[elevatedsoul]

So i saw my Pdoc today, it was overall a good meeting i think

he explained a few things to me about why he is hesitant to prescribe stimulants to me, due to my past (alcohol/weed)

he said we should try Strattera, since its a non stimulant and not a controlled substance... he said that this medicine is better for adults and that it shouldnt increase my anxiety

he was taking notes and said 1 thing that confused me, he said if strattera doesnt work then he wasn't going to diagnose me with ADHD, i guess because he doesnt want to give me Adderal or ritalin?

so what if strattera doesnt work, does that mean i dont have ADHD?
im clean now so why does my past abuse haunt me ... if i was interested in abusing adderall or speed wouldn't i just go out and get them from the streets? or resort to using cocain even?

i hope strattera works for me

[sideblinded]

elevatedsoul , Hello. trying to get help for ADHD as an adult is really hard and it shouldn't be. That doctor needs to diagnose you by your childhood history or problems that you are having focusing or attention span problems or hyperactivity...the list goes on. I really dislike that treatment providers don't think it is important to treat adults. I am sorry for this. Is this the right doctor for you? Therapist can help to diagnose ADD or ADHD as well. Let us know how the Strattera works. Regards.

[pinkflower17]

Originally Posted by elevatedsoul

So i saw my Pdoc today, it was overall a good meeting i think

he explained a few things to me about why he is hesitant to prescribe stimulants to me, due to my past (alcohol/weed)

he said we should try Strattera, since its a non stimulant and not a controlled substance... he said that this medicine is better for adults and that it shouldnt increase my anxiety

he was taking notes and said 1 thing that confused me, he said if strattera doesnt work then he wasn't going to diagnose me with ADHD, i guess because he doesnt want to give me Adderal or ritalin?

so what if strattera doesnt work, does that mean i dont have ADHD?
im clean now so why does my past abuse haunt me ... if i was interested in abusing adderall or speed wouldn't i just go out and get them from the streets? or resort to using cocain even?

i hope strattera works for me

That's kind of strange. I hope Strattera works for you too. I think statistically it works about half the time. I haven't ever heard of it working better in adults, but I could be wrong, maybe something to do some research into? I guess I thought if you have ADD, you have ADD. Period. Maybe he doesn't want to get into the stimulants, but there are other alternatives to stimulants than just Strattera, so overall, I find that comment kind of odd. Anyway, I hope it works for you. Good luck.

[elevatedsoul]

thanks for the responses

pinkflower17
if its not too much trouble, could you tell me other alternatives to stimulants?
i was thinking about asking of adding wellbutrin back into the mix

[pinkflower17]

Originally Posted by elevatedsoul

thanks for the responses

pinkflower17
if its not too much trouble, could you tell me other alternatives to stimulants?
i was thinking about asking of adding wellbutrin back into the mix

Wellbutrin is a great one, probably the most commonly used outside of stimulants, especially before Strattera. Also, several of the old TCAs, imipramine in particular, but also desipramine and nortrypline can be helpful for some people with ADHD or ADD. Fetzima and Effexor have also been used, but with mixed results, much less effective. Along the same thread MAOIs are also effective, albeit less so, and difficult to handle all the dietary restrictions.
Clonidine and Intuniv can also be used. They're especially helpful with helping with mental functioning.

If your doctor is comfortable with any stimulant, try asking about Vyvanse. It's metabolized by your digestive system to the active med and it's not activated if broken/crushed etc, so theoretically the abuse potential is lower. Obviously, you can still abuse it orally, but some prescribers seem to be more comfortable with it.
Good luck. I hope you find something that works. Let me know if you have any more questions.

[hypermic]

Well my understanding is that stimulants should generally be prescribed for pronounced ADHD, even with a history of substance abuse- that's if the substance abuse problem is currently stabalized. If its ongoing, then perhaps treating the substance abuse first may take priority.

Strattera is effective in around 1/3rd to 1/2 people with ADHD. An non-response to Strattera does not in any way rule out the diagnosis of ADHD.

Strattera can help definitely, but it usually not as much as stimulants. It can take several weeks at a strong dose before benefits are solidly noticed. Typical adult dose is 80mg.

