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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Mr.Scott on November 30, 2004, at 0:01:10
Has anyone had any experience using Strattera for depression or indications other than ADHD?
Scott
Posted by Peddidle on November 30, 2004, at 2:38:59
In reply to Straterra for Depression, posted by Mr.Scott on November 30, 2004, at 0:01:10
I have been using strattera for about 6 weeks for attention and concentration issues. A few days ago, after increasing to 80mg, however, I actually noticed I felt very depressed-- I wanted to stay home rather than go out with my friends, I had crying spells, and just a general "blah" feeling...I even considered increasing my zoloft because of it. I took 40mg yesterday, and I didn't take it at all today, and even though I still felt kind of down when I woke-up this morning, I felt better as the day progressed.
Hope this helps!
Posted by Bill LL on November 30, 2004, at 9:05:27
In reply to Straterra for Depression, posted by Mr.Scott on November 30, 2004, at 0:01:10
I take 60 mg Straterra in the am and 60 mg around 6:00 pm. I also take 30 mg Lexapro and a 200 mg caffeine pill both in the am.
The Strattera, in addition to helping with attention, makes me feel more calm. I have not noticed any major effect on depression.
> Has anyone had any experience using Strattera for depression or indications other than ADHD?
>
> Scott
Posted by Ritch on November 30, 2004, at 10:06:16
In reply to Straterra for Depression, posted by Mr.Scott on November 30, 2004, at 0:01:10
> Has anyone had any experience using Strattera for depression or indications other than ADHD?
>
> ScottI've had a good response from it for bipolar depression (either it or WB) combined with a tiny bit of Effexor, Cymbalta, or Celexa. I can take the Efx, Cymb. or Celexa by itself and it won't work, but if I add either a little WB or Strattera it seems to do the trick, so I know it's needed for the depression, the serotonergics just handle the anxiety primarily. The only trouble I have with Strattera is it has a bad tendency to "lock" my attention so badly that decision-making is impaired. OTOH, it does seem to have antipanic qualities to it. Also, when I first start it up my heart rate goes up quite a bit (on a treadmill-same level of exertion), and after a few days that drops to where it was-which makes one wonder about its "down-regulating" effect on adrenergic receptors.
Posted by Mr.Scott on November 30, 2004, at 12:59:08
In reply to Re: Straterra for Depression » Mr.Scott, posted by Ritch on November 30, 2004, at 10:06:16
Hey Mitch,
What's your current cocktail if I may inquire?
I'm on:
25mg Zoloft, 25mg Lamictal, .5mg clonazepam, 200mg-400mg caffeine and I just started strattera. Occassionally if depression is too lethargic I'll take a provigil as a kick in the pants. However after a few days or weeks stimulants make me more anxious and irritable.It would be so cool if I could tolerate enough ssri or lamictal to get the benefits out of it I need.
Scott
Posted by simoncat on November 30, 2004, at 13:27:07
In reply to Straterra for Depression, posted by Mr.Scott on November 30, 2004, at 0:01:10
I take it with my Lexapro. However, a few weeks ago, I took just it for 3 days without the Lexapro. Would NOT recommend taking only the Strattera for depression. Did not help at all.
Posted by Racer on November 30, 2004, at 13:32:33
In reply to Straterra for Depression, posted by Mr.Scott on November 30, 2004, at 0:01:10
Dunno how much it helped, because of other meds and the circumstances at the time. I know that I was better off while taking it than I was for about a year afterwards, though, if that helps.
My situation was very complicated, though. Without those complications, I'd bet it would have been pretty helpful.
Posted by Ritch on November 30, 2004, at 13:35:27
In reply to Re: Straterra for Depression » Ritch, posted by Mr.Scott on November 30, 2004, at 12:59:08
> Hey Mitch,
>
> What's your current cocktail if I may inquire?
>
> I'm on:
> 25mg Zoloft, 25mg Lamictal, .5mg clonazepam, 200mg-400mg caffeine and I just started strattera. Occassionally if depression is too lethargic I'll take a provigil as a kick in the pants. However after a few days or weeks stimulants make me more anxious and irritable.
>
> It would be so cool if I could tolerate enough ssri or lamictal to get the benefits out of it I need.
