How does Strattera Work?
ByI have recently started posting to this blog. I have really appreciated the great response to it, and I am watching the comments to find questions which may be worth answering on the blog. As my subscribers know, I have a database of thousands of questions on ADHD, and I will use these as well to draw for content. To become a subscriber, please go to: The ADHD Doctor.
Tim wrote a comment the other day with a question: “I’ve recently started taking Strattera (2 weeks ago). Would you please comment on its effectiveness, how long it may take (should I already be noticing a difference if it is right for me?), why its not prescribed for kids (or is it or when it might be acceptable to use it if it is effective), and what I should be looking for in regards to figuring out whether or not it’s working?”
Let’s answer this one.
Strattera is the first non-stimulant medication which has come out for ADHD. It is FDA (and Health Canada – for us Canadians 
) approved for the treatment of ADHD from the age of 6 years old and up. It is approved for Childhood ADHD, Adolescent ADHD as well as Adult ADHD. As a Psychiatrist who deals predominantly with children and teens, I occassionally like to smile at the idea of there being ‘Geriatric ADHD’. While I cannot comment on that at length, I am aware of adults who have started Strattera in their sixties with good effect.
Stratter’s other name is: Atomoxetine.
How does Strattera work?
Strattera selectively blocks the reuptake of norepinephrine (or noradrenaline) in the brain. This, in and of itself, can increase the ability to pay attention and improve hyperactivity. The interesting thing is that Strattera gradually has a downstream effect on the dopamine in the brain, specifically in the frontal lobe. Now, I am throwing around a lot of medical terms very quickly here. Allow me to explain:
The frontal lobe is the ‘command center’ of the brain. This is the area that new brain imaging studies show is most affected in individuals with ADHD. This command center allows people to use their ‘executive functions’, which are the thinking skills which allow for: sustained concentration, impulse control, delayed gratification, etc.
Norepinephrine and Dopamine are called ‘neurotransmitters’. These are little brain chemicals which jump from one nerve cell to the next in the brain to carry a message through the brain.
In individuals with ADHD, research shows that they have ‘underactivity’ of the dopamine and norepinephrine in the frontal lobes.
ADHD medication generally increases the activity of the brain chemicals dopamine and norepinephrine in the frontal lobe, and in so doing, they increase the attention, and decrease hyperactivity and impulsivity (i.e. they increase these ‘executive functions’.
So, coming back to Strattera.
Strattera brought some very unique features to ADHD treatment which were not there prior to its release.
The benefits of strattera include:
- 24 hour symptom control – although it takes the medication about 3-4 weeks to ‘kick in’, when it does, it works 24 hours per day, contrary to the stimulants which work up to 12 hours per day
- No abuse potential at all: because there is no increase of dopamine in the part of the brain called the nucleus accumbens, Strattera cannot be abused to provide any pleasure
- No increase in tics: because Strattera doesn’t increase dopamine in the part of the brain called the striatum, there is no increase in motor or vocal tics with its use. So, for people with ADHD and Tourette’s, this is likely the best ADHD medication
- Good for ADHD + Depression or ADHD + Anxiety: A recent study showed that Strattera helped depression and anxiety (when they were present in combination with ADHD) and the ADHD. This can often mean that someone could take one medication for their condition – i.e. Strattera, instead of needing to take two medications – i.e. one for ADHD and one for the anxiety or depression
- May help for nocturnal enuresis: Strattera causes some ‘urinary retention’. This means that for some children who wet themselves at night, this medicine may lead to more dry nights. This is not a main treatment use for strattera, but it can be a side benefit
- May not cause ‘personality changes’: Some of my teenage patients complain that their stimulant medicine helps their concentration, but may take away their personality, or spontaneity. Strattera is a good option for this, as it does not clinically appear to cause these results
Strattera works for approximately 75% of people who take it. There are some data which suggest that if one takes it after having had treatment with a stimulant, that this may yield a slightly lower response rate. Why is this? It is my clinical impression that this does not relate to the fact that the stimulant has ‘changed the brain’, but rather the fact that as in many conditions in medicine, if something doesn’t respond completely to the first treatment used, it is much less likely to respond to the second treatment – i.e. it is ‘harder to treat’.
How can you tell if strattera is working?
Generally, one should notice an improvement in concentration, and a decrease in hyperactivity and impulsivity. The benefits should generally last for 24 hours -and be more ‘steady’ than they are with the stimulant medicines. As mentioned above, it takes about 3-4 weeks for Strattera to start working, so one needs a little patience.
The long acting nature of strattera means that the benefits of the medication last into the evening – meaning that if a teen has homework or a project to be done, they can still have the benefits of the medication to help them late at night.
Also, there are a lot of data that people with ADHD have many more troubles driving – increased tickets, motor vehicle accidents, etc. So, if a teen (or adult) is going to drive home late at night after a party -it is better if their ADHD medication is still working in their system.
