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Dr. Bob is Robert Hsiung, MD,
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Posted by Msanjelpie on April 1, 2003, at 7:40:52
In reply to Re: Straterra - Back to Ritalin SR-Libby, posted by AS Mom on March 31, 2003, at 12:24:29
AS Mom: Why did you take both of your children off Strattera and switch to Concerta for them again. Why did you take them off the Concerta in the first place... How did the Strattera make them act...
THANKS - Jeannie
Posted by blondegirl47 on April 1, 2003, at 8:15:12
In reply to Re: straterra, weight, caffeine and nicotine, posted by babs on March 31, 2003, at 19:20:32
Hi Babs
I have slowed up on caffiene because it seems to mess with my adderall absorption. Also makes me more shakey. My pdoc is letting me take strattera with my adderall. If you go off adderall cold turkey and switch to strattera alone you won't be able to tell what strattera is doing because you will be crashing from no adderall.
From what I have read, once strattera kicks in (about a month) you might lose some weight. This is day 15 for me and I have been having intermintent binges. You may also experience some grouchies and a little dizzyness.
Make sure your pdoc gives you the samples that start out at 18mg and move up gradual. Good luck
Posted by Patt on April 1, 2003, at 10:15:07
In reply to Re: straterra, weight, caffeine and nicotine, posted by blondegirl47 on April 1, 2003, at 8:15:12
I am only at Day 5 on the Straterra 40 mg/day, but so far I'm starving. I did not take a stimulant medication prior to the Straterra, so didn't have to worry about withdrawal. I wake up during the night with my stomach growling, I'm so hungry. I've gained about 2 lbs. in the 5 days, so I'm hoping this passes. If not, I'll definitely have to stop! I drink regular and/or diet coke with the medication, and drink about 2 cups coffe each day & don't seem to have any problems with the caffeine.
Posted by blondegirl47 on April 1, 2003, at 10:25:38
In reply to Re: straterra, weight, caffeine and nicotine, posted by Patt on April 1, 2003, at 10:15:07
Hi Patt, seems like the doc started you out on quite a high dose. I started out at 18, for 4 days then 25 for 14 days. I agree about being hungry I take it before bed and sometimes I will wake up about 3:30 or 4 hungry. Yesterday I lost all control and ate everything in site. I still want to eat today, but I am in better control of it.
Strattera isn't a stimulant so it shouldn't be effected by caffiene. Although Strattera will make your blood pressure go up. I hope our hungry's go away soon!
Posted by paulk on April 1, 2003, at 15:11:27
In reply to Re: straterra, weight, caffeine and nicotine, posted by Patt on April 1, 2003, at 10:15:07
I've had problems with weight gain also - it seems that in the evening when it wears off I get rebound appetite. I’ve gained 5 lbs in the last month. I’m wondering if splitting the dosage and taking it every 12 hours would help.
Sure wish they had thought of a slow release – I bet it would solve other side effects as well.
Posted by blondegirl47 on April 1, 2003, at 15:19:49
In reply to Atomoxetine (Straterra) weight gain » Patt, posted by paulk on April 1, 2003, at 15:11:27
I have read where people are taking it twice a day. Since it makes me sleepy, I am happy to only take it once a day. I hope your weight gain stops, as well as mine. :)
Posted by LibbyH on April 1, 2003, at 15:43:19
In reply to Re: Straterra - Back to Ritalin SR spinning » LibbyH, posted by not exactly on March 29, 2003, at 18:17:14
> Sorry, but I am completely confused by your message.
Bob, sorry for the confusion. I had been taking the following combination for two years with great success for ADD & what my pdoc call Chronic Major Depression:
Daily:
Ritalin SR @ 40-60 mg depending on my work hrs.
