Another ADHD meds question
July 28, 2011 10:58 AM   Subscribe

I was prescribed Strattera for my adult ADHD, but after reading up on this drug I'm not so sure I want to take it. I'm looking for any Strattera experiences you may have, as well as general advice on the whole tweaking psych meds thing.

I've finally decided to try medicating my ADHD for the first time (I'm 35). I also have major anxiety problems. The psychiatrist I saw prescribed Strattera to start with, because it tends to help with the anxiety part rather than exacerbating it (as opposed to stimulant meds, I suppose).

Naturally, as soon as I got home I began "researching" this drug online, and wasn't crazy about what I saw. It seems that some people have mildly positive outcomes on it, but it can also have weird side effects, including a small chance of liver damage. Even if it did work perfectly for me, I'm not sure I want to take the risk of permanent damage to my internal organs, however minute it is.

Have you had experiences with Strattera, either positive or negative? Is it worth it to muscle through a month of taking a drug that I probably don't want to stick with anyway? I'll probably call up my psychiatrist and voice my concerns, but would like to hear others' experiences with this type of thing.
posted by indognito to Health & Fitness (15 answers total) 3 users marked this as a favorite
I took it for a short while. It made me lose weight pretty quickly, but did nothing for my ADHD.

Like you, I opted for Strattera because I have had serious anxiety problems in the past and was worried about stimulants. Turns out my fears were unfounded - Adderall is one of the best things that's ever happened to me. No anxiety at all. Just the ability to concentrate and think.
posted by elsietheeel at 11:06 AM on July 28, 2011

I took various strengths of Strattera and concluded that it did very little for me. Or maybe it did things that were too subtle; I don't know. At any rate, I never had a single danged side effect.

I do have a friend for whom it has worked very well, so YMMV.
posted by Madamina at 11:08 AM on July 28, 2011

I like the generic for Adderall, but frankly, they're all about the same--stimulant meds. Tylenol has a risk of liver damage. Give it a try, and see what happens. I think stewing about the medication is a good way to let your anxiety keep you from a positive treatment. Unless you have other serious health problems, stop reading the inserts, stop Googling around and let your Dr. treat you.
posted by Ideefixe at 11:17 AM on July 28, 2011 [2 favorites]

I haven't used Strattera -- Adderall has worked well for me -- but the people at this forum can offer you lots of advice and experience on tweaking psychiatric meds in general and Strattera in particular. Good luck with it all.
posted by virago at 11:19 AM on July 28, 2011

Strattera made me foggy and tired. I hated the way it made me feel, and it did nothing for my concentration.
posted by allnamesaretaken at 11:35 AM on July 28, 2011

I've taken Strattera since 2006, except for an interlude of a few months, and am currently on a daily dose of 80mg Strattera with 100mg Wellbutrin to fine-tune it a bit. Side effects I've had:

-- nausea after taking it on an empty or near-empty stomach, which is why I'm currently on 80mg instead of 120, which I was before. So I can't take it before breakfast. Problem solved by cutting back to 80 mg and by taking it right after breakfast.

--nausea if I eat something in the hour or so after taking it. Problem solved by taking it right after a meal.

--sleep disturbances if I took it before bed, as in I'd wake up in the middle of the night and not be able to go back to sleep for a couple of hours. Problem solved by taking it in the morning.

--'urinary incompetence' as the side-effects sheet says which means I occasionally can't fully empty my bladder. Problem solved by going to the bathroom again a short time later.

--extremely rare but random sudden vomiting experiences at night, as in I go from dead sleep to standing in front of the toilet barfing in seconds. It only happened about once every six months, and seems to have stopped completely with going down to 80mg and taking it in the morning instead of the evening. Even if it hadn't stopped, I could take barfing twice a year in exchange for the benefits I get.


--When I'm interrupted at work, it only takes me 10 minutes instead of 30-45 to get back into what I was doing.