The last part of your question, Tim, was why this medicine isn’t prescribed for kids. The answer is (as I am sure that you have gathered by now) that it is used for kids too.
There are some safety issues with Strattera, and these will be addressed in an upcoming blog post.
Thanks for the great question Tim, and I encourage other readers of the blog to comment on this or any other post. Please remember, that I cannot comment on every question, or every post, but I will try.
hi
i was trying to lessen my son intake of strattera,we gave him med at aound 1130 am,then he will go to school around 12 to 230 pm,anf after that he would sleep from 3pm til 6pm.He has difficulty sleeping at nght.He would sleep ariund 1am,it hard for him to wake up at 7am for his theraphy sesssion.What ive noticed is that when he take strattera he always felt uneasy and would cry a lot w/o any reason.I dnt know why?Help pls.He is 7 yo now.
My experience in the first week was an INcrease in anxiety and scattered/racing thoughts… thus, I stopped taking it.
I wonder (A) if I should give it longer — my M.D. stated 10 days was enought, and (B) if my malady is really ADD (“brain fog” experienced, perhaps more about circulation, or other physiological maladies).
My 9yr old was just prescribed Strattera just 10mg to start. However she cannot swallow a capsule yet and the doctor said I can open it put in pudding so she can take it. But the prescription says do not open capsules…What do you think?
Kathy – the biggest issue when opening strattera is that it can create a burning sensation/bitter taste, and may cause more nausea when it is opened. If your child can tolerate it – then go for it (And review it with your doctor).
Hi Dr. Handelman,
Aside from side effects, is there a reason to prefer strattera over desipramine when it comes to adhd?
Kenny, where are you practicing now?
Jennifer – I am practicing at the Oakville Hospital.
Hi Dr. Handelman,
My 12 year old son just started taking Straterra 10mg today and complained of headache, tiredness, feeling “not himself”. Is this typical or expected after the very first dose? I read that these were side effects but expected them to emerge after a few days or weeks.
Vernon,
Often these side effects come right away, but they generally dissipate within days…
My son is 16 he is recently started taking the strattera along with Celexa and Amitriptlyene at night, are the drugs okay to take in combination? He takes 20mg of Celexa, an 80mg of Strattera in the morning and 25mg of the amitriptylene at night?
Laurie – best to check with the doctor or pharmacist. It’s my impression that there are no concerns here…
My 12 year old has been on Strattera for 3 years now, we tried Concerta and adderall before that. Strattera has been great for him, until now, we are at puberty and as I read above my son is not the only one going threw the anger issues. I worry about it, as it is not only at home but at school. We tried uping his dose, but that just made him cry all the time, and we did not want that for him. We are going to talk to his doctor about a different med. As for his sleep we use Melatonin to help him sleep as he was DX with Autism at age 4 and at age 8 with ADHD. At age 4 he would only sleep a few hours and with school coming up we had to get him to sleep better. I just need advice and info from others, about if they have tried other meds for ADHD after there child hit puberty? Maybe there is something out there that will help my son make it through all these ups and downs and oh the anger. Thank you
This is not a sarcastic answer and is not meant to be offensive in any way.Have you tried taking him off all the medication completely? Maybe trying anger management or some other form of natural remedy might just be the answer. I have found that medications can cause a lot of side effects that are worse than the underlying issue. It is hard enough for children to go through puberty without there being drugs to alter his mind. But obviously you know your own son better than I do. Please just think about this and pray about the right solution, whatever that may be. I will be praying for your son.
Had my boy on strattera and it did not work for him(turning12) he was more impulsive, then they added Metadate er and then tried metadate cd with the strattera, which made him almost uncontollable. Had fits, tantrums, angry at me, accusing me of doing things I did not do, finally got the doctor to listen to me and take him off of all. Had to leave him on the strattera for a little bit, but now he is off completely. We have him on 15 mg. of Adderal, which seems to be working. My guy has ADHD. He also takes melatonin at night sometimes to help him sleep.
We have had our son on Vyvanse for two months with great results except the difficulty sleeping and some mood swings as the meds leave his system.
Our doc prescribed 10mg of strattera to piggyback but two days after his first dose his teacher noticed he was very withdrawn, is this a common side effect? He’s had it for five days but we’ve stopped it as i don’t like that.
I just started strattera a couple weeks ago, and I also noticed that it was making me rather lethargic. My doctor suggested I take it in the evening instead of in the morning, and this seems to be working well. I have been on several stimulant ADD meds, but not recently as my psychiatrist would not prescribe me anything because he was afraid it would have a negative effect on my bipolar disorder. I actually find that when I am on ADD meds my mood improves because I am accomplishing things, and I love getting things done. I think strattera is going to work well — thank you for this post!
We had to discontinue the Stratter as per the doctor’s orders. He said that our son’s behaviour is definitely tied to the drug and it’s side effects.
We will keep giving him the Vyvanse and hope that once the Strattera is completely out of his system we’ll have our better behaved child again.
It’s scary seeing what drugs can do to a person in such short time.
