Strattera vs stimulants

My doc has recently decided I should be switched to Strattera although stimulants are really effective for me. Long story, I'm really unhappy about it but trying to cooperate.

I wanted to see if anyone else has switched from stimulants (Adderall in particular) to Strattera, and if so, whether they found Strattera effective. I've done some reading up on it and I have pretty low expectations but thought I'd check and see what others have experienced.

The big complication I expect to encounter is that it's only been tested and dosage guidelines given for people between 126 - 147 pounds, and I weigh a lot more than that. In fact, I have never weighed 147 pounds in my adult life, even when I was in extremely good shape and quite thin! So if anyone has taken this med who exceeds the weight guidelines by at least 50 pounds, I'd really like to hear about that as well.

Strattera did wonders for my ADHD, and on a low dose, helped with my anxiety and depression, too. It was the first time in years that I could actually sustain focus on one thing for more than five minutes

Unfortunately when we upped the dose (still not to the full dose I would be weighted for) I became withdrawn and suicidal. Within days of going off of the Strattera those symptoms vanished and the quest to find a med that would help with everything began. I had been on stimulants prior to the Strattera, and they were messing with my body, so I couldn't continue on them.

I'm still only on 25mg after 4 days but having a hard time with side effects. Extreme fatigue as soon as the instant-release Adderall wears off, constant headaches, and a sort of dizziness as though I'm drunk. I've also been feeling a lot more depressed since I started taking it. It's really unpleasant.

AniManiac, I take low dose Wellbutrin for ADHD and have found it helps quite a bit. It seems to help a bit differently than the stimulants--has different advantages. It might be worth a try if the Strattera doesn't work out. I take Wellbutrin every day and Vyvanse as needed. My prescriber has suggested before that I just try the Vyvanse alone, but it just is not the same for me. That Wellbutrin really is doing something to help with my symptoms, and it is not duplicated by the stimulant. Hopefully, you will find similar benefits from Strattera.

As far as the dose/weight question goes, your prescriber will titrate the dose as needed, based on your symptom response, side effects, and drug safety considerations.

Thanks sunrise. I've been on Wellbutrin for 12 years and even at the max dose it does not do enough to control the ADD symptoms.

If I can stand the side effects, I'm going to try to give the Strattera a month or even two to see if it will work, but I can't waste any more time on it than that if it's not working. If it doesn't work out then I hope they will give me stimulants again because that was a very effective treatment with no noticeable side effects. If not, I will have to find another pdoc.

AniManiac, do you know why your pdoc wants you to try Strattera instead sticking with the stimulants? I know prescribers can sometimes be under general pressure from their place of employment not to prescribe a lot of Schedule II meds, regardless of the situations of individual patients. I haven't had any side effects with stimulants either. The new formulations help make them addiction-proof, which is reassuring to prescribers (and can be to clients too, of course). Good luck to you.

Yeah, I came up negative for amphetamines on a drug test when I should have tested positive. So he was "concerned" that I wasn't taking the meds, meaning he thinks I was selling it.

I would never do that for many reasons, not the least of which is that I desperately need it to do my work. In fact, I hoard them in case something like this happens, which is the only reason I'm currently getting by - slowly using up my Adderall IR and then I still have some Concerta that I can fall back on.

It's also the worst timing in the world, since I'm about three weeks from turning in my dissertation manuscript. But no mercy. So if he doesn't say that he's willing to give me stimulants again if the Strattera doesn't work out, I'm changing psychiatrists. I don't have to settle for that kind of disrespect and lousy care. It's really insulting on top of being really detrimental to my stability.

Update: Been on Strattera for 12 days. I know everyone says you have to tough it out for 4-6 weeks to see benefits, but I don't know if I can do it. I have never had so many side effects from one drug!

It's my 2nd day at 60mg. I'm still exhausted all the time. I'm still dizzy fairly often. My ears ring and I can physically feel the increase in my blood pressure in the veins in my neck.

The headaches are constant, getting worse, and starting earlier in the day. Previously they would start 3 hours after taking the meds, but now they are starting 1 hour after taking it. Today the headache came with a burning sensation on my scalp, quickly followed by the worst panic attack I've ever had. I was extremely anxious, shaking, and crying, with no trigger whatsoever. After a couple hours it subsided, but not before I had called the psych's office to ask to be taken off this med because this level of side effects is disabling. I'm hoping to hear back from them today. I haven't been able to work today since the Strattera started kicking in - kind of the opposite of the desired effect.

And it's still doing nothing to help my problems with ADD.

Update - I quit Strattera after the problems on 3/6/12. The psych's office never called back, so I quit them too.

All of the side effects were gone in 2 days! What a relief.

I don't understand....who drug tested you? Does your psychiatrist drug test you? I've never heard of that! That's crazy!

The drug test was administered by a lab.

But yes, they drug tested me to verify that I quit smoking pot because they issued an ultimatum that they wouldn't prescribe stimulants unless I quit. And then they also screened for amphetamines, for which Adderall should show up after 24 hours from the last dose.

The assumption was that because I tested negative for Adderall (the false negative rate is actually higher than the false positive rate for drug tests!) then I must not be taking it and therefore I must be selling it.

Of course, I was at a really low dose, drink a lot of water, and I take Vitamin C supplements. The acids in Vitamin C would lead to much faster drug clearance for a urine test. No one warned me that I shouldn't take Vitamin C with Adderall!

That is really freaky. I can't imagine my psychiatrist drug-testing me. I would never consent to that! My psych knows I smoke pot ocassionally, and she never said anything about it.

I'm wondering if you should file a complaint about this psychiatrist?

Could you tell your psychiatrist you didn't take the Adderall that day and so that's why it didn't show up on the drug test? I don't take my stimulant medication every day. I think this is quite common with people who take stimulant meds for ADHD. For example, some people only take them on weekdays to help them on the job, but don't take them on weekends when they have a lower cognitive load. I think it gives the heart a rest too--better for heart health. I don't see the problem. Plus, that way you can get a little cushion of meds built up so if you aren't able to go to the pharmacy exactly 30 days since the last visit, you won't be completely out of the med. Could you prove to the pdoc that you didn't sell the meds by showing him the meds in your pill bottle? If they're still there, then obviously you didn't sell them.

I told them I didn't take the instant-release afternoon dose the day before because it was the weekend and I often don't take the full dose on weekends, just like you. Especially because it's marked "if needed." It was a fasting test, so I hadn't taken it that day. Wish I had, though.

I also can't prove that I didn't sell the meds because I had taken them all, like I was supposed to! There was one day left when they told me that they were switching me off the drugs.

Anyway, I'm thoroughly disgusted with how they treated me and I'm not going back to them. I'm working on finding a new psychiatrist now.

Other students in my NAMI support group suggested filing a complaint. Everyone around here knows he's a crappy psychiatrist. I just don't have the energy, and I'm pretty sure the psych would have plenty of ways of undermining my credibility anyway.

My last psychiatrist before him specifically said, "I'm not the pot police." She took a very rational view of the whole thing, said occasional use is OK but every day use isn't. But I had other issues with her, including the expense, so I had to quit seeing her.

Now I'm looking for a third psychiatrist in a year. This is really frustrating.