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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Peddidle on December 3, 2004, at 23:29:08
I stopped the strattera completely earlier this week and I am now on Concerta, but I can't shake the feeling that maybe I made a mistake. After six weeks of gradually increasing the strattera, I was definitely starting to feel its benefits (i.e. motivation, attention, etc.), but at almost the exact same, I was also feeling really bad side effects: I had really bad crying spells (or moments when I thought I would burst into tears at any moment for absolutely no reason, I was tired all the time, and I would get unbelievably nauseous unless I took the pills with a full meal. This past Sunday, I took half my normal dose in the morning, with the intention of taking the other half that night when I got back to school, but after having another depressing crying spell, I called home and decided that I would just stop taking it all together.
Now I can't stop thinking that maybe I should have waited longer to see if the benefits would out-weigh the side-effects, or to see if what I was experiencing was even related to the strattera. In all fairness, I do suffer from adjustment disorder and dysthymia (or so I'm told), and I had just gone home for the holiday at the same time I increased from 75mg to 80mg, so I'm sure that was a factor in it, but the crying spells really scared me because I had never experienced anything that extreme before-- wanting to cry for no apparent reason. I guess I'm mostly upset because strattera is the kind of drug that needs to be gradually increased over however many weeks before the target dose is reached, and also because it took about six weeks for me to begin to feel any benefit from it. Because of this, I'm worried that I screwed-up because if I ever want to go back on it, I'll have to go through that same tedious process again. I'm wondering if I made the right choice to stop it, or if I should have waited longer, because I definitely loved having that feeling of motivation that the strattera gave me.
Sorry for the ridiculously long post, but I would really appreciate advice.
Thanx!
Posted by linkadge on December 4, 2004, at 10:09:45
In reply to I wonder if I made the right choice..., posted by Peddidle on December 3, 2004, at 23:29:08
Depression, crying spells, and melancholy are reported *often* with Straterra use. For many it does not improve over time. Medications can be mind games at times, because you don't really know whats good enough to stick with.
These side effects are serious however, and in my mind justify its discontinueation.
There is a significant interplay between emotions and cognition. Ie if you're sad, melencholic, and weepey, then theres only so far this med can go to help your concentration.
I think you've made the right choice. There are other options.
Linkadge
Posted by Peddidle on December 4, 2004, at 14:09:18
In reply to Re: I wonder if I made the right choice..., posted by linkadge on December 4, 2004, at 10:09:45
Thanx Linkadge! That makes me feel better, because when I told the pdoc about the crying spells, it seems like she completely ignored it, like she was more concerned with physical symptoms (ie. nausea).
Posted by zeugma on December 4, 2004, at 17:04:07
In reply to I wonder if I made the right choice..., posted by Peddidle on December 3, 2004, at 23:29:08
I had a similar experience with Strattera, but over a much longer time-frame. The increase in motivation, attention, etc., were great, and I also experienced a strong antidepressant effect. As time wore on, however, the fatigue which I always suffer from (I probably have narcolepsy as well as ADD) began to worsen, and my mood began to worsen. It reached the point where I was crying all the time, and could not stay awake long enough to eat dinner (well, I still struggle with that). I decided enough was enough after taking a 40 mg capsule in the afternoon and feeling the fatigue and sadness overtake me. I went off it completely and started Provigil, which worked amazingly well for my symptoms, but caused hellish side effects. I then tried Ritalin LA, which simply didn't work, and in desperation went back to Strattera. I can tell you that its alerting effects were there, and it helped me through a tight spot, but it quickly became clear that this was not going to be a long-term solution as its depressing and fatiguing elements were still there.
I went back to Ritalin LA and moved up the dosage to where therapeutic effects appeared (60 mg). Unfortunately that comes with its own side effects, but I have learned that every drug comes with its hazards, and my unmedicated state is intolerable. I don't think you made the wrong decsion in stopping Strattera, and if you need a similar medication, you can try one of the old TCA's that it most resembles, desipramine or nortriptyline. In my opinion these are superior medications because they don't cause the peculiar fatigue and anhedonia that Strattera does (at least, not typically: no drug is perfect!). I am currently taking nortriptyline and I consider that to be far better in terms of sustained efficacy and lack of energy drain. I hope the Concerta works for you.
This is the end of the thread.
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