stratera & Dexedrine/Addreall combination (ADHD & Depression)

[morphosis]

Hello,

My questions are strictly for those that take ADHD medication on a regular basis, not those that take it for recreational use.

I'm ADHD-PI, and have been on Dexedrine, and at one point Vyvanse, for many years, on and off. Dexedrine is generally helpful but sometimes the side-effects (specifically stimulant induced depression) can bother me so much that it barely seems worth it. However, I've gone months without Dexedrine and I don't do nearly as well in most aspects of my life.

So, I'm considering switching to Stratera, but I'm skeptical that it will work, and I'm wondering if any of you use it, and, if you do, are allowed to take Dexedrine/Adderall as a PRN?

I think I'm going to make the switch, to at least try it, in a few months, but I'm wondering if any of your Doctor's allow you to rely primarily on stratera but have a Dexedrine/Adderall prescription to be used as a PRN?

I should also note that I suffer from severe chronic depression (with or without the ADHD medications) and thus I also take an SSRI.

This may be a shot in the dark, but can anyone comment on this?

[rugoingplaces]

@morphosis You will have to try it. My doctor has seen strattera work for some. For me it was a horrible experience. Not an exaggeration. If you find that it does the same for you the effect will wear of in a day or two. Its a very person specific drug.

[Dr-Feel-Good]

This is a multifaceted question. Most doctors do not have the slightest idea of how these psychoactive chemicals affect your brain and the rest of your body. Doctors "PRACTICE" medicine, therefore they are always learning what works with their patients and what does not. Even if finding out that a combination on medications seems to alleviate your symptoms of ADHD or chronic depression, they have no idea what the long term effects are because not even the pharmaceutical companies that developed the drugs do. Now we do know that certain SSRI effects the way ADHD medications work because they both use the same pathway for breaking down the active metabolite in your system. This being said, the less medications you can mix the better off you will be. Strattera was originally designed as an antidepressant but did not pass FDA testing so they gave it a new name and put it in a new box and said it was for ADHD...ring any warning signs in your mind? It sounds like your body might be going through something called adrenal fatigue and there are many natural supplements that can cure this. I said cure, not treat. First of all you need more magnesium in your system if you are having issues with anxiety. These next two natural herbs will help your body up-regulate or down-regulate the neurotransmitters in your mind to help you get back to a state of happiness. Do a little research on Google about them. Ashwagandha root and Gotu kola

[GoingBananas]

Boy, I think if you go by the research you will find this is the mOST poorly rated med for ADHD but they sell some because they need something not a stimulant.

[slick76]

Strattera sucks big time!! Took it for a while when I was scared to use stimulants to treat my ADD-PI. It made me tired, dizzy and sweaty. Screw that shi& Get some Wellbutrin XL and get off the SSRI. Get some Adderall or go back to Dexedrine ER. The tablets are out of stock nationwide due to shortage of supply.

[loveoften]

I have to add that Strattera was the worst drug for ADHD I have ever tried. I take Adderall as prescribed for many years. I also take Wellbutrin XR that helps the Adderall. Best combination I have ever been on. Dexedrine is okay for me but I swear by the Wellbutrin/ Adderall combination.
Take care.
K.

[lllvibelll]

I have to add that Strattera was the worst drug for ADHD I have ever tried. I take Adderall as prescribed for many years. I also take Wellbutrin XR that helps the Adderall. Best combination I have ever been on. Dexedrine is okay for me but I swear by the Wellbutrin/ Adderall combination.
Take care.
K.

Just curious about your experience. What does the combination of adderall and wellbutrin provide for you over just adderall by itself?

[Buchanan35]

I am prescribed Adderall instant release 20mgs x 3.5 a day, and have been taking it for over ten years now. It works well for me. Although, I am also prescribed Xanax 1mg, 3 x per day, and that combination is perfect. There was a point where I kept asking my psych. for more and more adderall, when he eventually told me that I should never take more than four 20mgs a day, and that if I felt I needed something else that he would prescribe me stratera to supplement the adderall. I had only heard terrible things about Stratera, so I said no I didn't think I needed it..got out of there and never asked for more adderrall again (didn't want to take a chance losing it). I am also on subutex 8mg, 2x a day. Now, this combination is absolutely the best combination I could ever ask for. I feel incredible. The subutex was prescribed b/c I was abusing oxycodone and finally came clean to my doc, out of fear that he was going to take me off my other meds, but he didn't. So, to answer your question..yes doctor's will prescribe both together. However, I have never heard of anyone who thinks Statera works, and my doctor is apparently a little on the liberal side when it comes to writing scripts, b/c everything else you read say that subutex shouldn't be taken with adderall, and adderrall shouldn't be taken with Xanax, but that is what works for me. I'm just glad that my doctor apparently understands how the drugs work, and is not one of those docs that just will not prescribe the shit that actually works b/c it's addictive. I don't care if its addictive, (just as long as I always have a Rx), I just care that it works!

[StrikeMe]

I am on Strattera and this week i upped the dose to 60mg (18mg -> 40mg -> 60mg from this day). I will give it a month or so to see how it helps my ADD until i can find Adderall or Ritalin, which i think will help me more.

Some people take stimulants and Strattera together. I havent't tried that combination but i think these two can augment each other.

Lately i've been reading a lot on how to deal with amphetamine tolerance. It seems that to prevent it, one should find a way to antagonize NMDA receptors, which can be done by drugs like DXM, Memantine and so forth. So i was reading through studies on Strattera and came across this one: Atomoxetine acts as an NMDA receptor blocker in clinically relevant concentrations.