Sometimes using Melatonin helps them sleep at night or a small dose of benadryl. We were using Melatonin but it wasn’t working so our Dr. said to try benadryl.
We also used the Strattera in the evening when he was taking it because they said it could make them tired.
No longer on Strattera now.
Studies show mirtazapine 15 mg, given at night has a synergistic effect with strattera. Mirtazapine is one of the most effective drugs, with least side effects, for many people. Ask your doctor about this combo.
My 6yr old son has been on strattera for about a month. I just noticed this dry patch on his scalp. Is this a side effect. He is also on Tenex 1mg.
My 8 year old son B has been on Straterra 18 mg for 6 months and also has a dry patch on his scalp. Ive treated it with T-gel (and it helps) but it always returns within a week or so. My son spends hours a day scratching at his head for the last week or so and is causing it to bleed. The straterra doesnt seem to be working anymore ( Dr. upped his dose from 10 mg to 18 mg one month ago)…its almost as if the medicine is causing him to be less able to focus or pay attention than he did before being diagnosed with ADD. Im very concerned and Im scared of the side effects. He is really struggling in school, football, and making friends.
Just the othr night I told him that he had played his video game long enough and he went into a an emotional upset that scared me to death…took me over an hour to calm him, he stated that noone likes him and couldnt get his breathing under control. i had to hold a paper bag to his mouth to calm his breathing and rock him in bed for an hour until he fell asleep. He has NEVER behaved like this before….does anyone think its the medicine causing reverse effects??? Im soooo worried, I cant sleep at night….
Was wondering if you have left your child on the strattera or taken him off. We took our child off of it due to some of the same symtoms. Took me a while to get them to take him off, had to take hime to a psychiatrist to get it done. We went through a childrens services to get it done. He is now taking Adderall xr 15 mg. Seems to work better. He is calmer during the day and can concentrate on his school work. His teacher was amazed this year with the difference after putting him back on. We took him off for part of the summer and tried to start school without it but he could not stay on task. Best wishes to you.
Is Strattera better for the Non-hyper types? My son (8yrs) seems to have anxiety ever since he was a baby. He was diagnosed with ADD this year and began adderall but after 5 mths he became angry and sad(moody). Doc took him off mainly because of lack of appetite. Now he began Focalin (only one week now) but he seems more withdrawn and almost a flat effect. He is not impulsive(or hyper) but needs meds to keep his attention focused.
I would think Strattera may be good for him due to his anxiety/depression symptoms OR it could go the other way and likely make him more withdrawn? Need your professional opinion…
“ADD Low energy” – Strattera can be helpful for ADHD + anxiety. It can help people who are withdrawn, or it could make them more withdrawn. There is no way to know or predict without trying it.
Dr. Handleman,
My son is 7 1/2 years old (ADHD) and is taking Strattera (18 mg dose)… previously he had run through the regiment of stimulant based drugs with bad side affects, (staying up very late, accompanied by severe mood swings). The Strattera at this dosage seems to be working for him in the class room, but a couple of weeks back, he we saw that he was getting extremely tired, to the point where he would go up to bed after school and stay sleeping to the next morning, this is also accompanied by curtailing his appetite….Based on our Doctor’s recommendation, we had cut him back to the 10 mg. dose. (his appetite, mood and sleeping patterns benefitted) but, it was not enough to help in the classroom….Now we have him back on the 18 mg. dose (taken in the morning seems to have the best affect for him in the classroom) and we are noticing the same thing with regard to him being extremely tired……We had thought about averaging the 18 mg. dose and 10 mg. dose on alternate days (not sure if this would work or is a good idea)….We would appreciate your thoughts or any assistance you could provide…
Thanks
Phil B.
Phil,
A hard situation. A couple of thoughts:
1) consider splitting the dose – so maybe if he took 10 mg AM and 10 mg night time – he may get the same concentration benefit and not be so tired during the day
2) consider strattera 10 mg with a small dose of a stimulant – maybe low dose stimulant will just boost the concentration somewhat, yet not cause as many side effects he got with full therapeutic doses.
Of course – you’ll have to talk to your doctor about these options…
Best of luck.
What are the differences and similarities between Strattera and Bupropion (clinically as well as pharmacologically) in the treatment for ADD??
Hi Dr Handelman. I am new to your site and would like some information regarding ADD. We have a 14 y.o. son recently diagnosed with mild to moderate ADD (no hyperactivity). We have tried various non prescription meds to help with focus issues as well as initiation issues. We have also explored neuro feedback (use of BAUD therapy)_ We are hoping to find treatment without use of stimulants if possible. Do you have any recommendations as to non presciption therapeutic modalities?? If prescription meds are needed, what would you recommend for focus and initiation issues that would have the least side effects?? We did try Vyvanse for a short period but noticed suppression of appetite and worsening of insomnia. Do you have a recommendation for “go to meds” to treat the various presentations of ADD?
