Suggestions needed....

[Autumn]

I started taking Strattera two months ago; 20mg for the 1st month, then 40mg for the past 3 weeks. It's done nothing for the ADHD, but I don't want to stop taking it, because it's done some good things in the depression department as a supplement to the Lexapro.

What I'm thinking of doing is requesting a low-dose stimulant to add to the mix, and wondering if anyone has some suggestions. My next appointment with my pdoc is on the 4th.

I'm interested in something that has a good track record, that isn't brand spanking new on the market.

Thanks guys....

[Velvet Elvis]

Well 40 mgs is still a pretty low dose. My gf takes 80 + a stimulant and my brother takes 120.

So some things to try.

1. Go up to a much larger dose in graduated increments, waiting between each one.

2. Go up to a much larger dose PLUS add a stimulant.

3. Drop the strattera, go on a stimulant and look at something else for depression.

[Autumn]

Hmm. Thanks for the reply, Velvet Elvis. It hadn't occurred to me that the Strattera was still at such a low dose. I usually do my own research prior to posting questions like this. It helps to know what works for others, tho.

I just remembered, also, that Air Marshall takes a low dose stimulant with his Strattera. I just checked on his doses, and his Strattera is at 100mg! Aye.

Looks like I'll be having my dose increased, then, and I'm going to request the addition of a low-dose stimulant as well. This shyte is just taking too long to get under control, and I feel like beating my head against a wall sometimes.

I thought I'd add here that I've been decreasing my dose of Seroquel over the past month, down from 300mg because it made me start gaining weight. I haven't yet decided what to take to replace that, so in the meantime, I'm a bit concerned about a stimulant triggering mania. I freakin' miss my Seroquel, too -- it was working so good.

It takes me a long time to adjust my meds. I'm so sensitive, that I don't like adding more than one new med at a time, so I can monitor side effects. On the upside, I usually know within days whether or not something is going to work.

We'll see....

[Velvet Elvis]

Strattera alone shouldn't induce mania regardless of the dose but you do need to be on something to curb that before you start messing around with stimulants

[Autumn]

Hey there.... thanks for the reply. For some reason, I haven't been getting e-mail alerts. I prob'ly did something wrong.

As far as Strattera triggering a manic episode, that's of minimal concern, although it happened with Cymbalta, which I believe also works on norepinephrine. It was the worst episode I ever had. I'm maintaining my Seroquel dose at 200mg as a bit of insurance.

I decided against a stimulant med after all; I have a minor heart problem (mitral valve prolapse) that's easily aggravated, and I abuse other stimulants as it is (nicotine and caffeine). I drink about 3 liters of Diet Pepsi Max a day, which has double the caffeine of regular soda. I think that constitutes abuse, lol.

I bought a membership to Fit Brains, a site that uses different games to improve overall cognitive functioning, including memory and focus, so hopefully that will help with the increase in the Strattera. If not, I'll have it increased again, and probably go with some kind of dietary supplement, like Omega 3's or L-Tyrosine.

Thanks again for writing, and happy holidays!

[w0nderIngSparr0w]

If you are really hyper, by medicating with stimulants you won't get high........ It's called a deficit because u're under the baseline...The stimulants just act on other parts of your brain (amygdala and cerebellum i think), releasing and also blocking the reuptake of dopamine to counter-act the biological flaw.

I'm taking Ritalin, in the past i abused cocaine, and im impressed that I haven't even related the effects.........

I can sleep whenever i want, Im actually hungrier.

For the first time in many years i've been able to start and finish a novel........

Effexor could also help you to cope with the ADHD (above 150mg, so it blocks the reuptake of norepinephrine and so indirectly dopamine....... I tried strattera and it didnt work for me........ TCA's could also help...but the help takes a toll because of side effects..your choice.

Hope it helps.

[null0trooper]

As far as Strattera triggering a manic episode, that's of minimal concern, although it happened with Cymbalta, which I believe also works on norepinephrine. It was the worst episode I ever had. I'm maintaining my Seroquel dose at 200mg as a bit of insurance.

Cymbalta hits both serotonin and norepinephrine at the same time (more the former than the latter, according to some research). It should be less likely than a straight SSRI to trigger an episode, but obviously it's not impossible.

I bought a membership to Fit Brains, a site that uses different games to improve overall cognitive functioning, including memory and focus, so hopefully that will help with the increase in the Strattera. If not, I'll have it increased again, and probably go with some kind of dietary supplement, like Omega 3's or L-Tyrosine.

l-Tyrosine has triggered mania in one or two folks here over the years. My recommendation would be to try d,l-phenylalanine (some risk still, but an extra synthesis step is needed to get to dopamine) As long as you know what to watch out for, there's still a good chance of it working out OK.

[Guest Autumn]

If you are really hyper, by medicating with stimulants you won't get high........ It's called a deficit because u're under the baseline...The stimulants just act on other parts of your brain (amygdala and cerebellum i think), releasing and also blocking the reuptake of dopamine to counter-act the biological flaw.

I'm taking Ritalin, in the past i abused cocaine, and im impressed that I haven't even related the effects.........

I can sleep whenever i want, Im actually hungrier.

For the first time in many years i've been able to start and finish a novel........

Effexor could also help you to cope with the ADHD (above 150mg, so it blocks the reuptake of norepinephrine and so indirectly dopamine....... I tried strattera and it didnt work for me........ TCA's could also help...but the help takes a toll because of side effects..your choice.

Hope it helps.

Hi Sparrow -- thanks for the reply. Actually, I'm not hyper -- at least not physically -- but my mind races, my thoughts get jumbled up, I can rarely watch a movie in its entirety, finish tasks without becoming distracted, etc. It could be that I'm less physically hyper due to the Seroquel and Xanax, but then, I never was really physically hyper, even without those. So that makes me wonder if it's more of an ADD thing, as opposed to ADHD. My pdoc won't refer me for additional testing unless the need for a stimulant becomes apparent.

I've read some things about Effexor, lol. I'm not opposed to it though, since the Lexapro is my last resort in the SSRI department. Once that fizzles out (and it will), I might just take a closer look at Effexor. I kind of like the "all in one" package deal it offers, anyway, so I'll let that prospect simmer awhile.

[Autumn]

Cymbalta hits both serotonin and norepinephrine at the same time (more the former than the latter, according to some research). It should be less likely than a straight SSRI to trigger an episode, but obviously it's not impossible.

I was thinking that, too. I've run the gamut of straight SSRI's, so it was more than likely some kind of freak negative/allergic reaction -- besides triggering the mania, my whole body itched for like two days.

l-Tyrosine has triggered mania in one or two folks here over the years. My recommendation would be to try d,l-phenylalanine (some risk still, but an extra synthesis step is needed to get to dopamine) As long as you know what to watch out for, there's still a good chance of it working out OK.

Great. I appreciate the info -- I haven't seen anything in my travels about phenylalanine yet, as far as treating ADD/ADHD (I'd heard of it, but I was unfamiliar with what it's used for). Good stuff.

Thanks for writing!