>
> ScottScott, I'm on Fish Oil 2-3G, Depakote 250-375mg, .5-.75mg clonazepam, WB 12.5mg or Stratterra 5mg + Cymbalta .5mg or Celexa .4mg. The "or" has to do with experimenting with an AD combo that doesn't make my acid reflux so bad I french-fry my esophagous. SRI's just toast my GI tract, but help with anxiety (at low doses only). The lowdose Strat+Celexa works better for my head (depression/anxiety), but the WB and Cymbalta come fairly close without aggravating IBS symptoms. Even the Strat bugs my stomach. As far as taking enough SSRI goes... I've reached a point where only the tiniest dose to reduce anxiety is tolerable. I don't even attempt to use them as an AD anymore. Any more than a little sets off rapid-cycling, sleep disruption, even some EPS symptoms. It sounds like you are doing fairly well on your combo-hope the Strat works out. I'm super med sensitive to everything and the range on the Strat for me was 5mg-10mg. Higher doses make my stomach too wrenched, lower than 5mg doesn't do anything.--- Mitch
Posted by zeugma on November 30, 2004, at 16:06:30
In reply to Re: Straterra for Depression » Mr.Scott, posted by Ritch on November 30, 2004, at 13:35:27
> > Hey Mitch,
> >
> > What's your current cocktail if I may inquire?
> >
> > I'm on:
> > 25mg Zoloft, 25mg Lamictal, .5mg clonazepam, 200mg-400mg caffeine and I just started strattera. Occassionally if depression is too lethargic I'll take a provigil as a kick in the pants. However after a few days or weeks stimulants make me more anxious and irritable.
> >
> > It would be so cool if I could tolerate enough ssri or lamictal to get the benefits out of it I need.
> >
> > Scott
>
> Scott, I'm on Fish Oil 2-3G, Depakote 250-375mg, .5-.75mg clonazepam, WB 12.5mg or Stratterra 5mg + Cymbalta .5mg or Celexa .4mg. The "or" has to do with experimenting with an AD combo that doesn't make my acid reflux so bad I french-fry my esophagous. SRI's just toast my GI tract, but help with anxiety (at low doses only). The lowdose Strat+Celexa works better for my head (depression/anxiety), but the WB and Cymbalta come fairly close without aggravating IBS symptoms. Even the Strat bugs my stomach. As far as taking enough SSRI goes... I've reached a point where only the tiniest dose to reduce anxiety is tolerable. I don't even attempt to use them as an AD anymore. Any more than a little sets off rapid-cycling, sleep disruption, even some EPS symptoms. It sounds like you are doing fairly well on your combo-hope the Strat works out. I'm super med sensitive to everything and the range on the Strat for me was 5mg-10mg. Higher doses make my stomach too wrenched, lower than 5mg doesn't do anything.--- MitchStrattera caused a lot of lower GI tract problems for me- not pleasant. It worked, in a particular way, for my ADD_ it made my mind perfectly clear, but this was a mixed blessing, since it inhibited my decision-making capacity- that 'locked' feeling rings a bell- and ultimately I dropped it because of the aggravation of IBS and long-time fatigue it induced (and also see below for a major adverse reaction). A couple of months ago in desperation I used it as a PRN med, and it worked (it has this 'jolting' feeling that kicks in immediately) but I needed high doses to sustain this effect which cut up my GI tract and made me more fatigued (I have virtually zero enrgy anyway). Nortriptyline is a far more tolerable drug in terms of IBS benefit and lack of further energy drain, so I have stuck with nortrip at dosages of 75-100 mg/day.
Unfortunately, nortrip by itself doesn't help adequately with my ADD, and I need high doses of Ritalin (60 mg/day) to get any effect at all, and as a result, my appetite is a thing of the past, and my sleep is not what it should be. I don't know that combining an amphetamine with a TCA would be a good idea, and I cannot tolerate Provigil at all. That's a shame, because provigil had a better effect on my ADD than anything I have ever tried. They should try that drug out on dyslexics, since remarkably it reversed my dyslexic symptoms (made posting intelligible messages a lot less time-consuming!). Unfortunately it rivaled Wellbutrin in the 'weird side-effect' department, and I dropped it, reluctantly, because I simply felt ill constantly on it. (I feel ill enough anyway.)