I have also researched about the nonstimulating meds for ADD. What are your recommendations for these and what side-effects do they have.? Finally, what is your opinion on the use of Bupropion for ADD in this case?
Thank you for for your extremely informative website.
Sydney – you are asking very specific (and excellent) questions.
The reality is that your questions go far beyond the scope of me answering on a blog post.
A couple of quick thoughts – although stimulants work well – strattera is a good option too- and is a non-stimulant.
Buproprion can help – though it likely has less of an effect than starttera – and certainly less of an effect than the stimulants. Additionally – there is virtually no data about its use in teens.
Although this will sound quite ‘self promotional’ – there are ways that I can provide more information, or help. You can look at my membership site (You can learn about it here http://attentiondifferencedisorder.com/members/join-insiders/, or here http://attentiondifferencedisorder.com/members/add-insiders-coaching/ – we have coaching sessions tomorrow night, and a Q and A Call with me on Thursday), or get a copy of my book which is available for pre-order on amazon here: Attention Difference Disorder: How to Turn Your ADHD Child or Teen’s Differences into Strengths in 7 Simple Steps
Thank you Dr. This really helped me. I just got prescribed Strattera today and was afraid to take it, never taken anything for my ADD. So i am glad to see it can be for both.
I am a 34 year old Nursing student. I was diagnosed as a child with ADHD and was on ritalin for many years. When i got to eighth grade i told my mom that i wanted to be off of it because of how it made me feel all the time, and though my grades droped tremendously when i got off of it i felt a lot better. I have not used meds since. I learned to cope in my classes until i started clinicals last year. Ive struggled with my ability to sit still and concentrate with out becoming anxious and irritable in the long classes causing me to miss out on the information in class so i went to see a doctor. Ive been on Strattera for 8 weeks now and im quitting it tonight. I have began having heightened anxiety every evening followed by feelings of hopelessness and depression which i have never felt. I have had a few nights where its gotten so bad that ive cried uncontrollably. I also get intense headaches and have been had freezing hands and feet to where i have to run a hot bath a few times a night just to warm them up. It has not really helped my concentration at all. I agreed to try strattera because i did not want to be on a stimulant and im to the point where i feel no medications will help me and im just going to have to cope with whatever disorder i have.
My daughter has been taking sertraline for anxiety and it has worked wonders, she has NO side effects, I would certainly address the anxiety issue it affects your life so much it can be debilitating.
Dr. Kenny,
My son is 8 and we are on day 14 of the Strattera sample pack. Its the 40 mg dosage. His teacher and I have noticed an increase in his sensativity. He cries about everything from not having enough mayo on his sandwich to having to ride in the back seat of the car. I can’t find anything to tell me if this is a side effect and if continuing the medication will change this reaction.
Jordan, this can be a side effect (i.e. increased moodiness). Talk to the prescribing doctor about what to do about it.
Started 40 mg of Straterra today and it started working immediately. I did get tired and had some hot flashes for about an hour but now I am clear headed. I have had ADHD all my life and had not medicated it. I have also been diagnosed with anxiety disorder. This seems to be what I needed and I will see how it works in the long run.
strattera caused horrable side effects for me i lost bladder control and i was extremely exhausted. it was a nightmare. this was on 25mg once a day. i would rather have the adhd than pee myself it is way too embaressing. i stopped the strattera and the incontanice and extreme fatuige stopped. my doctor told me there is no way this medication would cause this. but i have read other threads where poeple had the same problem.
I was just taken off Strattera mostly due to the reasons above – TIRED to the max. I’d fall asleep at my desk at work.
Started out at 40mg for a week, then went to 80mg for 3 weeks, felt like I was high on cold medications all the time, weird feeling in my head, and napped at the drop of a hat. I have tiredness issues from time to time anyway, but the Strattera amplified that 100 times over. I literally had terrible issues during the day, slept like a baby at night. The kicker – it did nothing I could tell of for my ADHD (extreme case….)
Other issues – “sex felt weird”. Things worked, but it just wasn’t right. Bladder – control was ok, but had to go more frequently and felt funny when going.
My doctor refuses to even try other meds because as he says it “you are in your 5th decade of life” and he’s afraid of heart issues. My heart is strong, blood pressure is ALWAYS perfect if not on the low end and my heart usually just idles even when stressed.
So now I’m off meds – and not given ANY options. I’m sick of living this way, and it’s dangerous (accident prone, sometimes serious) and I get into trouble at work…….. on my 7th job in 30 years.
PS – I have meniere’s – under control, but the Strattera made is a lot worse. I got dizzy just moving in my chair or turning my head. That’s gone now that I’m off Strattera….
BillD
As long as your blood pressure and heart are good, you should be OK. The reality is that strattera also raises heart rate and blood pressure!
