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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 32. This is the beginning of the thread.
Posted by jealibeanz on February 19, 2007, at 21:28:34
Can you combine Strattera and stimulants for treatment of ADHD?
I think I've heard this done before, but am unsure as to whether or not it is common.
One reason why I ask is that my insurance company no longers covers any ADHD meds for adults, and that they kept turning down my docs request for a stim for narcolepsy because the company thought I was on Strattera.
Maybe they could possible cover both at the same time if my doctor works enough magic with the whole authorization thing. It's tricky.
Posted by med_empowered on February 19, 2007, at 23:40:59
In reply to Strattera and Stimulants, posted by jealibeanz on February 19, 2007, at 21:28:34
I have a friend on Straterra+40mgs/day of adderall. He says the straterra makes everything "come together" in terms of focus and what not. Personally, though, I think if you have to choose between having your insurance cover Straterra or cover a standard stim, you should probably go for the stim--its much more effective therapy, and much more predictable. Unless of course you go the generic IR route...then you might want the more $$$ straterra covered, and you might be able to swing the stims out-of-pocket.
Good luck.
Posted by jealibeanz on February 20, 2007, at 11:16:09
In reply to Re: Strattera and Stimulants, posted by med_empowered on February 19, 2007, at 23:40:59
I've taken Straterra before, so it's not like I don't know what I'm getting myself in to. It was helpful at first and definitely made a big difference. However, it faded. I never tried to increase. I think it may have been slightly depressing, but I have depressive tendencies anyway, so I can't attribute it to one drug. I was a little irritable, but I have Xanax now, which should help.
The stimulants aren't working so well right now. I know I *like* stims, since I've always been very very dependent on caffeine and do like the initial burst of Ritalin (for about 30 min!). But they aren't consistent in anyway, even though I have controlled release. I just need to find a controlled release form that works for me, or try continuous IR dosing.
I'm thinking the comination of a good stim and Strattera would help, since they work on different areas and Strattera is more even.
I think my insurance company may cover both, my doctor just has to call and tell them to.
I'm now wondering if it would be out of line to suggest this to my doctor.
Posted by Chairman_MAO on February 20, 2007, at 14:55:45
In reply to Re: Strattera and Stimulants, posted by jealibeanz on February 20, 2007, at 11:16:09
If you can deal with the side effects, desipramine would probably work better than Strattera for that purpose.
Posted by jealibeanz on February 20, 2007, at 14:57:28
In reply to Re: Strattera and Stimulants » jealibeanz, posted by Chairman_MAO on February 20, 2007, at 14:55:45
What is desipramine?
Posted by Chairman_MAO on February 20, 2007, at 16:08:01
In reply to Re: Strattera and Stimulants » Chairman_MAO, posted by jealibeanz on February 20, 2007, at 14:57:28
The most NE-selective tricyclic antidepressant. Well, protryptiline is stronger, but you don't want to take that.
Posted by jealibeanz on February 20, 2007, at 16:10:49
In reply to Re: Strattera and Stimulants » jealibeanz, posted by Chairman_MAO on February 20, 2007, at 16:08:01
I don't think my doc will go for tricyclics!
Posted by stargazer on February 20, 2007, at 18:05:02
In reply to Re: Strattera and Stimulants, posted by jealibeanz on February 20, 2007, at 16:10:49
Doctors are preventing their patients from getting well when they refuse to prescribe MAOi's and tricyclics...What does that tell you?
Years ago those were the only drugs for depression and after 15 years of trying all of the 'new and improved' SSRI's, I am worse off than ever since my depression has gotten worse from inadequate treatment with SSRI's, etc.
Now I'm going back through all of the older treatments because they worked better than the current drugs. Trying more drugs is not the answer, it delays you from getting well using some of the older, tried and true medications, like MAO's and tricyclics.
My first bout with depression was "cured" with low dose Nardil. It was only the second drug tried so I didn't suffer very long. That was the beauty of having less drugs to try.
So if your MD won't go fo the tricyclics or MAO's , find an expert that will be comfortable prescribing them. Good luck.
