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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 30. This is the beginning of the thread.
Posted by linkadge on November 9, 2006, at 15:00:11
I know I am a hypocite. Anyhow I'll let you know how it goes. Concerned about cardiac stuff, but we'll see.
Linkadge
Posted by Glydin on November 9, 2006, at 15:22:41
In reply to Giving straterra a whirl, posted by linkadge on November 9, 2006, at 15:00:11
> I know I am a hypocite.
~~~ No, just someone looking for an answer. It pays not to judge others or ourselves as we never know what decisions we may decide are best for us based on current circumstances.
I hope it helps.
Posted by ronaldo on November 9, 2006, at 15:37:38
In reply to Giving straterra a whirl, posted by linkadge on November 9, 2006, at 15:00:11
> I know I am a hypocite. Anyhow I'll let you know how it goes. Concerned about cardiac stuff, but we'll see.
>
> LinkadgeApparently there is some liver stuff that is cause for concern....
http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01335.html
....don't know if you are aware of this.
...ronaldo
Posted by linkadge on November 9, 2006, at 16:18:37
In reply to Re: Giving straterra a whirl » linkadge, posted by ronaldo on November 9, 2006, at 15:37:38
Yeah, this is a concern, though not sure how to process it.
Hate to be a crash test dummy, but I suppose time will clarify the extent of the problem.
Linkadge
Posted by linkadge on November 9, 2006, at 16:19:15
In reply to Re: Giving straterra a whirl » linkadge, posted by Glydin on November 9, 2006, at 15:22:41
Not to say I still don't hate meds.
Linkadge
Posted by ed_uk on November 9, 2006, at 16:31:33
In reply to Re: Giving straterra a whirl » Glydin, posted by linkadge on November 9, 2006, at 16:19:15
Hi Link
I'm hopeful for you. I really hope it helps.
Ed
Posted by Glydin on November 9, 2006, at 16:53:47
In reply to Re: Giving straterra a whirl » Glydin, posted by linkadge on November 9, 2006, at 16:19:15
> Not to say I still don't hate meds.
>
> Linkadge
I know...... Still wishing you good luck.
Posted by Phillipa on November 9, 2006, at 19:01:50
In reply to Re: Giving straterra a whirl » linkadge, posted by Glydin on November 9, 2006, at 16:53:47
Me too link. Did you start it yet? Love Phillipa
Posted by Declan on November 9, 2006, at 19:19:27
In reply to Giving straterra a whirl, posted by linkadge on November 9, 2006, at 15:00:11
Don't worry Link, consistancy is a vice of youth.
But this Straterra stuff, is it any good? What does it do?
Though who knows?
I know 2 people on reboxetine and they seem to like it, for heavens sake.
Very calm they seemed to me too.
Posted by saturn on November 9, 2006, at 20:17:26
In reply to Giving straterra a whirl, posted by linkadge on November 9, 2006, at 15:00:11
Posted by SLS on November 9, 2006, at 22:24:46
In reply to Giving straterra a whirl, posted by linkadge on November 9, 2006, at 15:00:11
I hope you get from Strattera what you are looking for.
I've seen it turn someone's life around. They had an unrecognized adult ADD that presented as mild depression.
- Scott
Posted by Meri-Tuuli on November 10, 2006, at 5:38:26
In reply to Re: Giving straterra a whirl, posted by SLS on November 9, 2006, at 22:24:46
I hope it goes well for you! I really do. What else do you currently take? Did you mention ativan? What would you say is the best benzo for panic attacks?
Posted by linkadge on November 10, 2006, at 7:09:37
In reply to Re: Giving straterra a whirl » linkadge, posted by Glydin on November 9, 2006, at 16:53:47
THX
Linkadge
Posted by linkadge on November 10, 2006, at 7:14:53
In reply to Re: Giving straterra a whirllinkadge, posted by Meri-Tuuli on November 10, 2006, at 5:38:26
Not sure what the best benzo for panic attacks is.
Anyhow, I started on 1/2 of lowest pill ie 5mg.
I already don't know if I can tollerate this stuff as it gave me some chest tightness, and tachycardia at just 5mg!! (5mg of 80mg)
Anyhow, it may have been that I was taking some herbs too, which I will discontinue for the time being to see whats what.
I did notice a lot less brain noise after first dose.
If cardiac stuff continues I will have to drop it. I am a sucker for giving into cardic side effects. Something just tells me not to mess with the heart.
Linkadge
Posted by zeugma on November 10, 2006, at 7:26:59
In reply to Re: Giving straterra a whirllinkadge, posted by linkadge on November 10, 2006, at 7:14:53
> Not sure what the best benzo for panic attacks is.
Klonopin is good.
>
> Anyhow, I started on 1/2 of lowest pill ie 5mg.
>
> I already don't know if I can tollerate this stuff as it gave me some chest tightness, and tachycardia at just 5mg!! (5mg of 80mg)
>
> Anyhow, it may have been that I was taking some herbs too, which I will discontinue for the time being to see whats what.
>
> I did notice a lot less brain noise after first dose.Its cardinal effect was mental clarity.
>
> If cardiac stuff continues I will have to drop it. I am a sucker for giving into cardic side effects. Something just tells me not to mess with the heart.
>
your instincts are not misguided.In my experience, Strattera is more a 'stimulant' than Ritalin, Provigil or Cylert. Although I had no cardiac issues on it. It was like rocket fuel at first, subjectively.
-z
> Linkadge
>
>
>
>
>
Posted by Meri-Tuuli on November 10, 2006, at 8:59:41
In reply to Re: Giving straterra a whirllinkadge » linkadge, posted by zeugma on November 10, 2006, at 7:26:59
> > Not sure what the best benzo for panic attacks is.