I was just diagnosed with ADD (no hyperactivity) and my doctor is prescribing me Staterra. I am concerned because i had a heart murmur as a child and I also have asthma. When I read the cautions it said not to take if you have EVER had an irregular heartbeat and it also said it can cause breathing problems. Is it ok for me to take this? Also, my asthma makes me so tired a lot of the time, I cant afford to have less energy! This will be the 1st medication I have taken for ADD, is this the right one for me?
I just started taking Strattera 40 mg. My first dose was yesterday. I had the most awful reaction to it. I became very sweaty, dizzy and nauseous. This finally calmed down after about an hour, however, and then I still could feel the effects of the medication but it wasn’t as serious. I did become very sleepy, however. My questions are whether or not 40 mg is a good dose to start at, will I my body eventually get used to it and not have those initial reactions, and would it be more beneficial to me to maybe take it in the evenings so that I won’t be as tired and have to deal with the initial reactions during the daytime while at work.
Kelly, generally, 40 mg is the right starting dose for an adult.
For many people, the side effects you talk about will get better in a few days…
Also, switching to the evening may help.
Best to talk to your doctor about the options.
I have been taking Straterra for 2 weeks. My first week was 40mg each night and the next was 80mg each night and my doctor thinks I might need to go up to 120mg but we’ll see. I haven’t seen him yet since I began taking this medication. I am very sensitive to medicine. I take several anti-depressants and one anxiety medication. I take them all at night. My doctor gave me Strattera because I can take it at night with the rest of my meds. I could never remember to take my ritalin. Initial side effects were dizziness especially upon standing and no appetite. At this point, there are pros and cons. Pros for me is an increase in attention, getting things done, and less impulsiveness. Cons include a severe bad taste in the mouth. Along with extreme dry mouth so bad I can’t talk. I have lots of mints with me always. Some foods don’t taste the same because this taste is very nasty. Standing up too fast or standing up from a crouched position will make me very dizzy and the world spins. I have asthma and have noticed no difference in my breathing. I like the way this medicine helps me concentrate. I’m a mom and with two boys, there is always much to do and this helps me very much! If only the bad taste would go away, there would be just the dizziness. I am 37 yrs old. I am also very anemic (not caused by Strattera). Just adding that in case someone is similar to me. Hope this helps some.
Thank God for finding your blog! My 8 year old son has taken Focalin, which worked well but had a HORRIBLE ‘let down’ period as the medication wore off….inconsolable crying for an hour. We then switched to Intuniv, increasing dosage up to 3 mg…which did not work very well and made him so sleepy that any benefit was counter productive. Now, the doctor has given me the choice between Straterra and Ritalin. I’m leaning toward Straterra because it is a non-stimulant and my son also has asthma and a heart defect. However, I’m concerned about the side effect some have with suicidal thoughts and depression.
What are your thoughts, Dr. Kenny?
Mom – strattera is probably a good option. The risk of suicidal thoughts is 4 per thousand – i.e. quite low. With effective monitoring, it shouldn’t really be a concern. Talk to your doctor about it.
That surprises me how Doctors can be so different, if your son has a heart defect and is giving you the option of ritalin. My 7 yr old has no heart defect, but a “variant to normal” result for his EKG, and nothing wrong with that take home EKG thing (dont remember technical terms sorry) But his doctor is not offering Ritalin or any other stimulant as an option at all. He was on Guafacine but it made him so lethargic today she prescribed Straterra.
I’m 18 years old (inattentive variant) have been on Strattera for about a month now and recently started taking 50 mg. At first, it made me extremely lethargic and I would often fall asleep (if I didn’t have to go out all the time) at 6 PM if I could. Also, I lost all my appetite and often would not eat if my mother doesn’t force me to. These side effects went away, however I still have chronic bad mood. When the side effects were really bad, I had suicidal impulses.
At 40 mg the effects started to kick in and I no longer hyperfocus on anything. Whereas before, something would have 100% of my focus, or close to 0%, now everything has about 30%. The nagging little thoughts that keep destroying my focus on a mundane task went away and I’m able to complete many small chores that I just couldnt before. I can block out background noise now and more tolerant of small talk. However, people have told me I look pale all the time and I feel chronically weak and sore. I’m just in a terrible physical state and can’t even find the energy to exercise. I lost interest in my hobbies and can spend a day hardly doing anything at all (or playing pointless games). I just seem “slowed down” when I’m a “low energy” person to begin with, with slight hypotension. I lost about 3 pounds.
I don’t think strattera is right for me. Should I try something else, like a stimulant?
My 7 yr old son is about to start on Straterra and reading the above posts scares me even more. The general concencous seems to be that it doesnt work and causes more problems then it solves.
I am also a bit sceptical as to why the Dr.Kenny is very selective in which posts he replies to. He doesnt seem to respond to all the negative posts which makes me think that is there an agenda?