[elevatedsoul]

when should i start noticing effects on Strattera?

i am on a starter pack, starting at 25mg for 5 days, going to 40mg 5days, 60 mg 5days, 80 mg

currently im at 40 mg and day 7

[pinkflower17]

Originally Posted by elevatedsoul

when should i start noticing effects on Strattera?

i am on a starter pack, starting at 25mg for 5 days, going to 40mg 5days, 60 mg 5days, 80 mg

currently im at 40 mg and day 7

You're probably not on a high enough dose. According to the PI, the dosage titration is recommended to rapidly titrate (starting at 40 and increasing to 80 after at least 3 days) and once you get there for 2-4 weeks, and if that's not effective to go up to 100 mg. Obviously, I would stick with whatever your physican recommended and continue the starter pack, but just know it might take a while before you see the maximum effect. Sometimes starter packs are really different from what the manufactor recommends.
From what I've read, it's effective anywhere from 30% to 90% of the time in adults, so I'd give it a fair try before you write it off.
I'd call your doc about maybe trying to titrate a little faster and see what he/she has to say, maybe you'll get some relief faster....
Good luck.

[elevatedsoul]

thanks, i thought it was a slow titration myself
im going to increase the titration speed, im not feeling anything really currently so no bad side effects

the onlything i feel is a little more tired than usual, i've already been sleeping too much so i dont need something to make me more tired... was kind of hoping to get a boost effect
it might also be helping with my anxiety a little? i feel calm but im not collected or organized at all, still having the usual problems..
we'll see what happens when i get to 80mg

pdoc said it should help with daydreaming and memory...
im afraid that it wont work and he'll label me as drug seeking for some reason...
im a recovered! alcoholic, i dont miss it at all... nor do i abuse drugs, but because of my past "self medicating" period i feel like im being judged

i feel like he doesnt trust me because he didnt want to Rx a stimulant, something that has been tried and proven effective, he even said in the meeting that stimulants were first line of treatment so im just perturbed about it
the wellbutrin didnt help either..

im probably looking into it too deeply

gonna try to talk to my case manager about all of this...

running on low sleep and feeling a bit bipolar today

I don't see what's so wrong with stimulants. Neither does my psychiatrist. I asked for Strattera and welbutrin while getting tested for ADHD and he says that it's illogical and pointless to prescribe welbutrin as it works for like 4 out of ten people and strattera works for 6 out of ten people. Stimulants works for 9 out of ten people so he started me on Concerta.

[hypermic]

You should give at least 6 weeks at a proper dose (around 80mg) to notice improvement. Some studies suggest benefits can continue to increase for a few months.

If you haven't noticed ANYTHING beneficial by 6-8 weeks though I would say its unlikely to help.

Tiredness is a common side effect and will hopefully pass a bit down the track.

[Miswimmy1]

Originally Posted by elevatedsoul

he said if strattera doesnt work then he wasn't going to diagnose me with ADHD, i guess because he doesnt want to give me Adderal or ritalin?

so what if strattera doesnt work, does that mean i dont have ADHD?

I was on Strattera for a while (100mg). I was on the maximum dose and it wasn't strong enough to control my ADHD symptoms. I don't think that your pdoc means that if it doesn't work, you don't have ADHD. It's my experience that doctors will "diagnose" you with whatever label will placate the insurance companies. They have to write something down. Given your addictive tendencies, it would make sense why your pdoc would be hesitant to prescribe a stimulant medication like Adderall or Ritalin. I think that it is more likely that he would move on to other non-stimulant alternatives such as Wellbutrin or Provigil (that are not technically approved to treat ADHD). Therefore he would have to "diagnose" you with depression or whatever the drug is approved for. I went through this my pdoc because I had a similar issue with one of my meds.

[elevatedsoul]

im still not noticing anything... besides a loss of appetite and more fatigue, the last thing i need is something to make me more sleepy

thanks for the replies,

if my pdoc is hesitant to prescribe adderall or ritalin, would he be more keen to prescribe vyvanse or concerta?