What's Wrong With Strattera?
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- Опубліковано 2 жов 2023
- The FDA approved Strattera (atomoxetine) two decades ago as the first non-stimulant for the treatment of ADHD. Although designed with the hope of being an effective antidepressant, it had more clearcut results for ADHD. But from the beginning, many, many people haven’t responded well to the medication. It seems to take a long time to work, and lots of people have troubling side effects. And that’s not just in comparison to stimulants. A recent head to head comparison with another non-stimulant for ADHD, Qelbree (viloxazine) found that Strattera was less effective, had more side effects, and took longer to provide benefits.
If Strattera is working for you, great, keep taking it. But if your response is mediocre or worse, there are several other non-stimulants that might help you more, including Qelbree, Wellbutrin, guanfacine, and even Cymbalta (duloxetine).
References:
Extended-Release Viloxazine Compared with Atomoxetine for Attention Deficit Hyperactivity Disorder (2023)
link.springer.com/article/10....
Atomoxetine in patients with ADHD: A clinical and pharmacological review of the onset, trajectory, duration of response and implications for patients
journals.sagepub.com/doi/10.1...
The Effect of Methylphenidate and Atomoxetine on Heart Rate and Systolic Blood Pressure in Young People and Adults with Attention-Deficit Hyperactivity Disorder (ADHD): Systematic Review, Meta-Analysis, and Meta-Regression
www.mdpi.com/1660-4601/15/8/1789
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Psychiatrist, neuroscientist, and author John Kruse, MD, PhD presents practical, actionable, well-researched information about treatment options that scientists and clinicians recommend for adult ADHD and other mental health conditions. Subscribe if you're curious about how neuro-atypical brains can optimize their functioning in our shared, and somewhat strange, world.
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In 1st few days on Strattera, I did notice the increase in suicidal thoughts and was so sleepy I would fall asleep at 5pm instead of my typical 10-11pm. Up until the 2nd week, it didn't feel like my ADHD symptoms were much better at first, but I did notice that focusing on tasks felt different, and I was a little more "locked in" when doing things.
In the 3rd week, I started taking it at night to counteract falling asleep during the day, but I wasn't able to get sleep at night. I did notice on the 3rd week that even with little to no sleep, my ADHD symptoms were reduced. As of 3 days ago, I switched back to the morning dose and am taking melatonin at night to help sleep.
At this point, I can say my ADHD symptoms have been significantly reduced, and as long as I can get my sleep adjusted, I will keep with it.
Thanks for the detailed recounted of your experience with Strattera. I'm glad it has benefits, and I hope that you can get sleep back under control.
I’m ADHD and I have been on Strattera for a few years now, and while it’s amazing for my hyperactivity, it doesn’t drive me to do stuff, but opposite. I’m still on it because not being hyper and being able to relax makes such a big difference to me, but I’m looking to also try a stimulant on the side to try to combat procrastination. On 100mg I do experience emotional blunting, where I’m kind of numb to everything and I don’t care about much, however, I’ve been on 60mg now for a few months and while it doesn’t fully control my hyper, it’s still a lot more manageable and I don’t get the emotional blunting anymore. I also find that it helps me be a lot less impulsive, I’m a lot more rational, I have control over my emotions and am able to sleep better without overthinking for hours or stressing about the next day.
Thanks for sharing your experiences. I also point out that there are extremely few people with ADHD for whom medications provide the whole answer. There are a number of behavioral and cognitive training approaches, that along with medication, may help with procrastination.
I found 80mg of atomoxetine to be very useful for me, but I was taken off it because I was also on duloxetine I have generalised anxiety disorder and chronic neuropathic pain as well) and it transpired that my blood pressure was very high on the combination, so I was taken off it.
Try to find a equalibrium. It has stopped your hyperactivity due to its effect on norepinephrine since certain parts of the norepinephrine system can regulate dopamine. It’s probably dampening dopamine a bit more than you would like. You can find your dopamine vs regulation equilibrium by either lowering the dose of strattera until you find somthing that you like more or you can tilter a stimulant like vyvanse until you feel like you are at the perfect ammount.
