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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 utopizen on March 12, 2004, at 20:07:14
Someone out there, I seem to read people claiming it takes 2 months or 5 days or less when they post Straterra experiences.
Is it that the people noticing a change in 5 days are taking 40mg for a few days then 80mg on the 4th or 5th day? And the 2 month responders are taking small babysteps as they reach their target dose very slowly?
I think I'd rather hit the target dose and stomach the side effects as they come rather than slowly spread out the dosing (and thus the side effects).
But if anyone has actually been convinced Straterra can work within a week, please let me know of your dosing and experiences, and whether you have taken a stimulant before and at what dose... I've taken Dexedrine, Desoxyn, Adderall, Dex Spansules, Ritalin. Provigil failed at 400mg to make me alert for my sleepiness.
My sleep doc wants me on Straterra+Provigil at the same time. Claims he's seen patients get synergy even after failing either one alone separately. I have ADD+social anxiety+sleepiness.
So basically, Straterra's my only current hope to avoid the non-efficacy of the stimulants. I'm now on Desoxyn at 50mg, and I still feel tired. It has appeared to get less and less effective since I first tried it in April. I'm tired and out of focus as ever.
But my doc claims that a very small percentage of patients reported somnolence, especially compared to placebo...
I just assumed, though, I would get it since I'm already tired. If you read this board, you'd think everyone gets it, but I have to remember people come here because, like me, they're not responding well.
Posted by Viridis on March 14, 2004, at 3:40:42
In reply to Can Straterra really work within a week??, posted by utopizen on March 12, 2004, at 20:07:14
Strattera caused a mood-lifting effect for me right from the first 25 mg dose. But I would NOT increase the dose too fast, because it can also cause nausea, dry mouth, etc., and (in my experience) it took a while to get over these side effects. You might try moving up in increments of 25 mg/ week or so. The target dose of 80 mg/day appears to be too high for many people, based on my experience and numerous reports here.
I really liked it for a while, but then the positive effects seemed to wear off and other side effects (e.g., speech difficulties etc.) took over. It was just too weird for me, even though it seemed promising at first, and others do very well with it.
Posted by utopizen on March 14, 2004, at 15:23:35
In reply to Re: Can Straterra really work within a week?? » utopizen, posted by Viridis on March 14, 2004, at 3:40:42
I'm not depressed, but I remember grinning happily and feeling almost euphoric simply after my doc threw sample packs of Effexor on my lap, knowing it was a more potent antidepressant than the SSRIs I had failed on for my social anxiety.
5 months later of feeling no different at 300mg, I quit. My only reminder I was on anything was the black-out effect I would get for a second or two if I rose from my seat too quickly now and then, just like the other ADs made me have.
I'd be weary of any effects within the first hours-- Straterra was developed initially as an antidepressant (until they observed attentiveness in the early trials), so it acts by slowly modulating receptors from one synapse to the next. This kind of modulation may, in some cases, be noticable in 5 days if you're really lucky, but not in 1 day.
You might experience side effects in one day, like dry mouth or sleepiness, but I'd be surprised if anyone even noticed increased energy the first day that was unassociated with the placebo effect.
If Straterra has had any effect on your energy levels, or your sleep-wake pattern, or your ability to sleep or wake up, please do report, including the dose you took when you noticed an affect, and the length of time you had been taking that dose beforehand.
Posted by Viridis on March 15, 2004, at 2:21:22
In reply to Re: Can Straterra really work within a week??, posted by utopizen on March 14, 2004, at 15:23:35
Strattera really didn't seem to affect my energy levels much, or interfere with sleep. But then, I don't seem to respond this way to some stimulants (Provigil, on the other hand, definitely increased my energy and promoted wakefulness).
I was surprised to notice a mood-lifting effect from Strattera right away, because I started at a low dose and really didn't expect to feel much for at least a couple of weeks. Given that placebo effect (which I agree can be very real) is based primarily on expectation, it seems that the effect was genuine. Yet it faded out over time, even with increased dosing, as did the initial improvement in concentration.
Most of these meds (SSRIs included) affect levels of neurotransmitters dramatically within a few hours of use. There's an interesting link here (it's in one of the messages this week; I'll have to check which) that shows the pharmokinetics of various ADs, demonstrating major changes in availability of serotonin, norepinephrine, etc. (depending on the drug) almost immediately. So, there is some reason to suspect that one could have a rapid response.
Of course, changes in receptor sensitivity etc. do take time, and some of these meds may even work by stimulating brain cell growth (which takes weeks). But it isn't out of the question that the rapid shifts in brain chemistry these drugs induce could cause various effects quickly, although not always the desired ones.