Wellbutrin SR 300 mg
Prozac 20 mgI started waking developing sleep problems, waking early & being unable to go back to sleep. Eventually, I started sleeping 10-14 hrs. a day, but never felt rested. I pushed myself to function, but nothing was fun anymore. Then, the oddest part. I started
waking in the middle of the night with panic attacks. Couldn't breathe. The doc thought changing the antidepressant would help. He was never very crazy abous prozac with me because lack of motivation has been a constant problem since he began seeing me five years ago, so he changed the antidepressant to Lexapro. He thought since I was having panic attacks, it might be a good time to try a nonstimulant medication for my ADD, so he asked if I was willing to try Straterra too. Since it was more convenient, I jumped at the chance. So he changed me to:
Daily:
10 mg Lexapro now titrated to 20
40 mg Straterra titrated to 80
and added
.5 mg Klonopin twice daily for panicI stopped the WEllbutrin ^ Ritalin cold turkey and within two days of titrating to 80 mg of Straterra, I found myself thinking about killing myself almost constantly, always by sitting in the garage with both cars running, and always carefully planned for times when no one woudl be aroudn to find me. These were not pleas for help. It was more like I'd think, "WEll, I'm about finished with life, so I guess I'll just kill myself. It's no big deal. No one will be home for hours." SO I'd leave a little note in an envelope on the front steps for my family not to come in, to call the police, that I was int he garage & I'd go in the garage & start the cars. Then, somewhere between 15 minutes to half an hour later, it's like I'd wake up & think what the heck am I doing this for? This is insane! I finally called my doc & said, "I think I need to be in the hospital." Even there, they treated the problem like a psychological one except that he did have me evaluated by a neurologist who put me on Topomax for atypical migraines I've had my whole life & had like gangbusters in the hospital. My pdoc said he thought that would help with the suicidal impulses, but it didn't. I had a low grade migraine for severtal weeks, but that's gone now & the Topomax does seem to be helping both headaches & stablizing my moods a little.
It wasn't until two weeks later & I was still having the problem & there was no psychological reason for my level of distress that my pdoc started looking closer at my meds. He finally called in my family one at a time & me and asked each of us what we thought my single biggest problem had always been. It was unanimous, "IMPULSIVITY!" So he said the Ritalin seemed to be keeping that in check at least, so why not try going back to it & keep me on the Klonopin for panic attacks & see how that does?
So now I'm taking, daily:
40 mg Ritalin SR regardless of work hrs.
125 mg Topamax for headaches AND moods
40 mg Lexapro for depression
.5 mg Klonopin twice daily for anxietyThis week, he added
2.5 mg of Zyprexa at bedtime because my depression always seems to cause difficulty with sleep first and also because my depressions are somewhat atypical in that they have an agitated component. When I get low on energy & fatigued, I tend to push myself to continue funtioning & end up snapping at people, getitng argumentative, etc. I am not Bipolar because I've been through all the trials with those drugs and get MORE, not less agitated on them.Hoep this helps clear up why my pdoc blamed my agitation on the Straterra.
Honestly, I didn't FEEL worse on Straterra. I FELT better... clearer, more energetic, etc. than on Ritalon, but my family is telling me they are thanking GOD I'm back on Ritlin SR right now.
Thanks for asking.
Libby
Posted by LibbyH on April 1, 2003, at 15:47:16
In reply to Re: Straterra - Back to Ritalin SR-Libby » Proud2B-ADD, posted by blondegirl47 on March 31, 2003, at 9:13:44
I think that part of my problem with the agitation was quitting the Ritalin "cold turkey." I know that ADDers don't get addicted to stims in the same ways as most of the population, but it seems to me that the Ritalin acted as a calming agent on me & I could have withdrawn from that calming action just like most folks woul dhave withdrawn from its stim action. 'Course I have NO SCIENCE AT ALL to back up that claim. It's just a guess on my part. Still, I wonder if I'd done better to taper off the Ritalin.