>
> Klonopin is good.Is that the one which also has anti-depressant properties? I forget which, I haven't paid much attention to benzos because they're treated like anthrax in the UK.
Have you tried a benzo link? And if so, what did it feel like?
Posted by SLS on November 10, 2006, at 9:03:40
In reply to Re: Giving straterra a whirllinkadge » linkadge, posted by zeugma on November 10, 2006, at 7:26:59
It might be worth tolerating the elevated HR now to evaluate the efficacy of the drug and deal with the side effects later. If the benefit is worth the complication, perhaps using a beta-blocker to offset the sympathetic activation can be used.
I guess each person has his own scale to balance. For me, the increased HR produced by TCA has been a worthwhile trade-off for the potential to be able to function and return to society. People have been maintained on TCA for decades. I don't think there has been a demonstrable increase in the risk of death due to CV causes. Even if there were, for me, it seems to be small enough to be worth taking. TCAs have the advantage of being alpha-1 blockers, and can reduce the workload on the heart. This is not true of Strattera.
I found Strattera fatiguing. I don't recall having an alerting or energizing reaction to my first dose.
- Scott
Posted by Meri-Tuuli on November 10, 2006, at 9:04:05
In reply to Re: Giving straterra a whirllinkadge, posted by linkadge on November 10, 2006, at 7:14:53
>I am a sucker for giving into cardic side effects. Something just tells me not to mess with the heart.
I'm a sucker now for anything that could possibly do me *any* harm! Heart, with liver, is right up there for me. Although I'm less worried about the heart - I think you get complacent being a healthy young non-smoking chick - you just don't think heart troubles will effect you.
Anyhow, I tried reboxetine and that made my heart do something different, not sure what. I think it might have made it beat faster perhaps? I remember thinking it was impossible to get a panic attack on rebox because your heart was beating so fast anyway...... it was a strange med.
Anyway good luck with the stat. Keep us posted!
M
Posted by linkadge on November 10, 2006, at 9:09:31
In reply to Re: Giving straterra a whirllinkadge, posted by Meri-Tuuli on November 10, 2006, at 9:04:05
Does anyone know a typical half life for this drug?
Linkadge
Posted by zeugma on November 10, 2006, at 10:22:37
In reply to Half-life ?, posted by linkadge on November 10, 2006, at 9:09:31
> Does anyone know a typical half life for this drug?
>
>
> Linkadge
it's genotype dependent. in 2D6 slow metabolizers it's 24 hrs. in rapid (or 'normal') metabolizers it's 5 hrs. But there is controversy over how many doses per day are needed. Most of the time I took one morning dose, and it lasted about as long as two doses of Ritalin LA (i.e., about 8-10 hrs.)-z
Posted by zeugma on November 10, 2006, at 10:33:16
In reply to Re: Giving straterra a whirllinkadge » zeugma, posted by Meri-Tuuli on November 10, 2006, at 8:59:41
> > > Not sure what the best benzo for panic attacks is.
> >
> > Klonopin is good.
>
> Is that the one which also has anti-depressant properties? I forget which, I haven't paid much attention to benzos because they're treated like anthrax in the UK.>>they're not nearly as bad as anthrax :-)
Klonopin is usually blamed for depressing people. Xanax is claimed to have AD properties. I haven't had any problems with Klonopin.
>
> Have you tried a benzo link? And if so, what did it feel like?
>
>what is a benzo link? ah, this question was not addressed to me :-)
-z
Posted by Meri-Tuuli on November 10, 2006, at 10:54:00
In reply to Re: Half-life ? » linkadge, posted by zeugma on November 10, 2006, at 10:22:37
Sorry to interrupt, but I have a question....
>in 2D6 slow metabolizers it's 24 hrs. in rapid (or 'normal') metabolizers it's 5 hrs.
How do you know which genotype you are? Well other than expensive genetic testing, I mean, what are the clinical signs (in general) if you can tell?
Kind regards
Meri
Posted by zeugma on November 10, 2006, at 11:07:40
In reply to Re: Half-life ? » zeugma, posted by Meri-Tuuli on November 10, 2006, at 10:54:00
> Sorry to interrupt, but I have a question....
>
> >in 2D6 slow metabolizers it's 24 hrs. in rapid (or 'normal') metabolizers it's 5 hrs.
>
> How do you know which genotype you are? Well other than expensive genetic testing, I mean, what are the clinical signs (in general) if you can tell?>>the main way to know is to get your plasma levels tested while taking a TCA. This was standard practice here in the U.S. for many years and I have had my nortriptyline levels taken several times.
But so many drugs affect this. For instance Paxil will convert you from a 'rapid metabolizer' to a 'slow metabolizer.'
It has been known even before the relavant enzymes were identified that TCA's were dependent on plasma levels. For other psych drugs, relationships are less clear.
But I'd guess, for example, that reboxetine's efficacy would be lessened by provigil.
-z
>
> Kind regards
>
> Meri
>
Posted by Meri-Tuuli on November 10, 2006, at 12:42:37
In reply to Re: Half-life ? » Meri-Tuuli, posted by zeugma on November 10, 2006, at 11:07:40
Thnanks for the reply (and sorry for the interuption)
I guess I'll never know if I'm a rapid/slow metabolizer, as I don't ever plan on taking a TCA. Is there any other way, other than getting your plasma levels checked? I guess not, it'd be quite hard to tell and very variable....
Kind regards
Meri
Posted by ed_uk on November 10, 2006, at 14:44:57
In reply to Re: Giving straterra a whirllinkadge » linkadge, posted by zeugma on November 10, 2006, at 7:26:59
Hi Link
Strattera causes 'sinus tachycardia' very frequently. Although this is not a serious arrhythmia, it can be unpleasant.
Ed
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