Dubai Red – I respond when I have time too…
My son was about 7 when he started Strattera. I have a step-son who used Ritalin and had serious problems when he reached puberty with it. When my youngest was diagnosed I asked if there was something other than stimulants to use and he started Strattera. It has worked well for him. There is a definite difference when he hasn’t taken it that even he can see. It’s only side-effect that continued after the first few weeks has been that if he doesn’t eat before he takes his med he gets a bad stomach ache. He has still had problems, but in comparing my son and my step-son’s use of the differing meds Strattera has done much more for my son than I ever expected. I definitely think that everyone reacts to differing medications in differing ways, but I’m recommending that my 10 year old grandson with ADD try strattera. How has it been working for your son?
I am glad I found this blog. I have been taking Bupropion XR 300mg QD in the morning for depression. I’ve been taking it almost a year, it was great at first, I was on top of the world cleaning my whole house and acting like the energizer bunny. That eventually wore off but I still take it. Without it I can feel the difference and get nothing done. I take it around 7:30am, work from 8-5pm in an office job. By 3-4pm I am yawning and by the time I get home at 6pm I want to fall flat on my face in the bed. I went to my doctor today and told her I have a lot of brain fog. I can’t concentrate, my work is piling up because I’m doing everything except work and I can’t get online at home to finish school. I have to beat myself up to sit down and do it. She prescribed Straterra to me and said I should try it, that it would help me focus more. I’m reading everywhere that Buporpion and Straterra are not a good match, bad side effects, that they do the same things, etc… I’m scared to start it.
I have not been officially diagnosed with ADD and I am far from being hyper. I have been on Bupropion XR (Wellbutrin) 300mg/day QAM for about almost a year now. I went to the doctor yesterday and she prescribed Straterra because I told her I have been getting a lot of brain fog, I have a hard time focusing on my work and my school and it’s getting to the point where I’ve dropped my class and my work is piling up. I can’t figure out if it’s the fact that I’ve been doing the same thing at my job for 13 years and I’m getting bored or if it’s just me. She gave me a trial starter dose pack that starts out with 5 tabs of 25mg and works it up to 80mg. Everything I am reading online has not been good results from a combination of Wellbutrin and Stretarra. Can you please tell me how exactly both of the medications work?
i just started taking straterra, and have had the strangest side effect, of getting hot flashes and then i get cold sweats, is this normal? I am also taking zoloft, and buspar.
i started taking strattera when i was 16 and noticed my sex drive drastically descreased and i could no longer achieve a full erection. this was a problem for me so i stopped taking it. however, the good effects strattera had on me were more than great. i have started taking strattera again and im curious to know if i’ll have the same problem with my sex drive? as it is important to me. if i will be having the same problem, could i take viagra? i don’t want to stop taking straterra this time.
im 18 now.
Kalen – that is a problem with Strattera. I don’t know if viagra could help with that. You’ll have to talk to your doctor, or look for other adhd treatments (like concerta, vyvanse, etc.)
I am 40 years old and was misdiagnosed with depression and then later with bipolar. I stopped all meds and started Strattera on Jan 24, 2011. Shortly after starting I woke one morning to a quiet mind. No racing thoughts, no fidgeting. I felt like I went from the busiest day at a carnival (yelling, music, conversations) to just me, alone, by myself. It has been an amazing transformation. I suffered years with addictions, unable to keep a job or do well in college and of course the side effects of prescription drugs. I was considered a bad teenager, unresponsible adult. Now I am a totally different person. This drug has been life changing for me.
I have a 14 year old son who’s been taking Strattera for about 7 years. It hasn’t been the magic pill, but it has helped tremendously! He’s always had some severe anxiety/phobia’s that began with seperation anxiety so severe he was unable to sleep on his own until he was about 10. It seriously effects his life, he can’t get dental work done, can’t get his vaccinations – even though he has tried time and time again (without being pressured). He has hit puberty and while the strattera definitely still works we have some pretty serious issued that always seems to come back to his anxieties. His counselor has suggested medication for anxiety/depression and I wondered if you can tell me if there’s a medication that works well with Strattera. Thanks so much for being a safe place to come for the information we need!
my daughter has been taking sertraline for anxiety disorder and it has had an incredible effect. SHe had anxiety for bugs and seperation anxiety and also selective mutism, she found it difficult to speak with teachers and friends she didnt know. The effects in just one week were incredible, she has been taking it for 9 months now with NO side effects. It has changed her life. She also had night terrors and woke most nights. She now sleeps through the night.
Thats a great story- I think its what Im looking for here!! Its great to hear of something that worked perfectly and made such a big difference for your kid:)
Personally, for a medication that decreases anxiety I would choose Wellbutrin. At moderate doses it does quite well, although it may make you jumpy. Its an actual anti-depressant, and it worked quite well for me for a very long time. The only drawback is that if you are an epileptic or go over the recommended dose(Like my doctor prescribed to me) you have the possibility of having a seizure. But when I was on it, it really helped my depression. At higher doses it had even more positive effects, but this is my personal experience, and everyone reacts to these drugs differently. This is not professional advice though too, just a drug I was prescribed in the past.