Libby
Posted by Lexxey on April 1, 2003, at 17:07:00
In reply to Re: Straterra - Back to Ritalin SR - Bob, posted by LibbyH on April 1, 2003, at 15:43:19
when a person stops stimulants there will often be a period when they are depressed. The brain gets used to those chemicals. That's why I have always taken one month off ritalin for the almost 20 years I took it. It just makes me a little draggy for a few days. This makes sense to me and I can cope if I have to. I just drop everything I don't bump into. Clumsiness comes back and drives me nuts!!!
Posted by paulk on April 1, 2003, at 17:33:57
In reply to Re: Atomoxetine (Straterra) weight gain, posted by blondegirl47 on April 1, 2003, at 15:19:49
> I have read where people are taking it twice a day. Since it makes me sleepy, I am happy to only take it once a day. I hope your weight gain stops, as well as mine. :)
Dividing the dose may make you half as sleepy twice a day. A time release version may eliminate the sleepyness altogether. I remeber how surprised I was when I took effexor and switched to the slow release - almost like a different drug.
Posted by not exactly on April 2, 2003, at 3:05:31
In reply to Re: Straterra - Back to Ritalin SR - Bob, posted by LibbyH on April 1, 2003, at 15:43:19
Libby,
I can't believe your pdoc switched you from Prozac+Wellbutrin+Ritalin to Lexapro+Strattera+Klonopin all at once! That seems completely irresponsible - no wonder you felt suicidal. I'm sure the bad reaction you had was not due to the Strattera, but rather withdrawal symptoms from quitting the Wellbutrin and Ritalin cold turkey (both should be tapered off very gradually to avoid severe rebound depression).
- Bob
Posted by AS Mom on April 2, 2003, at 8:00:52
In reply to Re: Straterra - Back to Concerta - AS Mom, posted by Msanjelpie on April 1, 2003, at 7:40:52
DD's reaction to Strattera: weepiness and extreme fatigue! She has an autoimmune disorder so we didn't want to see her more tired than she already is. Also - did not help her ADD at all. She was on Concerta for 3 years prior to trying Strattera. We will be switiching her today to Ritalin (not time-leased) so we can give her the medication only when she needs it for school. Some days she is so tired that she doesn't attend school and we don't give her medication for ADD on those days. This was another reason we stopped the Strattera. We want to be able to have the option of reducing meds when she isn't feeling well.
DS's reaction: EXTREME moodiness and hyperactivity. He also had very vivid, disturbing nightmares. Now that he's back on Concerta, he's not having the nightmares and is calm and in control. He's been on Concerta/Ritalin for 3 years prior to trying Strattera.
My son also suffers from anxiety/depression. We took him off of prozac, and we'll see the psych today to discuss other meds that might help him with anxiety. The prozac did not help his anxiety at all. He was on that for about 2 years. We were hopeful that Strattera would be able to help both ADHD and anxiety, but it didn't work for him.
Posted by LibbyH on April 2, 2003, at 12:47:41
In reply to Re: Straterra - Back to Ritalin SR » LibbyH, posted by not exactly on April 2, 2003, at 3:05:31
I've experienced the rebound depressions before and every depressive episode is a little different, but over the course of my entire life, up until this last time I could say I've had certain tendencies when depressed. This last time, the impulsiveness and suicidal impulses specifically were awful. Between suicidal impulses, I felt great. It looked a lot more like mania. It was strange enough to make me wonder if all those trials with the BIpolar drugs were a fluke & I actually had some weird type of super rapid cycling bipolar with swings every 2-3 hrs. instead of every several days, so much so that I asked my pdoc about it.
He directed me back to my history, the trials, the testing, and the fact that I had been stable for two years on a pretty high doe of some pretty stimulating meds, so he was pretty confident I wasn't Bipolar.In other words, it wasn't like I was DEPRESSED so much as BIPOLAR, so I think what was goin on must have been a combination of both the sudden withdrawal from the Ritalin (the Wellbutrin had pooped out months ago) AND the effects of the Straterra. I have been doing some reading on the drug since my experience & increased impulsivity can be a side-effect of the drug. I understand that sometimes this can settle down as one builds a tolerance, but I was in a situation where I was making active (albeit not very seriously threatening) suicide attempts. I had never seen myself behave this way. I was scaring myself, my family, and even a pdoc who has seen me through five years of awful depression. I couldn't afford to wait. I don't mean to alarm anyone, but I will be on Ritalin for as long as the FDA, my pdoc, and my health will allow. Without it, I am dangerously impulsive and thoroughly capable of destroying my life in less than a week.
