View Full Version : Looking for Strattera Transition recommendations

John E
06-06-17, 01:03 PM
I have inattentive ADD and I've been taking Strattera for a number of years. It works well, but the pattern here is that it works less well over time. So I keep having to up the dosage periodically. I can read the writing on the wall that at some point I will either be at peak dosage and won't be able to go higher OR the side-effects will become more dominant (unacceptably so) as my dosage gets very high.

I'm looking for feedback from those who have blazed a trail before me and have had a similar experience. What did you end up doing about it or transitioning to?

06-07-17, 06:01 AM
Have you ever considered stimulants?

06-07-17, 05:48 PM
What dose are you taking now? The manufacturer sample packs of Strattera involve gradually going up to 60 or 80 mg (based on patient age and weight) over the course of 15 days. The recommended maintenance dose is 80mg or 100mg for adults. You're actually expected to gain tolerance to the lower doses, and while there might be some people (especially kids) for whom those are effective doses, i think pills in those doses mainly exist to ease the transition to a higher dose.

(Seems doses over 120mg haven't been studied much. Seems weird the max studied dose is only a little higher than the recommended typical maintenance dose... I guess since Strattera is still fairly new?)

If you actually do get to a point where 100mg or 120mg is not effective... Unfortunately, there doesn't seem to be much research on the topic of medicine tolerance at all, especially for non-opioid meds. I think the most common tactic is to switch meds. With stimulants for ADHD, people may switch between two acceptable meds every few months (abstaining from a med a while often reverses the tolerance at least somewhat). I've read people doing a permanent switch to different SSRI or SSRI when treating depressive disorders, but Strattera is the only SNRI indicated for ADHD, so your switch would probably have to be to another drug type.

I'm in a similar bind with Adderall.

06-07-17, 11:50 PM
My understanding is that strattera is fairly binary in regard to an individuals peak dose....

It's usually the negative side effects and diminished respite over time that renders it no longer beneficial.

There might be scope..... although few doctors might be onboard with this..... to phase it with another med.... But the tapering duration makes this quite time consuming....

( something like 6-12 months on 3-6 months off might work )
( or 3-6 months on a stimulant back to 6-12 months strattera )

It is very common though for those who run the duration with Strattera to be placed on stimulant or cyclics.... Your doctor should be up to speed on your options.