Have you found atomoxetine to help with focus?
Modafinil almost killed me, I had 3rd degree SJS just like you mentioned and stayed 2 weeks hospitalized at just 25. I never had any reactions to drugs never mind severe ones until then. I think you might want take a look again at what's been coming out on that topic world wide. I have ADHD and now take Ritalin but I have taken Vyvanse in the past, none gave me such harsh side effects. My psychiatrist now prescribed Atomoxetin as an add on to the Ritalin as an attempt to try and take care of the ansiety side of things (Viloxazine unfortunately is not available in Brazil, where I live). Thank you for all the great body of work here on your YT channel by the way.
I'm sorry to hear about your horrible and dangerous experience. Thanks for pointing out cases of SJS reported elsewhere in the world (3 possible cases in Singapore www.hsa.gov.sg/announcements/safety-alert/severe-cutaneous-adverse-reaction-reports-with-modafinil-and-armodafinil). This is a drug that has been around for thirty years (four years in France before FDA approval in the US) so it's strange that there would be a flurry of recent cases without extensive past reports. Maybe it is particularly risky in combination with some additional agent or factor.
@@DrJohnKruse Thanks Doc. I agree on the part that there shouldn't be a flurry of SJS cases linking back to modafinil just now, but the mechanisms of action are quite distinct for this drug as it a very weak noreperephrine reuptake inhibittor at the same pace that it is a strong histamine releaser - and I am sure these specifics are not new to you. All of that is to say that I doubt very much the FDA dropped licencing the drug based on one spetacular case of SJS in the US of wherever that occurred, maybe someone on the board knew better at the time (and please note that I am a FDA skeptic myself).
This drug actually worked well for me. It helped me out of my depression from being wrongful diagnosed.
I'm glad that it helped you and appreciate your willingness to share your positive experience.
My son, who has ASD and ADHD would turn into an angry and all stimulant just gave the worst problem. Strattera is rhe only thing that have worked for him. Thanks for the information. What I realized is how different stimulant work when a person has comorbidity.
Thank you for sharing your son's positive experience with Strattera.
My ADHD is like a car, with the dashboard in various languages and constantly switching spots, and stuck in neutral. I tried quite a few meds, including Welbutrin and Cymbalta, and got little-to-no success. Last year, I tried Focalin, and my PTSD was WAY worse. This year, I tried Strattera, and the dashboard (my emotions) stayed in one place and translated to english, but the gear was still stuck in neutral, and not eating with the meds made me EXTREMELY sick. I tried Adderall, and i was stuck in 5th gear going in the wrong direction with no brakes (I could only focus on things I DIDN'T need to be doing, and couldn't stop). On both, I'm able to feel my emotions without reacting to them, be active, do things with my kids, and force enough focus to get some important things done. Even if I miss a day, I still have some benefit. My big problem is remembering to eat before noon.
I'm sorry it took so much experimentation, but I'm glad that you found a combination that works for you. Thank you for sharing your experiences. You may have already tried these but setting an alarm for lunch might help, or enlisting you children or others to remind you to eat. Depending on their ages, you could even make a game out of this. This is not to put the burden on others, but rather to make use of social supports that may already be available.
Just found your channel, fascinating information.
Great! Feel free to share with others who may benefit.
@@DrJohnKruse have already shared with my brother. Particularly enjoyed your brief history lesson regarding the origins and how it stacks up to other similar drugs. This one was of particular interest, will be going through your other videos thanks.
I was prescribed atamoxatine 3 years ago. Sadly I suffered the most severe psychosis with hallucinations straight out of a horror movie, from this medication and was left with lifelong severe CPTSD and subsequently developed heart failure following the stress the events placed on my body.
When my clinic realised their error and I begged for help. I received an email stating that they were halting all treatment due to them being "underequipped to help with the collection of unique issue i now present".
