken anti-depressents in the past, everytime something went wrong, my husband would blame it on the drug (because he's the type that just doesn't believe in taking a pill to make you normal). I just want to be able to evaluate this drug on my own without his slanted opinion. Oh, by the way, he really is a nice guy, but just a little too protective of me.
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.