Stargazer
Posted by jealibeanz on February 20, 2007, at 18:17:56
In reply to Re: Strattera and Stimulants, posted by stargazer on February 20, 2007, at 18:05:02
Well, right now I'm mainly trying to treat ADHD. So the tricyclic/MAOI issue isn't a problem, since I have options. I love my doc. I'm not switching! :)
I was thinking about EMSAM for depression, but never asked about it. I don't think I'll like it much more than the meds I've tried. I hate the weight gain, nausea, numbness...
Posted by kelv on February 21, 2007, at 3:53:54
In reply to Re: Strattera and Stimulants, posted by jealibeanz on February 20, 2007, at 18:17:56
> Well, right now I'm mainly trying to treat ADHD.
DEXEDRINE!
Before their blacklisting in 1970 when Amps use fell by 80-90% Amphetamines were recognised as awesome pills.
5-15mgs Dextroamphetamine banishes fatigue and lifts the spirits of the depressed, Methylamphetamine is stronger and longer lasting. They were also successful in treating OCD and acute mania.
I read too much:)
Posted by jealibeanz on February 21, 2007, at 4:08:27
In reply to Re: Strattera and Stimulants » jealibeanz, posted by kelv on February 21, 2007, at 3:53:54
> > Well, right now I'm mainly trying to treat ADHD.
>
> DEXEDRINE!
>
> Before their blacklisting in 1970 when Amps use fell by 80-90% Amphetamines were recognised as awesome pills.
>
> 5-15mgs Dextroamphetamine banishes fatigue and lifts the spirits of the depressed, Methylamphetamine is stronger and longer lasting. They were also successful in treating OCD and acute mania.
>
> I read too much:)Dexedrine helps with OCD? Hmmm. Weird! Well, I'll just have to see what my doc's next suggestion is.
Posted by kelv on February 21, 2007, at 4:25:56
In reply to Re: Strattera and Stimulants, posted by jealibeanz on February 21, 2007, at 4:08:27
> Dexedrine helps with OCD? Hmmm. Weird! Well, I'll just have to see what my doc's next suggestion is.
Yes, Recently i was in detox and met an American man who has OCD and was scripted Dexaml in the early 70's and found relief from his symptoms when he sourght relief for depression, he was unknowingly self medicating and took higher doses than scripted, would run out early and buy Benzedrine on the streets, Amps were cheap and available then. He also experienced relief when taking LSD-acts on Serotonon, a phenomonon i read of before.
Posted by Chairman_MAO on February 21, 2007, at 5:16:04
In reply to Re: Strattera and Stimulants, posted by jealibeanz on February 20, 2007, at 16:10:49
You've got to be kidding me. No tricyclics? That is ludicrous. Fire your doctor. Even the most conservative, "by-the-book" doctor I ever saw had no problem prescribing tricyclics. As another poster said, had he not done that, he would have prevented many of his patients from getting well.
Posted by Chairman_MAO on February 21, 2007, at 5:18:14
In reply to Re: Strattera and Stimulants » jealibeanz, posted by kelv on February 21, 2007, at 3:53:54
Yes, indeed this is true. D-amphetamine and methamphetamine can be amazing treatments for OCD.
Methylphenidate does not work, however.For depression, they're best used along with a TCA or MAOI (unless the symptomology is primarily along the lines of "psychomotor retardation").
Posted by jealibeanz on February 21, 2007, at 14:23:15
In reply to Re: Strattera and Stimulants » jealibeanz, posted by Chairman_MAO on February 21, 2007, at 5:16:04
Whoaaa... I never said I asked him about tricyclics. He's my family doctor. I highly doubt he would want to use a tricyclic, since it's not common practice and he's most likely never prescribed one. GP's tend to be a little cautious, with good reason. If he thought it was in order, he'd probably refer me to a specialist, then possibly manage himself.
Posted by jealibeanz on February 21, 2007, at 19:06:51
In reply to Re: Strattera and Stimulants, posted by jealibeanz on February 21, 2007, at 14:23:15
OK... leading back to my original question. Does anyone have any positive experience with taking both Strattera and a stimulant at the same time?
Posted by Joe Bloe on February 21, 2007, at 22:53:57
In reply to Back on Track: Strattera and Stimulants, posted by jealibeanz on February 21, 2007, at 19:06:51
I tried Strattera for a couple of months, and after a few weeks on it, I ended up adding small doses of Adderall IR (like 2.5 mgs as needed) to make it more effective. I was able to concentrate really well with this combo, but the side effects from the Strattera were ultimately too much to handle. It is probably the drug I dislike the most of all the several that I've tried.