Hi, I have a few questions that I hope you can answer. My son who is 17, has just recently started taking Strattera 10mg going up to 60 mg by the time 4 weeks have past along with 50 mg of Adderall. I wanted to know if this is a normal thing to do? I think the iintension is for the doctor to wean him off the adderall. My son says the adderall it doesn’t completely hold him through school so this is why the doctor is adding the Strattera. He has asthma and uses the albuterol inhaler medicine only on occasion usually when he has an intense wrestling match. Will this be a problem? Also he already has some sleep and anger issues while using the adderall, do you think this will continue with the added medicine or od you think it will help? Thanks
Dear Dr. Kenny,
I’m having a problem with strattera that is quite different than the ones I am finding in these blog posts. I am low energy ADD, and I’ve had great reactions to strattera in general: more motivation, less depression, more socially active, being able to organize things and focus, and even being more energetic and things of the such. The problem is now, while on a 60mg dose for about 1-2 months, I feel that I have built up a tolerance for it. Its always felt quite effective, and just recently it has been feeling like this. I am an adolescent, but I haven’t gained weight significantly. The only bad reaction I can think of having from it was my episodic memory being slightly worse. Does this mean I have built up a tolerance to strattera? Is that even possible? I have dealt with many different medications before too, Bupropion, Concerta, Amphetimines, and Ritalin. And with Bupropion(Another slow building anti-depressant/ADD medication) I never built up a tolerance effect, even after months of usage. Is it possible for someone to actually have a tolerance effect with this medication? And does your recall/encode of episodic memory happen to be slightly worse while taking the drug? Any information is appreciated.
My 10 year old ADHD daughter started Strattera last month after having tried Ritalin, Amphetamine and Dextroamphetamine, none of which worked well on the ADHD symptoms, and all of which had unacceptable side effects of insomnia and appetite suppression. The Strattera made a huge difference in the ADHD symptoms, and had the additional benefit of regulating her mood to a nice steady general calmness and happiness (not mania). After about 4 weeks of being on the full dose (for her) of 10 mg. in the morning and 10 mg at night, I noticed that for about a week she had been having itchy skin on her cheeks, ears, arms and legs (I thought it was poison ivy, which is fairly common for her in the summer time, but no poison ivy rash was present). No other symptoms, no rash, no jaundice. The doctor took her off the Strattera and we are awaiting results of a blood test to check liver function. I would love to be able to have her go back on the Strattera – she’s been off for a week and is so unhappy and her focus is shot. Has anyone else had this side-effect? I’m wondering if it’s from something else – it’s been a week off the Strattera and she’s still itchy. I think she felt “normal” for the first time in her life – she’s actually begging to go back on it. It’s heartbreaking!
Just an update on my daughter. The itching was determined to be from something else, probably a plant sensitivity, as I kept her from going on the long walks to the lake to go fishing and after 2 weeks, the itching stopped completely. The lab tests also came back with no liver impairment. When we put her back on the Strattera and the itching did not return, I realized it was most likely something she was coming in contact with during these weekly fishing outings with her dad and brother. Thankfully, she is doing great! She is on a single 25 mg capsule and it has been wonderful. She is so happy, feels normal, is doing great in school. She says it makes her “not feel day-dreamy all the time like before”. Though she still needs some reminding on routine things like teeth brushing and putting things where they belong, she tackles all her homework with a great attitude and stays with it until it’s finished. Strattera has worked wonders for her.
My 7 yo grandson took his first strattera today for ADHD. He seemed to already be more calm, more attentive and less impulsive. Is that possible, could it be working this soon?
My son has recently been diagnosed with ADHD and he has been on strattera for about a week now. He seems to be tolerating it ok but he does complain that his head feels funny about half hour after he takes it. He says the feeling gets better as the day goes on. I am noticing a decrease in appetite which for him is a good thing because he has really packed on the pounds this past summer. I was told once his system gets used to the medication he won’t notice this feeling in his head anymore. Is that true or should I be concerned? We just increased his dosage from 25 ml to 50 ml today. Dr. is waiting to see how well he tolerates it to increase him to 60 ml which is the actual dosage he will need to be based on his weight.
24 hours!?!? that sounds amazing! i was just thinking about getting a depression pill for the afternoon to see if that’d help my focus so that i can do home work. i already take two adderall a day, anymore and it’ll effect my heart, but i need more to focus. this pills sounds perfect! i have anxiety, depression, and innatentive adhd. when im off the adderall i’m depressed, anxious, i cant do creative things (im the artsy type), and im easily aggitated.
Dear Dr. Kenny,
I find it absolutely appalling that there is absolutely zero discussion here nor on the official Strattera website, even in the FDA approved “Medication Guide” designed for parents’ education, of the pink elephant in the middle of the room when it comes to teenage men and SNRI an SSRI Class drugs.
What am I talking about?
Anorgasmia.
If you’re an adult and still don’t know what it is, it’s time to grow up. As a family practitioner, I assure you one of the worst, and sadly often bashful complaints man on antidepressants have is difficulty or even impossibility with attaining an orgasm.
