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General Medication Discussion This section is to be used for general medication discussion and other medications not broken out in their own respective forums.

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Old 01-04-13, 03:22 AM
RyanV25 RyanV25 is offline
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Need advice... Quitting Strattera after 3 months for a stimulant

I have been taking Strattera for 3 months now, as follows:
Wks 1-3: 25mg
Wks 4-7: 40mg
Wks 8-11: 60mg
Background:
I am 29 years old and have been living with undiagnosed "extreme ADHD" my whole life (until 3 months ago). My psychiatrist said I am a textbook case, but I've gone undiagnosed because I'm very high-functioning and have a co-morbid diagnosis of mild OCD, which she said further masked my ADHD symptoms to other docs.

The impetus for the diagnosis was a nasty, nasty blackout drunk which landed me in some big trouble. For the last 10 years I've been a heavy binge drinker with frequent blackouts and regular marijuana abuser. Never was allured by any harder drugs. I don't consider myself an addict or alcoholic, but I definitely abused/self-medicated using these.

I've been completely sober for the last 3 months (haven't drank a drop or smoked any weed), and it really has not been a huge effort. I'm not making a lifelong attempt at sobriety, but staying sober long enough to adjust to my new lifestyle with proper medication (instead of using alcohol and marijuana as self-medication). I have decided to give up binge drinking entirely, though. Now that I've got an ADHD diagnosis I understand that the binge drinking all along was nothing more than self-medication. Also, no plans to use marijuana again (which is a shame, I loved it, but over time it really contributed to depression and seemed to exacerbate the worst of the ADHD symptoms).

ANYWAY, I have had mixed results on Strattera.

The positives:
- It has made it incredibly easy for me to stay sober. I have been able to go with friends to cocktail parties, fancy dinners, nightclubs and concerts without even a temptation of consuming alcohol (all of which were scenarios where I would do heavy drinking before). In fact, I've rather enjoyed being the sober one and marveled at how I thought I was "enjoying" myself at these events while intoxicated in the past.

- I am much calmer and more relaxed. I used to be highly anxious, worrying about every little thing and very on edge. It's really, really calmed me down and made me much more easygoing. I used to be hypercritical of others, but now I'm much more understanding.

- I occasionally get a fleeting "high" from it that is absolutely the most blissful, peaceful feeling I have ever experienced. It's unlike any high I've ever experienced from recreational drugs because this one feels very genuine and rooted in true feelings of peace and happiness. The "high" sensation is always triggered by some event that makes me happy (such as working out, hearing one of my favorite songs, having warm conversation with someone, etc...).

- I am able to see tasks through to completion more frequently. I'm still often distracted and will "jump ship" temporarily to other tasks, but I'm now able to return to the original tasks and finish them off.

- My family has said they can see a difference on my face. They say the frown lines/wrinkles in my forehead are much less pronounced and they attribute it to my newfound easygoing outlook on things.

- When coupled with high doses of caffeine, my mind is freaking SHARP! It's unreal, it's like a constant stream of brilliance!!! But when the caffeine dies down and the Strattera lethargy sets in, the mind gets pretty foggy.

- I used to be super fidgety... While at my desk at work, there was ALWAYS something in my hands that I would fidget with (pen cap, paperclips, etc...). Without making any concerted effort to stop, this behavior has virtually disappeared. I'm shocked -- who is this person I've become?!?! LOL

The negatives:
- My day-to-day focus does not seem to have improved. In fact, in many cases I feel like it's getting worse!! It was always bad, but now it's so bad that other people are noticing. The only time my focus is good is when I'm heavily caffeinated.

- The sexual side effects are still significant after 3 months. Erections more difficult to come by (pretty much impossible until 12+ hours after taking my daily dose). Orgasms are weak.

- The usual dry mouth, urinary dysuria, decreased appetite, fatigue/lethargy, etc... do not seem to be going away.

- I've become incredibly messy in my house. I'm co-morbid OCD, so I usually keep a very tidy home free of clutter, but the last few months, I've really let myself go. This is REALLY unlike me and I don't like it. Yet, the thought of keeping up with the house just exhausts me and feels so futile.

- The "easygoing" attitude is not sustaining the longer I'm on the medication. As my body is adjusting, this benefit is waning.

The decision:

- My doc has approved me to try Vyvanse or Concerta ER if I really want to. But she said as long as Strattera is working, there is no need to change. I really want to try the stimulants as I think I would have great results, but I'm really scared to give up the positive effects of Strattera. I was someone who would binge drink virtually every weekend and smoke pot every day and with the help of Strattera I have completely walked away from that lifestyle. So I don't take this decision lightly.

But at the same time, I think the mere UNDERSTANDING of what I was doing (self-medicating) has been a bigger influence for making a change than the Strattera has been. I'm just scared because my doc keeps telling me that with stimulants, by the time I go to bed, the meds will have worn of completely and its as if I've had none at all (vs. Strattera which provides 24 hour effects). I'm concerned about going out into nightlife without the protection of any ADHD meds.
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Old 01-04-13, 11:36 AM
RyanV25 RyanV25 is offline
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Re: Need advice... Quitting Strattera after 3 months for a stimulant

I should clarify... My main concern is I want to boost my focus. I feel like Strattera is almost making my focus WORSE, so I feel like a stimulant could help. But I'm experiencing so many positive effects of Strattera, I don't want to give those up. I would really like to take both Strattera AND a stimulant, but my doctor was not very receptive to this, saying she only diagnoses people for both in very rare/extreme cases.
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Old 01-05-13, 01:59 PM
deezzyy deezzyy is offline
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Re: Need advice... Quitting Strattera after 3 months for a stimulant

Perhaps keeping strattera and adding a stimulant could be beneficial as it was for me. Here are some literature that supports this combo. Also if you do a thread search on this forum, you will find various threads talking about this combo.

This article documents 4 case studies of using strattera in conjunction with a stimulant: http://www.ncbi.nlm.nih.gov/pubmed?term=15142400

This website also supports this combo: http://www.childadolescentpsychophar...-addition.aspx
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Old 01-05-13, 08:51 PM
RyanV25 RyanV25 is offline
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Re: Need advice... Quitting Strattera after 3 months for a stimulant

Thanks, deezzyy! I really appreciate the links. I will reference these when I visit my doctor next week.
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