--I'm actually doing stuff at work, unlike what I was doing the year before Strattera, when I hit a crisis point.

--Impulse control much stronger. I paid off a $14K credit card debt and paid my car off almost a year early within 3 years of starting Strattera, because I simply no longer made impulse purchases.

--50 pound loss as I can now stick to an exercise and eating plan longer than two days.

--Cleaner house. The first time I emptied the trash can and tied the bag off, then took it out to the dumpster instead of leaving the trash bag on the kitchen floor until I'd accumulated six of them I marveled to myself, thinking "Is this what it feels like to be normal?" I can also spend longer cleaning than I used to be able to. I'm by no means an ultra-neat person now (I solved that problem by moving in with my neatnik boyfriend), but previously I was heading towards hoarder territory, and post-Strattera I could invite people over without having to remove piles of stuff from furniture so they could sit down.

It's not perfect - migraines, short sleep, and stress all can knock out the effects of the Strattera. I'm also getting accommodation at work for this, which helps its effects along - I got moved to a private office with a closed door instead of sharing one in a hallway that guaranteed frequent interruption. And the hardest part of the day is to START work. If I can do that, there's a good chance of being able to stick with it the whole day, whereas if I start off by surfing the Net, it's much, much harder to get into work. It's still 100% better than where I was 5 years ago.

And, as the psychiatric nurse who monitors me says: there's a slight chance of liver damage, as in four out of the several million people who've used it have experienced it. Chances are, I won't be #5. I just periodically get my blood tested to see if everything's OK.

Overall, the benefits outweigh the side effects for me.
posted by telophase at 11:48 AM on July 28, 2011 [2 favorites]

It definitely did not work as well for me as any of the stimulant medications did (I've also been on adderall, dexedrine, and ritalin at one point or another). Strattera also made it hard for me to pee, and 8 years later (!) that's finally starting to no longer be a problem.
posted by rabbitrabbit at 11:59 AM on July 28, 2011

Oh! Another thing! Wellbutrin might be a good option for you. Antidepressant with some stimulant type side effects which help some people who have ADD. I was definitely less anxious when I was on that.
posted by rabbitrabbit at 12:00 PM on July 28, 2011

I have ADD and anxiety too. The researching, thinking, re-thinking, and re-thinking some more is worse for you than any trial of a med will be!

Give it a shot. Aim to stick with it for a month, and if you feel worse or have bad side effects, stop and call your doctor. In my opinion (and experience), IF you can treat it without a stimulant it is definitely preferable in the long run.

If you don't try, you will always wonder. Just go for it -- meds can be a long haul trial and error.

Good luck.
posted by dlouise at 12:28 PM on July 28, 2011 [2 favorites]

I've been on Strattera since last December, and overall, it's worked well for me. There have been a few annoying side effects though, but every ADD med is gonna have side effects. The side effects I've experienced with Strattera include: loss of libido (though it has since come back), the same sleep problem mentioned by telophase (I also take it in the mornings now), and nausea when taken in the mornings without food in my stomach.

Anyways, overall I recommend you at least try it out. It seems to be very hit or miss for a lot of people. It hasn't helped very much, if at all, with anxiety though unfortunately.
posted by BenS at 2:05 PM on July 28, 2011

I've been taking Strattera for almost a year, and it works well for me. The main side effect I've noticed is that it killed my appetite when I started taking it and whenever I increased the dosage, but the problem has always gone away within a week. I used to take Adderall, and for me Strattera is better because it works about as well without the side effects of Adderall; Adderall caused me to grind me teeth enough that my dentist pointed out the tooth damage to me, and it would sometimes interfere with my sleep.

I have anxiety problems too, but I've never noticed either Strattera or Adderall having an effect on my anxiety. Adderall did improve my mood a lot when I first started taking it, but the effect went away pretty quickly. Strattera never had a pronounced effect on my mood.