My partner left me, my business failed, I lost my home and developed severe drug addictions during the aftermath.
While I'm now 1 year clean and my heart is repairing. I still suffer flashbacks, severe night terrors and depressive suicidal episodes. Probably will till the day I die. BEWARE OF THESES DRUGS!
I truly appreciate you sharing your truly horrendous experience.
I advocate against Cymbalta because of my experience with it. I was only on it for a short period and I went on a trip having left my meds behind on accident. I went borderline psychotic in a foreign country from the sudden withdrawal. I nearly holler at doctors when they mention it. 😅
Some people do feel really lousy when they stop it abruptly - although the withdrawal problem tends to be more common and more severe with either Effexor (venlafaxine) or Paxil (paroxetine).
Hope to see video about books on your bookshelf😁
Any shelf in particular?
Any thoughts on taking armodafinil with a non stimulant for adult ADHD? I am 44, take low dose BP medicine, use a cpap for sleep apnea and also on TRT. The doc will not let me try Vyvanse or any other stimulant even though I'm willing to give up the armodafinil. The ability to start or complete task is really taking a toll on my personal and work life. Some days its to mentally painful to even think about certain things, even things I found fun before. Its caused a downward spiral. Thanks for any opinions.
Could you do a video on withdrawal symptoms timelines when coming off your stimulants cold turkey due to the shortage ? Sometimes I have to wait 14 days in between scripts since my prescriber wants me to stay on same medication ( vyvanse 70 mg ). Or what can be done to help the awful symptoms such as exhaustion and lack of motivation when going without your meds. I have alot of friends struggling w same scenario. I would love to send them the video too!
That sounds like it would be a really useful topic. I will look to see if there is any rigorous research on this, and might just go with my clinical recommendations if I can't find anything.
@dr.johnkruse6708 thanks so much! I’m looking forward to watching a video if you make it ! 🙂
Thanks!
To add to the "reviews" of the medication:
I started taking atomoxetine 7 weeks ago. I started at 40 mg and had no side effects. I didn't feel any benefits from it after 4 weeks so I asked my psychiatrist to increase my dose. Luckily, I experienced no side effects at 80 mgs, but I've been at this dose for 3 weeks and still have not experienced any benefits. This is the first ADHD medication I've taken, and I'm not sure why my psychiatrist chose it over other non-stimulants like Qelbree and cymbalta.
I would hope that as part of informed consent most doctors would at least try to explain why they chose the medication they did. Very often Strattera is a default first choice (whether or not it should be) because that is how they have been prescribing for years, or that is how they perceive the doctors around them prescribing.
You mentioned something about the potential long term benefits Atomoxetine, that it might be due to its up/down regulation of various systems in the brain. And that it could cause a "lasting benefit" in the wiring of the brain.
If there was a patient that was tolerating 80mg of Atomoxetine well, but that patient wasn't really seeing any immediate benefits (still disorganized and unmotivated) would you switch them over to Cymbalta or would you rather see them continue on with Atomoxetine?
Hope I worded that hypothetical correctly.
My approach is almost always to try to maximize benefits and minimize side effects of whatever someone is on before jumping to a new medication. Theoretically there would be room for most people on 80 mg atomoxetine to try a higher dose.
Well, in my country only Atomoxetine is approved for medication, there is no other choice. Currently it has been 6 months since I started.
Two major minuses I felt: sexual problems and extreme sickness if I forgot to drink it even for 1 day. First one is simple: ED and “shifted” sexual behaviour. Less emotions, strange ending, really unstable performance time from 2 minutes to 20. Second is much worse. If I forget to drink the pill, I will face electricity all over my body, like if I was burnt on freezing cold the same time. It is a good reminder, but REALLY painful.