In any case, good luck with Strattera!
Posted by EscherDementian on March 15, 2004, at 3:38:41
In reply to Re: Can Straterra really work within a week?? » utopizen, posted by Viridis on March 15, 2004, at 2:21:22
Viridis,
Thank you for the info.
And please do post the info that you were going to find. Since the change in Adderall's "non-active" ingred., it hasn't been good for me.
Escher
Posted by liquidchakra on March 15, 2004, at 9:16:42
In reply to Re: Can Straterra really work within a week?? » utopizen, posted by Viridis on March 14, 2004, at 3:40:42
> I really liked it for a while, but then the positive effects seemed to wear off and other side effects (e.g., speech difficulties etc.) took over. It was just too weird for me, even though it seemed promising at first, and others do very well with it.
What kind of 'speech difficulties' are you talking about? If anything, I speak much slower and more concise now, and find it easier to finish a sentence before I loose the idea. I've always had trouble with stuttering because I would forget the word halfway through, but Strattera cured 95% of that.
Posted by utopizen on March 15, 2004, at 10:30:53
In reply to Re: Can Straterra really work within a week??, posted by liquidchakra on March 15, 2004, at 9:16:42
I am hoping simply switching back to Adderall after having been on Desoxyn since April will help me feel more in control of my life to some extent.
I suspect now my low energy levels are largely related to depression, although it's far from anything featuring sucidal ideation and I have been in denial that I could ever get it, being the happy kid I once was just a year ago. But stress over school and feeling out of control with things has led me to feel overwhelmed, and hopeless.
I see a therapist now again to remind me that I can't convince myself I can cram or chunk up large tasks so much that they seem too insurmountable to approach at all.
But it's tough, because mid-terms are already well underway and I still have two incompletes that have switched to F's and must now begin those and then finesse my professors into changing my grades despite the missed deadline.
Adderall seems to be a better bet, despite my apparent lack of concentration and moderate depression on top of anxiety about everything.
My doc gave me klonopin, which I haven't had since January for my social anxiety, and this appears to help with calming me down into realizing college isn't a boot camp for my brain.
My only concern is not passing my courses, which means not living with my roommates... oh well, so much for that(?)
I do have a 504 plan, a neuropsychological evaluation, and a triad of docs willing to write me notes for my dean or housing as necessary... but I like things to be more predictable and less reliant on the fickle swaying of the powers that be at my college, despite my ADD and its nature of placing me in these akward situtations.
I don't think Straterr'a worth the risks from now until final's, despite its potential. There's just too many chances it will either not work (and without Adderall, that means no backup strategy) or give me side effects that don't let me function enough to do my readings and studying.
My doc meets with me weekly. But he's so rigid about the one-drug-at-a-time approach that it's irrational. He took 3 weeks just to "wean" me off of Xanax XR, which I was on at 3mg/day for two months. He acted like he was taking me off of an 8-year old crack habit! And he wouldn't prescribe anything in-between, thank god I had my useless desoxyn filled by my former pdoc just before seeing him.
If I'm lucky, he'll give me Adderall, as my Desoxyn runs out today and I see him tomorrow. He was ready to give it to me a month ago, but I went off on how I wanted Desoxyn, and he never heard of it, so refused to prescribe it on that basis. (He also is "uncomfortable" with the notion of prescribing Klonopin Wafers over Klonopin tablets for the same reason!)
He also sounded like he wanted to spent the next four weeks making sure my Klonopin dose was perfected to a T, and then the following four weeks weaning me from the Nadolol (all-day beta blocker for my social anxiety disorder)
I haven't told him I haven't bothered to even refill for a month now. He didn't have any clue about its use in social anxiety disorder, despite my detailed explanation into how a psychosomatic biofeedback response stemming from the heart exacerbates social anxiety states.
He tried to rule the possibility of my other doctor's basis for this out by looking at the PDR and not finding that indication in it. I had to crack up laughing at how naive he appeared to me several times. I'll be damned if he uses Nadolol tapering as a basis for not changing a med in the future, as I haven't used the stuff in a month now. I've already wasted three weeks from him tapering me off Xanax, as I pretended to go along with him and act like I was. 2 months, if that, at 3mg, this guy is ridiculious.
Posted by Viridis on March 17, 2004, at 5:42:34
In reply to Re: Can Straterra really work within a week??, posted by utopizen on March 15, 2004, at 10:30:53
Utopizen,
Just my experience, but if you can, try Adderall, Klonopin, and Lamictal together. A very good mix, for me at least. Provigil could fit in there too.
Again, just my experienece.
This is the end of the thread.
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