I think you would be well-advised to try Strattera. It's not something you should have to "muscle through"; it will most likely either work or not do much of anything.
posted by shponglespore at 3:19 PM on July 28, 2011

If you're that worried, maybe the stimulants will be more reassuring to you as they've been around much much longer and are some of the most highly researched and safe drugs around.

But you might as well give the Strattera a go, knowing there's a safe "timeless classic" alternative if that doesn't work out.

Also, I have anxiety too, and I never noticed the stimulants making me more anxious. I treat the anxiety with propanolol, as it's a heart-rate-reducer, not a downer.

It may take you a while to get comfortable, but you'll figure it out.
posted by tel3path at 3:34 PM on July 28, 2011 [1 favorite]

Thanks all, I appreciate your responses. Yeah, I am a pro at the whole stewing and researching phase of any decision (it took me several years to finally get my ass to a doctor about this). Although the list of possible side effects weirds me out, I may just suck it up and take the stuff, and pray that I have no lasting urinary incompetence.
posted by indognito at 6:29 PM on July 28, 2011

Seconding what allnamesaretaken said; it made me foggy and nauseous with little positive effect and I switched it after six weeks.

If you do try it, make sure to give it at least four weeks to gauge how it's doing. These drugs take a while to reach full effect.
posted by Hardcore Poser at 12:06 AM on July 29, 2011

This is way late so I doubt you still need info, but since I was just searching AskMe for info on Strattera anyway...

I've been taking Strattera (with Wellbutrin) for, lord, five, six years? I'm not even sure how long. After my initial ADD diagnosis, I tried Ritalin briefly and disasterously. (I lost weight rapidly, couldn't eat, and over-focused like crazy. Hated every second of it.)

Overall, I'd say my experience aligns well with telophase's. I have heartburn and motion-sickness - my solution has been taking the Strattera immediately before going to sleep (after getting in bed, even) so I fall asleep before the heartburn hits and the motion-sickness has long worn off by morning. (I'm also much better at taking pills at night - I realize I lose some of my effective time to sleeping, but taking my meds regularly more than makes up for it, to me). I am a heavy sleeper, so the fact that Strattera makes me a lighter sleeper is beneficial to me. I definitely have not had the vomiting. It's true I don't pee quite like I used to.

Recently, I accidentally let my prescription slip (I don't see a therapist regularly because my meds are generally working), and I went a week without the Strattera. It was a very interesting glimpse into what the drug does for me. Most noticibly, I had more trouble falling asleep and waking up. The waking up makes sense (I'm a heavy sleeper, Strattera makes me a lighter sleeper) but it turns out that the Strattera is playing a greater role than I realized in helping me calm my thoughts (and anxieties) when I'm trying to fall asleep. Other than that, a lot of ADD symptoms resurfaced or were worsened: I babbled more. I swore more/got frustrated more easily. I accidentally sang out loud more. Like, while walking down the hallway at work. Whoops. Restoring my Strattera prescription fixed these symptoms.

So, I'm not sure if that helps you, OP or fellow Strattera search-term typer, at all... My opinion is that Strattera is not going to magically help you sit down and focus on your studies. What it is good at is helping to regulate your attention. I'm still just as distracted by conversation and TV and the internet as I ever was. But I can manage to always put my keys in the same place when I get home from work. I can lay my head on the pillow and sleep instead of worrying about what I need to do tomorrow. If something doesn't work the first time, I can give it a second and third try before cursing. These are smaller, subtler effects than the stimulants promise, but they are much more important to me. They may not be the solution you are looking for.

If getting through a lecture or meeting without your mind wandering off is the goal, go with one of the stimulants. If staying in a conversation with a television in the background is what you want to do, go with Strattera. If focusing on a single specific task is the problem, try the stimulants. If multi-tasking is part of your job, consider the Strattera.
posted by maryr at 7:58 PM on February 8, 2012 [2 favorites]

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