I would say nortriptyline and Strattera have similar AD properties, but I think a metabolite forms in extensive metabolizers of CYP 2D6 (a majority of the population) which is responsible for the energy drain Strattera causes, and in some people (including me) it can bring on a full-scale anhedonic depression after long-term use.
Posted by zeugma on November 30, 2004, at 16:49:11
In reply to Re: Straterra for Depression, posted by zeugma on November 30, 2004, at 16:06:30
I would say nortriptyline and Strattera have similar AD properties, but I think a metabolite forms in extensive metabolizers of CYP 2D6 (a majority of the population) which is responsible for the energy drain Strattera causes, and in some people (including me) it can bring on a full-scale anhedonic depression after long-term use.
Conceivably taking enough of a 2D6 inhibitor such as Prozac or paxil would alleviate this problem. But Prozac and Paxil are not IBS-friendly drugs, and I think it's unwise to take a drug for the sole purpose of mitigating a side effect from another drug, unless absolutely necessary. I am not going to mess with Paxil in the hope that it would make strattera more tolerable.
Posted by Ritch on December 1, 2004, at 10:03:48
In reply to Re: Straterra for Depression, posted by zeugma on November 30, 2004, at 16:06:30
>Strattera caused a lot of lower GI tract problems for me- not pleasant. It worked, in a particular way, for my ADD_ it made my mind perfectly clear, but this was a mixed blessing, since it inhibited my decision-making capacity- that 'locked' feeling rings a bell- and ultimately I dropped it because of the aggravation of IBS and long-time fatigue it induced (and also see below for a major adverse reaction). A couple of months ago in desperation I used it as a PRN med, and it worked (it has this 'jolting' feeling that kicks in immediately) but I needed high doses to sustain this effect which cut up my GI tract and made me more fatigued (I have virtually zero enrgy anyway). Nortriptyline is a far more tolerable drug in terms of IBS benefit and lack of further energy drain, so I have stuck with nortrip at dosages of 75-100 mg/day.
I was on nortriptyline in the past and found it to be the most tolerable TCA I had taken (the others were doxepin, amitrip., imipramine, desipramine). Nort. was the only one that didn't give me any postural hypotension, and I didn't get blurred vision as bad as with desipramine. The cotton mouth was pretty significant though and I had elevated heart rate. Too bad some pharma company doesn't explore mfg. and testing nortriptyline's metabolite (forgot the name). I've heard it is supposed to be a powerful anxiolytic.
>Unfortunately, nortrip by itself doesn't help adequately with my ADD, and I need high doses of Ritalin (60 mg/day) to get any effect at all, and as a result, my appetite is a thing of the past, and my sleep is not what it should be. I don't know that combining an amphetamine with a TCA would be a good idea, and I cannot tolerate Provigil at all. That's a shame, because provigil had a better effect on my ADD than anything I have ever tried. They should try that drug out on dyslexics, since remarkably it reversed my dyslexic symptoms (made posting intelligible messages a lot less time-consuming!). Unfortunately it rivaled Wellbutrin in the 'weird side-effect' department, and I dropped it, reluctantly, because I simply felt ill constantly on it. (I feel ill enough anyway.)
Not only do I have a "multimodal mood disorder", but there is the ADD thing that's fairly complex. It involves a combo of two problems: 1) Task ridgity (the "lockup" effect)...when I fail to take any SRI..an ocd-like thing, and 2) Excessive multitasking, incompleteness, etc...more a classic inattentive ADD thing... when I don't take a noradrenergic med. So taking a little of both seems to help both. The SRI's augment task flow and "satisficing" of tasks, while the NRI's keep me ON task and allow follow-through. I had a reasonable amount of success taking *neither* and just using Depakote+Ritalin in the past. Have also tried just using Depakote+WB, but then I have a lot of residual anxiety with those.....
Posted by Peddidle on December 1, 2004, at 12:06:43
In reply to Re: Straterra for Depression » zeugma, posted by Ritch on December 1, 2004, at 10:03:48
Ritch-
I experienced horrible fatigue from the strattera as well. My therapist thought that was a weird reaction, but my pdoc said she had heard of that happening. I stopped taking it a few days ago-- I started having really bad mood swings and crying spells, plus I couldn't stand the nausea and fatigue. My pdoc just gave me a prescription for concerta yesteray...we'll see if it helps!
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