Libby
Posted by not exactly on April 2, 2003, at 13:59:21
In reply to Re: Straterra - Back to Ritalin SR - Bob, posted by LibbyH on April 2, 2003, at 12:47:41
> the sudden withdrawal from the Ritalin (the Wellbutrin had pooped out months ago)
Drugs "poop out" because your body adjusts to them. This is virtually the same phenomenon as "tolerance", an aspect of addiction. Just because a drug has pooped out does not mean that you won't get a violent reaction to discontinuing it.
However, I'm willing to believe that the presence of the Strattera made the Ritalin & Wellbutrin withdrawal symptoms more severe and qualitatively different from what you may have experienced in the past.
- Bob
Posted by LibbyH on April 2, 2003, at 19:07:25
In reply to Re: Straterra - Back to Ritalin SR » LibbyH, posted by not exactly on April 2, 2003, at 13:59:21
Poop out = tolerance = addiction? Really? I had never heard of this. I had taken Wellbutrin before & so had my husband & daughter & none of us had ever been tapered off it before. Had no idea youit was a drug you needed to taper off. What a nightmare.
My doc is usually very conservative. It's not like him to do something so radical. The withdrawal effects had never even occured to me until a psych nurse in the ER mentioned it as a possibility following my last suicide attempt. Then it was like a light bulb went off... oh yeah, the last time I went off Ritalin cold turkey (had a bad stomach flu for two weeks) I went into a terrible depression. As I said before, the "mania" was really baffling about this time though.
Posted by snowflake on April 3, 2003, at 11:11:23
In reply to Re: Straterra - Back to Concerta - AS Mom, posted by AS Mom on April 2, 2003, at 8:00:52
Hi,
As I posted before my 11 year old son was not helped by Strattera, it sent him down the same road as your children(AS Mom). He has been put back on Adderall XR, but it will be a couple of weeks until we can bring him back up to speed. We saw his doctor this week and she verified that some other children she treats have had the same reaction. I wonder if it's better for adults. Anyways, I just to post this incase it helps other families. If anybody has more updates on this please write.
Posted by blondegirl47 on April 4, 2003, at 12:19:55
In reply to Re: Going To Start Straterra This Week, posted by teacherkris on March 31, 2003, at 15:57:52
Hi teacherkris
Just wondered how it was going with you. Tonight I start on 40 ml strattera...for 4 days then I go to 60. I hope it gets rid of these munchies!
Posted by teacherkris on April 4, 2003, at 12:46:06
In reply to Re: Going To Start Straterra This Week, posted by blondegirl47 on April 4, 2003, at 12:19:55
Hi - things are much better. I seem to be doing fine now at 80 mg (40 am 40 afternoon). The side effects have gone away. I still don't seem to be very hungry but I'm not dropping weight like I was. Although I had an interesting experience the other night, I forgot my afternoon dose and woke up in the middle of the night hungry. So maybe the twice a day dosing is good which doesn't make me really happy but oh well! :-) Next week i'm supposed to go to 80 mg. just in the a.m. so we'll see what happens. I'm now on a half of my regular concerta dose too, only taking 36 mg now. He doesn't want me off concerta for the next three weeks. I'll keep you updated. Thanks for asking :-)!
