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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by SLS on July 10, 2003, at 16:04:12
Has anyone suffering from depression (without ADD) responded well to Strattera?
What dosage?
Side-effects?I've been taking Strattera for just over a week. My doctor wants me to work up to 80mg. I really don't expect it to work, but I can't afford to overlook possibly effective treatments.
Thanks in advance.
- Scott
Posted by KRM123 on July 10, 2003, at 19:04:47
In reply to Strattera for depression without ADD?, posted by SLS on July 10, 2003, at 16:04:12
I was on Strattera for 2 weeks for depression/anxiety. I do not have ADD. I was also on 50mg of Zoloft. My pDoc perscribed it to help my anxiety, concentration and energy. It helped diminish my carb cravings and pepped me up a little bit, but I had to quit because it was causing severe menstrual cramps. I think I would have liked- bummed it didn't work out. I felt the best on 80mg. Good luck.
Posted by fallsfall on July 10, 2003, at 20:18:40
In reply to Strattera for depression without ADD?, posted by SLS on July 10, 2003, at 16:04:12
I have depression, but no ADD. I've been on meds for the last 8 1/2 years. 1 1/2 years ago I crashed for the second time. We tried a bunch of med changes including Parnate. Nothing helped. 10 months later Prozac showed some promise, but I was so fatigued that I couldn't do anything. 13 months into the depression we tried Provigil and Strattera (each drug, on its own, didn't do enough, but together there was a sizable improvement in energy levels).
So I've been taking Strattera since February. There were side effects, (but I think they are gone now). Nausea and dizziness were the worst (Ginger capsules from the health food store helps the nausea). Start small and increase slowly so the side effects don't get overwhelming.
(Bonus) Strattera and Provigil (I can't tell which because I started them together) work really well at reducing suicidal ideation.
I take 80mg in the morning. I also take Prozac, so 80mg is actually a large dose (Prozac makes the Strattera more potent). He wants me to try 100mg.
So, I looked for a long time for Strattera. Why do you expect that it won't work?
Hope your search is successful.
Posted by Viridis on July 11, 2003, at 2:28:03
In reply to Strattera for depression without ADD?, posted by SLS on July 10, 2003, at 16:04:12
I recently started Strattera for ADD, but it also has a mild mood-elevating effect for me (I suffer from depression too). I think the manufacturer is trying to get it approved as an AD, although apparently initial trials have shown mixed results. I like it, and think it's worth a decent trial unless you really react badly. The side effects were mild for me at each dosage increase and went away quickly, unlike SSRIs or Wellbutrin.
Posted by SLS on July 11, 2003, at 8:29:01
In reply to Re: Strattera for depression without ADD? » SLS, posted by fallsfall on July 10, 2003, at 20:18:40
Hi.
Strattera made me feel pretty weird during the first week. I am on day 10, but I have been titrating gradually and am now at 65mg. I felt somewhat spacey at 25mg, but feelings of unreality and anxiety predominated. I was also experiencing suicidal ideation. I have to say that these things have disappeared entirely. I am also taking Lamictal 250mg + imipramine 300mg.
> Why do you expect that it won't work?
Because nothing ever does. I guess I have two reasons. First of all, I have a 20 year history of being treated for depression with only one success. Depression remitted completely for about 9 months when I took a combination of Parnate + desipramine. Unfortunately, it no longer works. The other reason is that I am under the impression that atomoxetine did not show robust efficacy for depression during its initial trials under the name tomoxetine.
For some stupid reason, I get enthused and optimistic with every drug trial. Since I have failed at least 60 of them, it makes no sense to be optimistic. Perhaps depression leaves me delusional :-). This is the first trial I can remember being pessimistic about. I guess that means it will work. Crap. See what I mean! :-)
> Hope your search is successful.
Thank you.
- Scott
Posted by zeugma on July 11, 2003, at 9:45:05
In reply to Re: Strattera for depression without ADD?, posted by SLS on July 11, 2003, at 8:29:01
> Hi
>
> Strattera made me feel pretty weird during the first week. I am on day 10, but I have been titrating gradually and am now at 65mg. I felt somewhat spacey at 25mg, but feelings of unreality and anxiety predominated. I was also experiencing suicidal ideation. I have to say that these things have disappeared entirely. I am also taking Lamictal 250mg + imipramine 300mg.
That's quite a noradrenergic cocktail. I am taking 80 mg Strattera, 75 mg nortriptyline and 30 mg buspirone. Constipation has been a problem but concentration has not (I added Strattera because my ADHD was still acting up).
>
> > Why do you expect that it won't work?
>
> Because nothing ever does. I guess I have two reasons. First of all, I have a 20 year history of being treated for depression with only one success. Depression remitted completely for about 9 months when I took a combination of Parnate + desipramine. Unfortunately, it no longer works. The other reason is that I am under the impression that atomoxetine did not show robust efficacy for depression during its initial trials under the name tomoxetine.
>I figured that tomoxetine was not developed by Lilly in the late 80's because they were busy launching Prozac and selling pdocs everywhere on the serotonin theory of depression. They didn't want to confuse issues by simultaneously plugging a drug for depression that didn't do anything for 5HT.