Who here in this day and age still doesn’t believe masturbation is a major preoccupation for all teens once they discover their new-found ability? If grown men complain (some need urging) how much grief this causes them, imagine the problem famously tight-lipped and secretive teenagers suffer with silently.
I’m convinced that this problem alone accounts for much of the elevated suicide stats for teens on antidepressants. But, who will finally bring this out in the open? We still have a prudish society.
Personal to you, doctor,
After reading my comment bak, I realize you will want to edit it as it came off as a public accusation of you personally. I regret that, but I hope you as a doctor with concern for parents’ and youths’ frustrations alike will take this bull by the horns and end some of the head-scratching by mother who are often completely naive about this issue, especially since SSRI/SNRI induced anorgasmia doesn’t commonly occur among females, so it’s often the last thing they’d think of in speaking with a struggling teen. My wrath is really directed at the FDA and Big Pharma
I’m 58, and I have been taking Strattera (80mg/day) for around 6 years for adult ADD. It’s been very helpful. I have two concerns:
Ongoing and just about since I started using it, I’ve had an itchy or scalp, sometimes itchy skin too. I notice from your article this could be a sign of liver trouble, but tests I had a few years ago showed none. Second, I feel I still have issues with hyperfocus and forgetting to pay attention (to where I put my keys, etc). Would I benefit from taking one of the stimulant medications in addition to strattera? I also take prozac for depression due to complications of undiagnosed ADD, for at least 10 years.
Bets – a couple of thoughts:
1) if you have itchy skin from liver problems, you would be jaundiced, quite sick, and have many more symptoms. It may be a medication side effect, but it’s unlikely to be caused by the liver.
2) If you are having trouble with day to day focus issues – see if you can develop some strategies to help with the symptoms. If those don’t work, yes, adding a stimulant to strattera can help too.
Best,
Dr. Kenny
p.s. our Insiders membership site has very affordable group coaching – you can learn more here: attentiondifferencedisorder.com/members/join-insiders
Hi Dr Handelman,
First thanks for hosting this site. I am a 39 year old male and have been taking 25mg of adderall xr daily for 10 months with positive results. This is the only medication I have ever taken and am leery of taking medications in general. The last few months the positive results seem to be diminishing with focus/impulse control, so my Dr has suggested that I take 40mg of Strattera in addition to the 25mg of adderall. The Dr’s rational is that adderall helps with certain area’s of the brain and Strattera works on other areas. Question; is this a good approach? I am a bit uncertain of adding another medication daily and wonder if a single adhd medication is available / recommended? Also, should my adderall dose be lowered?
Thanks for your time and help.
Ian – that is a reasonable approach. Some doctors may try to raise the Adderall dose first to get a one medication treatment – though 25 mg is near the recommended max. Good luck.
My 6 year old son has been on 25 mg stattera for 8 months, which has been working wonderful. He was intially on retalin and it was horrible. He is Adhd – impulsitivity. He is now in 1st grade, he is beginning to show signs of being aggressive again. He is growing, and I am wondering if we need to increase his dosage. thanks!
KK – the dosage is done based on weight. Take his weight in kg (take pounds and divide by 2.2). Once you have the weight in kg, then take the dose he is taking – i.e. 25 mg, and divide it by his weight. If his weight is 30 kg – then it would be 25 mg/30 kg = 0.833 mg/kg/day. The target dose is 1.0-1.2 mg/kg/day. So, if your son has gained enough weight that he is not in that range, talk to the doctor about raising the dose.
I’m 30 and a month ago was prescribed Straterra. I am also on Lexapro 20mg, but my PCP said to cut the Lexapro in half. I was prescribed Straterra to help me focus. So far, so good. It’s taken years for me to find a concoction that has benefited me. I am confident this go round, these two medications will help me. Any feedback is appreciated.
Does this work for ADD as well? I don’t like the feeling of being tired. But am wondering if it would help with anxiety as well.
To all of you. I hope this helps you I have a son that was extreme ADHD. and they had him on a very High dose of Ritalin over 50mg even at a very young age and not over weight, which was the drug used at the time . It took quite a few years to work on getting him help as it was not a greatly known condition at the time. There are real side effects to all drugs you give your children so be very careful and think twice before giving them drugs specially more then one at a time. Doctors are quick to say someone is ADD or ADHD but be real sure please. One of the conditions of ADHD is Sleeping problems and bed wetting this is not due to the meds so giving them more meds for that is heeping more problems for you. The more you work with your own child the happier you both will be not just more meds. Liver problems, stunting growth, and may more. Teachers have no idea how to deal with your child it’s up to you and you can do it. I finely removed my son off all meds over time, do not do it all of a sudden all at one time. He is older now and doing well but it took allot of deteramnation and work on my part and his part as well. My son does have stomach problems now that he is older so watch out. If you would like ideas on how to help him keep busy etc.. please respond back and I will give you idea’s to help you out.