Pluses is uncountable. Every other aspect of my life has been improving for 6 months crucially. I raised my GPA from 3 to 3.6 that semester, overcame my social anxiety, focused on many things at the same time and still can be productive with all of them. It does not destroy neither hyperactivity nor ADD, but helps to control it very effectively. Like to Atomoxetine.
I appreciate that you shared the details of good and bad parts of your experience with Strattera.
I just feel so gross after taking it
I went on Wellbutrin for anxiety/depression. And PMDD. My mood issues didn’t go away entirely but improved dramatically. When I felt ready after two years I weaned off incredible slowly. Once fully off for a couple of months, PMDD symptoms started again and I also realized how much Wellbutrin actually treated my ADHD. I decided to go back on, at a lower dose which feels good. In realizing that my ADHD needs treatment and having been on stimulants when I was younger (no good, became addicted), I thought maybe I should switch to strattera or other non-stimulant ADHD medication. Seeing this, I’m now wondering if I should just stick with Wellbutrin which seems to be beneficial enough to improve my quality of life although not perfectly treat my ADHD I guess. Hard not to chase the potential for better effects with other medications more intended for ADHD but perhaps I should just count my blessings as is. Things are fairly good so maybe shouldn’t mess around with it… Helps to type it all out I guess 😅
With both ADHD and depression medications, I have often seen that individuals don't fully appreciate what the medications were doing for them until they were off of them. If you do try to compare the Wellbutrin to other non-stimulant options, I would try to record some detailed notes of how you are feeling/performing before you switch, because it is often hard to fully recall where your mind was at weeks/months/years later when you try to contrast it to the benefits and costs of an alternate treatment.
@@DrJohnKruse Great advice. Thanks!
What would you recommend for someone who struggles with general anxiety disorder in addition to ADHD and MDD. The stimulants increased their anxiety and had to be discontinued (various MPH extended-release options were tried, also Vyvanse). Venlafaxine caused extreme panic attacks. The SSRIs did nothing. Now trying Strattera (25mg, titrating up) with no noticeable side effects other than nausea on the first day or two.
I can't give specific recommendations but would say that lots of the ADHD experts in similar situations start people on guanfacine, and when stabilized on that, if more help with ADHD is needed, add on stimulants, which are usually tolerated far more easily than they were in the absence of guanfacine. I've also seen some people's anxiety improve with buspirone, which some people feel can also help with ADHD (but has very little data to support this use).
If you could put together a 3-5 minute video of the key points it would be very helpful to us with ADD… Sorry but I can’t stay focused, you lost me after about 6-7 minutes of this video.
The key points are in the take home message in the first 2-3 minutes. More detailed information is in the next 20-25 minutes.
I was on atomoxetine at one stage (it was very helpful) and the doctor was so surprised to hear that I did not feel nauseous on it.
There are clearly some people who do well on it. Lucky you!
I do not feel nauseous either!
@@kimdobbins1214 Yay! Are you still on atomoxetine?
I was taken off of it because my blood pressure was very high.
Hey Doc, I have tried adderall, Vyvanse & wellbutrin. Both Vyvanse & wellbutrin made me weird.. Adderall seems to work but i can't tolerate the side affects. Do you think I should try Strattera? Or perhaps ritalin? I have a terrible ADD at the age of 40..
I can't make specific recommendations without an evaluation. I'm clearly not a particular fan of Strattera. I'm much more likely to use Cymbalta (duloxetine) for ADHD than Strattera. Certainly some people with ADHD obtain better effects from ritalin than amphetamine based products (although they are a minority). It also sounds like guanfacine and modafinil would be medications to consider, given that they help some people with ADHD and theyt work via different mechanisms than the medications you mentioned. ua-cam.com/video/kp9bGbwk3BA/v-deo.html ua-cam.com/video/T01xvC1OeBw/v-deo.html
@@DrJohnKrusedoc, i actually did get modafinil from off market to try as my previous psychiatrist didn't prescribe me one. Modafinil wakes me up but doesn't stop my brain from wandering away at all. I do become very talkative and feel i get a cognitive boost but i still can't read a paragraph like normal people.. I'm such a mess.