Posted by Magpie on April 4, 2003, at 14:10:42
In reply to Re: Started Strattera Yesterday Woo-Hoo!, posted by macaroni on March 15, 2003, at 1:06:46
Hi Gang,
Well I've been browsing this thread and it seems most ppl are using this drug for ADD / ADHD. I do not have either of those DXs but I had been on Adderall as a stimulant to counteract the fatiguing side effects of my other meds. Now this past Wednesday the Adderall was stopped and I started taking 40mg Straterra. I have been totally exhausted ever since. I am also concerned because the PI says "not a stimulant". I just got off phone with doc a while ago and she says it only says that because it doesn't have FDA approval as such. Is anyone else here using it as a stimlant and not for ADD / ADHD and how are you making out with it? TIA,
Magpie
Posted by blondegirl47 on April 4, 2003, at 14:15:38
In reply to Straterra- anyone using as stimulant?, posted by Magpie on April 4, 2003, at 14:10:42
Hi Magpie
For me Strattera is definitely not a stimulant. I take it at night before bed, because it wacks my adderallxr. I am add without hyper. Strattera used to be an anti depresant. It didn't quite make it as an anti depresant though. Its supposed to be used for focus not as a stimulant.
Posted by Lexxey on April 4, 2003, at 15:02:39
In reply to Re: Going To Start Straterra This Week, posted by blondegirl47 on April 4, 2003, at 12:19:55
Blondie...
About the munchies....I didn't get them when I started on Stratterra [I can't remember how to spell it] and that's amazing cuz just watching a commercial can get me going. I wonder if it could be coming down off stimulants that could cause that. I do notice that I get them for a few days when I used to go off Ritalin for one month every year.
Had you been taking stimulant meds?
[I use lexxyred cuz of my red hair...part of my identity and temperment]
Posted by Lexxey on April 4, 2003, at 15:07:29
In reply to Straterra- anyone using as stimulant?, posted by Magpie on April 4, 2003, at 14:10:42
I don't see any way this could be a stimulant!!!
It's supposed to effect brain chemistry with norepinephirine and dopamine by suppressing the pump or something like that.
But it does cause the heart rate to increase and can cause the bp to also....maybe that's what he means. It sure doesn't stimulate me. I'm still waiting for the foggy slow motion feeling to fade.
Posted by blondegirl47 on April 4, 2003, at 15:34:27
In reply to Re: Going To Start Straterra This Week, posted by Lexxey on April 4, 2003, at 15:02:39
Hi Lexxyred :)
Thanks for your input. Yes I am still on my stimulant medication. I was having some munchies before strattera, but now I have food specific munchies. I want fried salty stuff and chocolate. I will get a handle on it, I just have to do a better job of self parenting. I'm giving Strattera a month or so. If I don't see a lot more focus and clarity, strattera will have to go. :)
Posted by Viridis on April 4, 2003, at 20:01:32
In reply to Re: Going To Start Straterra This Week, posted by blondegirl47 on April 4, 2003, at 15:34:27
I think this question has been asked here before, but has anyone had success (or problems) with Strattera plus a stimulant? I take Adderall for ADD (and also as an antidepressant) and am quite happy with it, except for the inconvenience of its Schedule II status. I'd like to try Strattera, and my pdoc is quite enthusiastic about it. However, if it takes a while to kick in, I'd rather not discontinue the Adderall, at least not at first. And, I'm curious about whether the combination might provide better focus.
I don't see anything in the prescribing info that contraindicates stimulants such as Adderall while taking Strattera, and have seen reports on other boards of people combining both types of meds. I'd be interested in the experiences of those here.
Thanks in advance!
Posted by Hyperactiveone on April 4, 2003, at 20:16:25
In reply to Re: Going To Start Straterra This Week, posted by blondegirl47 on April 4, 2003, at 15:34:27
Well let me introduce myself my name is Dave and I was one of the ones in the clinical trails that made this drug in the testing faze but could not handle the ups and downs of placebo. So I got off them and went back to treatment and was put back on ritalin. Day one of the straterra this week I will keep you posted on how I feel I have been taking ritalin four about 10 years and wanted to come of stimulants trying to see how atomoxophine is going to work with ritalin.---I will let you know. Does anyone have weird dreams?
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Dr. Bob is Robert Hsiung, MD,
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