Parnate and desipramine seems like it would be a very activating combination. Do you find Strattera activating (sepecially in comparison to a TCA?) I find Strattera not to be energizing, but to increase my sensitivity to stimulating substances like caffeine and chocolate, and to give me a feeling like I'm fully awake. Depression for me becomes a trance-like or dream-like state where I feel like my mind and senses become 'deactivated.' The other side of that coin is sleep states that are way too lucid. The nortrip got the sleeping states under control but is probably too sedating to give me fully differentiated 'waking' states. The Strattera helps with that a lot.By the way,the Strattera script information contraindicates MAOI's strongly. But I assume it would be safe since Strattera is pharmacologically similar to a secondary amine TCA.
> For some stupid reason, I get enthused and optimistic with every drug trial. Since I have failed at least 60 of them, it makes no sense to be optimistic. Perhaps depression leaves me delusional :-). This is the first trial I can remember being pessimistic about. I guess that means it will work. Crap. See what I mean! :-)
>
> > Hope your search is successful.
>
> Thank you.
>
>
> - ScottI hope so too.
z
>
Posted by SLS on July 13, 2003, at 14:42:01
In reply to Re: Strattera for depression without ADD? » SLS, posted by zeugma on July 11, 2003, at 9:45:05
> Parnate and desipramine seems like it would be a very activating combination.It was very activating the first time I tried it. Of course, my system was closer to being in a virginal state than it is now. At the time, I had total insomnia and needed to take Ativan and Halcion for sleep. My REM was probably 100% suppressed, as I didn't dream at all. Unfortunately, this combination does not now affect the quality nor duration of sleep, and I dream all of the time. I believe this gives evidence as to how my nervous system has been changed by repeated exposure to various drugs and why so many drugs are no longer helpful to me.
> Do you find Strattera activating (specifically in comparison to a TCA?)
When I first started Strattera, it reminded me of how I feel whenever I begin a tricyclic. It is sort of like being slightly activated and sleepy at the same time. What I find encouraging is that the Strattera had this effect on me despite my already being on imipramine 300mg. Maybe it is doing more of what I need from the tricyclics. Who knows? You can't blame a guy for hoping.
> Depression for me becomes a trance-like or dream-like state where I feel like my mind and senses become 'deactivated.'
Ditto.
> By the way, the Strattera script information contraindicates MAOI's strongly. But I assume it would be safe since Strattera is pharmacologically similar to a secondary amine TCA.
That's what I was thinking. As far as combining medications is concerned, I have had less trouble with side effects when using Parnate rather than Nardil in combination with tricyclics. With Parnate, I can use imipramine, desipramine, and nortriptyline without sequalae. However, combining imipramine or nortriptyline with Nardil produces serotonin syndrome, severe hypotension, and the inability to initiate urination. I have managed to combine successfully Nardil and desipramine, although I still have trouble with hypotension and urination.
- Scott
Posted by zeugma on July 14, 2003, at 7:52:28
In reply to Re: Strattera for depression without ADD? » zeugma, posted by SLS on July 13, 2003, at 14:42:01
>
> > Parnate and desipramine seems like it would be a very activating combination.
>
> It was very activating the first time I tried it. Of course, my system was closer to being in a virginal state than it is now. At the time, I had total insomnia and needed to take Ativan and Halcion for sleep. My REM was probably 100% suppressed, as I didn't dream at all. Unfortunately, this combination does not now affect the quality nor duration of sleep, and I dream all of the time. I believe this gives evidence as to how my nervous system has been changed by repeated exposure to various drugs and why so many drugs are no longer helpful to me.Yes, I worry about that too. At this point, though, the period I spend dreaming is significantly less than when I was severely depressed and off meds. One reason I am so happy with the nortriptyline is that I simply cannot sleep normally without it. I also was very prone to getting REM-induced headaches which were another manifestation of the 'dissociated' wake and sleeping states. Those seemed to diminish around the time I started taking Buspar, and I haven't had an episode in a number of months. Have you ever tried Buspar? There is a theoretical possibility (due to its being metabolized to an alpha-2 adrenergic antagonist) of its potentiating a noradrenergic agent. I know that I was still feeling a lot of dysphoria at the time I added the Buspar, but my mood seemed to improve almost immediately after adding it.
>
> > Do you find Strattera activating (specifically in comparison to a TCA?)
>
> When I first started Strattera, it reminded me of how I feel whenever I begin a tricyclic. It is sort of like being slightly activated and sleepy at the same time. What I find encouraging is that the Strattera had this effect on me despite my already being on imipramine 300mg. Maybe it is doing more of what I need from the tricyclics. Who knows? You can't blame a guy for hoping.I can't! I certainly hope it does help.
>
> As far as combining medications is concerned, I have had less trouble with side effects when using Parnate rather than Nardil in combination with tricyclics. With Parnate, I can use imipramine, desipramine, and nortriptyline without sequalae. However, combining imipramine or nortriptyline with Nardil produces serotonin syndrome, severe hypotension, and the inability to initiate urination. I have managed to combine successfully Nardil and desipramine, although I still have trouble with hypotension and urination.
>
I appreciate the info about tricyclic/ MAOI combinations. I have thought a lot about MAOI's lately, after realizing that I have avoidant personality disorder along with all the other syndromes. I plan to start cognitive/behavioral therapy for this problem and for the general phobias I suffer from, since I doubt whether MAOI's are an option for me at this point. I am going to see my pdoc this morning and I am going to report a lot of improvement on the depression and ADHD fronts, but less for the fearfulness around people and social inhibition. The generalized phobia seems to be going down,however. The combination of phobia and insomnia has always precipitated a slide into severe depression in the past, which is why I am so determined to find a solution for the phobias that remain (whether through meds or therapy)-z
-z
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