I just started atamoxotine a month ago along side of methylphenidate . My reason for it is because of impulsivity to shopping and other things. What do you think about these 2 together? I just started from 25 to 40 today . I have ADHD.
There are many people who use the two together, for a variety of reasons. It's not clear whether you were already on methylphenidate, but I would almost never start the two at the same time, because then you don't know which is responsible for good or bad results. If the atomoxetine is an add on, give it a few months before deciding whether or not i provided any new benefits for you.
Any ideas why a doctor would prescribe this as a first line of treatment. I have had it for 5 days and I am having well let's say plumbing issues.
Interesting.. I got a SJS - erythema multiforme minor - after 2 weeks on 100 mg of modafinil.. histamine system has never been the same, since. never knew that SJ reaction was a factor in it not getting approved for adhd. Moda sure worked for mine, better than regular psychostimulants. Though neuroeedback worked better, ultimately. But was pretty surprised at the hybrid exec support and anxiolytic effect from modafinil, before it backfired.
Thanks for sharing your experience, good and bad, with modafinil. I hope that you have found something else that helps.
@@DrJohnKruse yeah - neurofeedback :)
Have you had any experience prescribing Milnacipran or Levomilnacipran? What's your take on it.
I've used both and found that they (Fetzima, Savella) were quite helpful for many with ADHD (and depression). Of all the SNRI currently available, these two have the strongest norepinephrine reuptake action and thus should be most potent for ADHD. Most US doctors seem unfamiliar with these medications, and many insurance companies make it expensive to take them.
Went off Effexor cold turkey since i hated the side effects. Horrible withdraw symptoms: constant dizziness, depression and worsening anxiety. Never again did i do that.
Effexor is completely different
I wonder if older adults are doomed to a life of misery. I tried Vyvanese and overall there were noticeable improvements including concentration driving, engagement with coworkers, better mood, less emotional outburst, but I am having heart flutters its been a few days with this new batch and some moments of anxiety especially socially, a pre-existing condition, but I handle it much better. I think my doctor will discontinue this treatment because of the heart fluttering, and I am not sure what other option I can take to help me, because my life has been a real struggle before meds. What would you recommend?
I can't make specific recommendations here, since we don't have a doctor patient relationship. But my first thought is that for people in a similar situation my first thought would be to decrease the dose of Vyvanse slightly. Often people adapt to relatively benign cardiac side effects, and many of them can, after a few weeks or months, tolerate without problem a dose that caused palpitations or anxiety earlier.
I sweat so much on strattera, have face flushing and have anxiety? Does this make sense? Does this go away? If it increases norepephrine would't that incease anxiety etc. ?Doesn't make sense. Thanks
Sweating, face flushing, and anxiety are all symptoms of Serotonin Syndrome. Strattera causes Serotonin Syndrome. Be advised these side effects do not go away if you keep taking Strattera. Your body is trying to tell you something and it's telling you that you are now experiencing IATROGENIC symptoms caused by Strattera. Report these side effects to your prescriber immediately.
Yes, those are fairly common side effects. Many people would decrease the dose until it is tolerable, and then see if these side effects go away completely with time, as they often do (but not always).
After three months on Strattera, I'm still experiencing high heart rate, tingling in hands and legs, nausea, shortness of breath and headaches, it is also making it hard for me to drink water. I'm on buspar and hydroxezine for anxiety but still feel anxious on strattera to an extent. It does help with some adhd symptoms but I've just been feeling like such crap for months now. Do you recommend I try something else?
I'm also on cymbalta right now too
Have you tried other things?
I can't make medical recommendations without evaluating you, but others with similar sets of side effects have considered guanfacine, as well as lowering the strattera dose. ua-cam.com/video/kp9bGbwk3BA/v-deo.html
How many milligrams have you been taking?