Posted by jealibeanz on February 22, 2007, at 4:33:07
In reply to Re: Back on Track: Strattera and Stimulants, posted by Joe Bloe on February 21, 2007, at 22:53:57
>
> I tried Strattera for a couple of months, and after a few weeks on it, I ended up adding small doses of Adderall IR (like 2.5 mgs as needed) to make it more effective. I was able to concentrate really well with this combo, but the side effects from the Strattera were ultimately too much to handle. It is probably the drug I dislike the most of all the several that I've tried.
What were your side effects, if you don't mind me asking?For me it caused fatigue for the first few days of each dose increase, insomnia for the first two weeks, nausea every time I took it, irritability.
Posted by Joe Bloe on February 22, 2007, at 13:18:57
In reply to Re: Back on Track: Strattera and Stimulants » Joe Bloe, posted by jealibeanz on February 22, 2007, at 4:33:07
Of the side effects listed for Strattera on Crazymeds.org, I will highlight the ones I had:
Strattera's Typical Side Effects: The usual for NRIs - headache, dry mouth, urinary hesitance [bad], constipation [very bad], early awakening [very bad].
Plus, "fatigue and tiredness instead of increased energy and motivation," a general "blah" feeling or a kind of cloudy head, and sexual dysfunction - different and worse than the typical side effects from fluoxetine. I basically had more interest but less ability.
Oh yeah, plus very quick weight gain: talking 10 lbs in the first month, certainly related to the constipation, but I also seemed to retain a lot of water.
Posted by jealibeanz on February 22, 2007, at 14:20:26
In reply to Re: Back on Track: Strattera and Stimulants, posted by Joe Bloe on February 22, 2007, at 13:18:57
> Of the side effects listed for Strattera on Crazymeds.org, I will highlight the ones I had:
>
> Strattera's Typical Side Effects: The usual for NRIs - headache, dry mouth, urinary hesitance [bad], constipation [very bad], early awakening [very bad].
>
> Plus, "fatigue and tiredness instead of increased energy and motivation," a general "blah" feeling or a kind of cloudy head, and sexual dysfunction - different and worse than the typical side effects from fluoxetine. I basically had more interest but less ability.
>
> Oh yeah, plus very quick weight gain: talking 10 lbs in the first month, certainly related to the constipation, but I also seemed to retain a lot of water.
>Hmm... I don't think I had most of those. This just goes to show that we are all different.
Posted by KayeBaby on February 22, 2007, at 18:41:09
In reply to Re: Strattera and Stimulants, posted by jealibeanz on February 21, 2007, at 4:08:27
Dexidrine helps with bipolar according to my Sr.
kaye
Posted by KayeBaby on February 22, 2007, at 18:43:54
In reply to Back on Track: Strattera and Stimulants, posted by jealibeanz on February 21, 2007, at 19:06:51
> OK... leading back to my original question. Does anyone have any positive experience with taking both Strattera and a stimulant at the same time?
Yes. Made me hypomanic (fun!) for a few weeks then not so good. Kinda flat and lethargic and then I noticed my eyes turning yellow.
Kaye
Posted by jealibeanz on February 22, 2007, at 18:50:04
In reply to Re: Strattera and Stimulants, posted by KayeBaby on February 22, 2007, at 18:41:09
OK... so now I have no idea what I want to suggest to my doc. Strattera and another form of MPH? Straterra and dexedrine or focalin or another trial of Adderall? Just plain stimulants? Ahh!
Posted by kelv on February 22, 2007, at 19:11:04
In reply to Re: Strattera and Stimulants, posted by KayeBaby on February 22, 2007, at 18:41:09
> Dexidrine helps with bipolar according to my Sr.
>
>
> kaye
I'v read that it was successfull in treating acute mania in a couple studies, and used to be an OCD treatment, but helping bipolar?-refrences?
Posted by theo on February 24, 2007, at 17:26:43
In reply to Re: Back on Track: Strattera and Stimulants, posted by Joe Bloe on February 21, 2007, at 22:53:57
I was able to concentrate really well with this combo, but the side effects from the Strattera were ultimately too much to handle. It is probably the drug I dislike the most of all the several that I've tried.
What side effects did you experience?
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