![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by nmk on February 7, 2003, at 19:00:33
I am baffled. I started strattera (18mg) approx. six weeks ago for depression and noticed a marked improvement within two days. The following 5 weeks were blissful.....no depression, little anxiety, and I was sure I finally conquered the depression. For the past week, the depression has returned, along with a lack of motivation to do anything. I typically experience a worsening of my symptoms one week prior to my cylce, which is where I am now. What I don't understand is that this did not happen to me last month while on the strattera. Should I ask my doc to double the dose? For you long term users, has anyone experienced that "high" fading after a month? Any insight would be appreciated.
I knew this was too good to be true.
Nicole
Posted by SLS on February 8, 2003, at 14:00:45
In reply to Strattera poop out?? Need some opinions please., posted by nmk on February 7, 2003, at 19:00:33
Hi Nicole.> I am baffled.
> I was sure I finally conquered the depression.
> For the past week, the depression has returned, along with a lack of motivation to do anything.
> I knew this was too good to be true.
:-(
Sorry to hear that. I know the feeling all too well.
I guess that increasing the dosage of Strattera would be the preferred next move. It is possible that your current dosage is barely enough to hold things up in the absence of environmental or endogenous biological stresses. The hormonal changes occurring this month might be just the source of systemic stress that could cause medication bleed-through. Taking more Strattera might put you over the top with some head-room so that stressors are better tolerated. Regardless, it is important to avoid or effectively handle stress as much as possible.
Have you had partial success with Prozac, Zoloft, Luvox, Paxil, or Celexa? Perhaps you can add one of these to Strattera. Caution, however, must be exercised when adding Paxil. It probably interacts with Strattera such that the levels of Strattera become significantly elevated. Simply, that means using a lower dosage of Strattera in this situation.
Good luck.
- Scott
Posted by juanantoniod on February 8, 2003, at 22:28:27
In reply to Strattera poop out?? Need some opinions please., posted by nmk on February 7, 2003, at 19:00:33
Hi, Nicole. Thanks for your posting. I've been looking forward to adding Strattera to my AD regimen and am going to ask my Pdoc when I see him next. Your experience gives me hope that it might be helpful to me.
I have the prescribing information on Strattera (for ADHD) and it says, "Strattera should be initiated at a total daily dose of 40 mg and increased after a minimum of 3 days to a target total daily dose of approximately 80 mg administered either as a single daily dose in the morning or as evenly divided doses in the morning and late afternoon/early evening.
oAfter 2 to 4 additional weeks, the dose may be increased to a maximum of 100 mg in patients who have not achieved an optimal response. There are no data that support increased effectiveness at higher doses.
oThe maximum recommended total daily dose in children and adolescents over 70 kg and adults is 100 mg.So it seems like you have some more room to add to your dosage.
(FWIW, I had a similar response to Provigil -- I felt great on it for the first 5 days or so, then absolutely nothing. The feeling I miss most is waking up and WANTING to get out of bed rather than dreading it.)
Posted by nmk on February 9, 2003, at 12:06:21
In reply to Re: Strattera poop out?? Need some opinions please., posted by juanantoniod on February 8, 2003, at 22:28:27
The feeling I miss most is waking up and WANTING to get out of bed rather than dreading it.)
I hear you on that one! This past week, all I have wanted to do is roll over and continue with my peaceful slumber. Unfortunately, this is not an option since I have three kids and work full-time.
I asked my doctor about the difference in dosages for depression only and for ADD ( I do not have ADD) and he said the max dosage he prescribes for depression is 40 mg. So you are right, I have room to increase and I will talk to him tomorrow to get his ok. If this doesn't work, I think a healthy dose of estrogen might do the trick. Thanks to you and SLS for responding, I really appreciate it. Please keep me posted on what your pdoc says and we can compare notes. Are you ADD or are you taking it for depression only? SLS had asked me if I am augmenting with anything and yes, zoloft 50 mg and synthroid.
Nicole
Posted by juanantoniod on February 9, 2003, at 14:54:30
In reply to Re: Strattera poop out?? Need some opinions please., posted by nmk on February 9, 2003, at 12:06:21
Hello Nicole,
I will be using the medication only as an augmentation for depression. I do not have ADHD. Everything else, but not that -- j/k lol.
Perhaps if you discussed the prescribing indications maximum dosages with your pdoc, you could get him to go up a bit on your dosage (or you could do it yourself with the pills you have and then try to get more after the fact).
I will post after I start taking Strattera. But your post has been very valuable to me, especially since it shows that I might achieve a response at a much lower dosage than that given for ADHD. My pdoc isn't as up on all the new stuff as I am so he kind of lets me guide the way.
Best wishes to you,
Antonio
> The feeling I miss most is waking up and WANTING to get out of bed rather than dreading it.)
>
> I hear you on that one! This past week, all I have wanted to do is roll over and continue with my peaceful slumber. Unfortunately, this is not an option since I have three kids and work full-time.
>
> I asked my doctor about the difference in dosages for depression only and for ADD ( I do not have ADD) and he said the max dosage he prescribes for depression is 40 mg. So you are right, I have room to increase and I will talk to him tomorrow to get his ok. If this doesn't work, I think a healthy dose of estrogen might do the trick. Thanks to you and SLS for responding, I really appreciate it. Please keep me posted on what your pdoc says and we can compare notes. Are you ADD or are you taking it for depression only? SLS had asked me if I am augmenting with anything and yes, zoloft 50 mg and synthroid.
>
> Nicole
>
>
This is the end of the 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.