I found my balance but with a relatively high dose of Elvanse, the problem being living in Italy and having to leave the boarder every 3 months! Also expensive and I have been harassed on my trips by the customs brutes. In the states the stress was monthly, every time I approached the end of the month, but I was in the system enough to where it was almost free compared to now, but it is so stressful, if the adhd isn’t distracting me from life, because maybe I am medicated, then the distraction becomes the periodic ordeal of running out …
It's sad that our societies make it so difficult for some people to obtain tools that help.
Can you give some information regarding how strattera interacts with lexapro or whether they are ok to take together, or if straterra would be a good replacement for lexapro?
Strattera is a relatively pure norepinephrine reuptake inhibitor, while lexapro is a serotonin reuptake inhibitor, so combining the two is very similar to taking Cymbalta (duloxetine) or Fetzima (milnacipran). Most research finds very little impact of SSRIs on ADHD symptoms. Many individuals find that either SSRI or NRI action can help with depression or anxiety. To over simplify, the most common side effect from NRI is overactivation - tremor, agitation, restlessness; SSRI can initially cause some of these symptoms but sexual side effects, gastrointestinal effects, and emotional numbing are more common.
I took Strettra on and off for a year with varying doses. The only thing it did was take my anxiety away it did not stimulate my executive function task. My issues where with the side effects that never went away. Nausea almost everyday, vertigo and erectile dysfunction that Cialis would not even touch. The Side effects where not worth it. I'm now on Adderall with no side effects feeling the best I have in years.
Thanks for sharing your experiences, which resemble those of many I have worked with. I am glad that you have found a medication that helps.
Started a week ago, the first meds i tried for adhd. Im so tierd on it, dry mouth and lack of appetite. I fell more relaxed but its not helping on the adhd symptoms as procrastination etc. I get more sleep wich was needed.
Some people do obtain more benefits when they give it more time, so if this is tolerable it may be worth continuing on this track since many side effects can subside with time.
I tried Strattera and I liked it except the fact that it crushed my libido . Also my hear rate rose 10 beats above average according to my heart rate monitor. I am considering using Guanaficine. Do u think it will have the same side effects as Strattera? Thanks for the post.
Guanfacine usually lowers blood pressure and is neutral with respect to heart rate. It is not strongly associated with libido issues. But any drug has the possiblity of causing anxiety, if your body perceives it as unfamiliar, and anxiety is a potent way to increase heart rate.
Hey, you should try Guanfacine if you are the hyperactive type. I recently got on it. I have a very very over stimulated mind that’s always running and high levels of base dopamine. I’m basically high on myself and that messes up my executive functioning, aswell as making me very very impulsive. Anyways, I started Guanfacine 3 weeks ago. It has changed my life. The Guanfacine stimulates the Alpha2A receptor which actually regulates dopamine. So all of my natural dopamine was regulated. I started to have many benifits. Emotionally I’m more stable, I’m not impulsive anymore and don’t have an addiction to porn anymore. Disapline is now actually a choice I have now. Since dopamine is damped my exectutive functioning is much better and is still improving. It’s like asking a guy on crack to thread a needle. Overstimulated brains due to norepinephrine not regulating dopamine is a huge problem and Guanfacine can fix that atleast partially. Even at low doses. Also since Guanfacine is working on norepinephrine, you don’t gain a tolerance to it in the traditional sense. The fight or flight system isn’t like dopamine. We evolved to have norepinephrine receptors unable to become tolerant or atleast very very very hard for them to be. Think about it this way. If a bear is running at you, and then your adrenaline is released and you run away your safe. Now let’s say that happens every single hour. If your norepinephrine receptors said “hey, this is the norm. Let’s not react” you would be dead. So that’s why things that work in norepinephrine. Guanfacine, Armodafinil, strattera, you won’t gain tolerance, because evolutionarily, it’s a detriment for us to become tolerance or down regulate norepinephrine receptors. The reason why strattera provides benifits even after discontinuation is because the fight or flight system dosnt down regulate, and the strattera might have tricked it to thinking it’s a dangerous environment, so the body’s norepinephrine release more to stay more alert. And like I said they don’t down regulate so it stays that way.
Important note: 25:10
My experience was the opposite. Qelbree 200mg made me feel horrible and provided no cognitive benefit. Horrible headaches and I was not productive at all.
Strattera has plenty of side effects but it does work. I get bad dry mouth and some insomnia. Strattera has mild sexual side effects but it also has a short half life so I can skip a dose and most of the problematic effect is alleviated.
I appreciate you sharing your experience. It's good to highlight that individual results may vary.
Tried it for 5 days, 18mg… side effects were too great.. dry mouth upset stomach, nausea… not worth it.. can’t do it
I hope that you find something that helps you and that your body can tolerate.
Does it cause hair loss or hair thinning?
Possible, but not particularly common - in the 1% of people range in most of the studies I have seen.
I'm on strattera but I'm struggling to urinate and it's impossible to get an erection.. is there anything out there to help me overcome these problems. Thank you
I've seen some people who overcame these by backing down on the dose and giving it a lot of time. I don't know of any studies looking at specific medication (or other) remedies for these norepinephrine effects.
Strattera made my 12 year old son’s OCD go through the roof. As well as hair trigger angry and aggressive outbursts. It was nothing short of a nightmare. Never again.
I'm sorry to hear that. The frequency of stories like your son's are part of why I almost never start patients on Strattera.
And to clarify for anyone interested, it was the non stimulant option to trial for his ADHD after low dose Focalin created aggression and mania.
We are going the nutritional/supplement/lifestyle route now.
He is thankfully responding well. It’s not perfect but he is much happier, has gained weight and growing. He still has his tough moments. But nothing compared to what the pharmaceutical route did to him.
Every person is different.
@@lalas.2215 thank you for letting other's know about your son's experience.
How many milligrams was he taken?
Same thing happened to my 13 yr old son taking strattera. Very upsetting watching him go through extreme OCD.
How long will my anxiety stop after stopping strattera?
Strattera should be completely gone from your body within a few days. But for some individuals, withdrawal triggers its own anxiety response, and there can be other bodily reactions that can make withdrawals stretch out longer.
@@DrJohnKruseI never want to take medication again. I pray I’ll be back to normal ADHD self
Hey Doc, i have adhd I've tried ritalin but it doesn't do anything beneficial for me. What would you recommend i do?
I tried upto 30 mg ritalin. Should i try strattera?
I can't make specific recommendations without a doctor patient. But in general, it makes sense to keep increasing the ritalin dose until there are either benefits, or side effects, and to not focus too much on the specific dose. If side effects are showing up without benefits then it usually is reasonable to switch medications. Adderall, Vyvanse, or other amphetamine based stimulants often provide benefits for people who did not get much out of Ritalin but they also pose certain uncommon but really bad side effects. I usually move on to Wellbutrin, Cymbalta, Qelbree or even guanfacine before I move on to Strattera.
@@DrJohnKruse are those medications you mentioned used with ritalin or standalone?
I can't find anyone online with your credentials that are prescribing duloxetine over atomoxetine.I have searched reddit and I can't find many people having good effects with duloxetine.Then again,there are many bad stories about atomoxetine,but there are some good stories too.
Most doctors follow the crowd or what the drug reps tell them. Eli Lilly, which makes both drugs, had a huge incentive to not jeopardize atomoxetine sales by promoting duloxetine for ADHD. Many of the San Francisco area psychiatrists I have interacted with, and who adopted duloxetine as a non-stimulant option for ADHD in preference over atomoxetine have reported back to me what I have seen - it is at least as effective for the ADHD symptoms, and side effects are much more manageable, and concomitant depression or anxiety better treated.
@@DrJohnKruseWow,thank you,I spent countless hours trying to research anecdotal effects of these drugs before taking them.I will definitely consider taking it since straterra has not really worked for me.And Methylphenidate makes me fatigued.
@@DrJohnKruseDo you find Duloxetine more or less helpful than Bupropion for ADHD from your observations?
Hello! Is Wellbutrin more effective than Strattera for ADHD?
In the meta-analyses of multiple options for ADHD, Wellbutrin and Strattera results look quite similar. And in my experience (and most of my colleagues), Wellbutrin is much better tolerated. But individual results vary.
I’m 69 years old and have recently diagnosed with add. I was initially put on 25 mg atomoxtine( Straterra) but after 6 weeks of increasing side effects...urinary swelling and could barely start to urinate. Headache in the beginning. Insomnia and nightmares every night. Dry mouth. All went away after doctor switched me to 1 mg guanfacine. I seem fine on guanfacine but noticed slower resting heart rate as told it would do. Seem to be not as emotional so intensely and actually find myself seeking to find my sticky notes and act on them. It is slight but I’m happy so far. I believe doctor will add a stimulant soon but she wanted heart rate to be less. Looking forward to see if I can tolerate those meds?? Journey continues...
I just entered a reply but forgot to mention my Wellbutrin generic a couple years ago. I was put on 75mg and believe I already was on cymbalta generic for years 60 mg daily. The drug worked too fine for me. I was intense and driven but my wife actually called my doctor to complain. It was like I had way to much coffee. I’m a bit concerned that I’m so sensitive to Wellbutrin and Straterra even at a low low starting dosage that I might not do so good on a stimulant med. Figured I would mention that. I also had bleeding in my urine for years at my DOT physicals and found it to be from statins...Lipitor. Orange pee gone within days. I’m amazed to how everyone is really different. I always heard that but said that was nonsense. I was totally wrong.
@@johnslot7397 Best wishes. And feel free to update here with what turns out to work best for you.
@@johnslot7397 yes, if you are that sensitive to Wellbutrin and Stattera you may well have a strong reaction to stimulants.
Clonidine is the only Medication which helps me for ADHD
I'm glad that you found something that works for you.
I know this, i know this..... The answer is Everything
Strattera absolutely, crushed my wife’s sex drive and her libido. So much so that we freaked out and poured through the Reddit forum which are filled with women complaining about their libido literally disappearing overnight on this drug. Forewarning stay away from this if you want to have any kind of relationship.
Thanks for sharing your experience.
Yeah that is a problem so I think it's a hard no for me.
This was terrible for me. If I wasn’t asleep all of the time , I was uneasy and not sleeping.
I'm sorry it wasn't a good match and I appreciate you sharing your experience with the medication.
This medication was awful. Complete anhedonia and overall melancholic perspective immediately after the first dose. Like I would never feel happy about anything ever again. Also felt as if all of my movements were slow, like I was trying to run through water. I can’t find any sources as to why that would be the case. When you think norepinephrine, you think “fight or flight”. Why would the opposite occur?
I don't have a good explanation. Although primarily a norepinephrine reuptake inhibitor it does have weaker effects on other systems, so perhaps you were particularly sensitive to effects on other receptors.
Facts this med is trash
Really terrible drug for me I was just sleepy all the time.
I hope that you found a more tolerable and helpful alternative.
Taking it before bed helps.
Nothing wrong with Strattera expect it doesn`t work.
It does unless you're already a junkie 💁♀
You’re right it doesn’t work as a focus medication. Anxiety and depression maybe but not a focus medication.
No absolutely hell no bro the medication strattera is for less effective than most stimulants believe I would know
Strattera sucks.
Any ideas why a doctor would prescribe this as a first line of treatment. I have had it for 5 days and I am having well let's say plumbing issues.
I'm not a mind reader regarding other doctor's prescribing practices, but I have seen some doctors always go with non-stimulants first. Some are very worried about potential adverse effects from stimulants. Some do it intentionally as a test - that someone can't be "trusted" with stimulants unless they have made a good faith and prolonged effort with other approaches.