Does it mean that taking Strattera and any of the amphetamine-baed ADHD drugs will prevent one from developing tolerance to the latter drug? Does anyone has any experience with this kind of combination?

[etinin]

Well, it really depends. NMDA receptors aren't really well understood. It may be that it requires some specific type o antagonism to achieve that. NMDA receptors aren't all alike. DXM and memantine are both NMDA antagonists but their effects are very different. The former is a powerful hallucinogen and the second has very different effects. Memantine has a much higher specifity for the receptor subtype we'd be looking for. To exemplify this, I mention the fact that to get any significant tolerance-reducing effects with DXM you gotta be tripping balls with it and it's still not as effective as memantine.

There's also an old antibiotic called D-cycloserine, which antagonizes NMDA receptors and has been used succesfully to cure anxiety when administered prior to exposure to anxiety-inducing situations.

Fact is that it may work or not. Only way to find out would be if it were specifically researched for this purpose.

[StrikeMe]

Etinin,

I will go for memantine then. There are some studies indicating that it may be helpful for ADHD when taken alone and a lot of reports on it being helpful with memory and cognition (when titrated properly), which would be very nice in my case since my main goal is to get rid of the ADHD symptoms and be more motivated/productive.

Still might attack it from the different angles, by supplementing with Magnesium and _maybe_ DXM, if Memantine won't do its trick.

We know that those help with Adderall and the like, but what about methylphenyldiate (Ritalin)? Seems not so effective?

[morphosis]

I talked to my doc about all the options and I'm going to at least give Strattera a test run to see how it goes. I study depression, and tend to tabble into the adhd literature as well, and there's some good research suggesting that Strattera is especially helpful for those with ADHD, depression and/or anxiety comorbidity. Like many of you have stated, it varies from person to person and there's very little way to predict how we'll respond to each. I figured, though, that since dexedrine makes me more prone to stress and depression, Strattera is worth a shot. Thanks for your responses.

[BlackWater]

I'm with @Buchanan35 on this one. "I have never heard of anyone who thinks Statera works". I have family and friends who have tried Strattera for ADHD/depression - worthless would be an understatement. From my experience, Strattera does not fall into the category of "it woks for some and for others it doesn't". It just plain out doesn't work.

[GoingBananas]

I just had an appointment with what a thought was a Dr but turned out to be a PA (Physician's Asst) that actually studied ADHD at Duke University on ADHD in Adults and there are not many! (Drs that have done this that I had seen so I was excited!)

My family Dr, Psychiatrist and one other Psychiatrist ( Yes I like to be sure) all said I had it.

Anyway, What was interesting is that he said very often males would be kicked out of the study group because they suffered more from a mood disorder that caused the lack of attention and other like symptoms and not ADD.

Well, since I had been on 30 or 40 ( little exaggeration) mood related medications and had been borderline suicidal for decades and at times had not come out of my room sometimes in months and was on Prozac I agreed I had some metal issues!

However, none of the meds ever made any difference and if anyone ever REALLY looked at the studies you would have actual CAUSE to be depressed. Depression is treatable but not very well for most it seems to be a life long battle. I digress.

So, one day I took an ADD test sittig on my DRs desk while I was waiting. He didn't say anything too much but he looked at the test which I thought he was going to yell at me for touching and then RX'd me Adderall.

Things started to change.
Over a few months the dosage increased and my life changed for the better and has not gone back. Although I am at 60mg which for my heart and health is as high as I can go and may have to decrease even.

I had finally found something that helped. Now this ADD SPECIALIST NON-MD FROM DUKE who (Coincidentally) worked for a Dr who used to be the head of the biggest Drug and Alcohol Treatment center in Minnesota where there are many!!!!!) was saying no, no you need to take Lithium.

I had taken it when I was hospitalized at 17. I almost died from side effects.
So, he said let's go with....I got up and walked out.

I used to have a low opinion of Physicians Asst. as they practiced same medicine you paid for when you saw a real Dr but after seeing this guy I had to rethink all of it.

G.B.


BTW- I am now on probation in this state for medical misuse for seeing too many Drs. Not getting double RX's nothing like that as I am not stupid and all these Drs were in the SAME GROUP!!!!!! But, since it is the state that is paying they decided.

I decided to quit using the state.
At least this way I will get a chance before they rule me out as poor and the reason they don't make more money!!!!

[morphosis]

I appreciate the comments from everyone. I went ahead and started a little tester with Strattera. It's been about a week and today I just doubled the dosage - up to 80mg/day now. I only had one day of side effects; I woke up really early and felt scared, nauseous, cold, and sweaty. Since then it's been fine, however. I'm not convinced that it's really working but I haven't dismissed it yet either. I'm willing to give it a chance. Unless I have really bad and persisting side effects with a new med, I usually give it a couple weeks or so to evaluate how I am doing in different situations, moods, etc. I'll post back in another week or two and give my full opinion on Atomoxetine's efficacy for me personally.

[morphosis]

After a couple weeks, Strattera was put in the can. I want to say, though, that I don't think the medicine was completely ineffective. It had some benefit, but unfortunately not enough to replace stimulant therapy. The reason I tried Strattera is because of how prone to depression I am, and stimulants worsen the depression when it comes. I hope in the near future (say, 10 years or so) more alternatives to stimulants are available. For now, though, I'm switching back to my most successful combination of treatment Effexor (SNRI for depression) and Vyvanse (longer lasting Dexedrine, basically). Again, thanks for the comments.

[MandatoryInsanity]

Strattera, is tricky to dose. A lot of bad information stated children needed lesser doses or that an effective dose for a child is less effective for an adult.

Actually the opposite is true. Children need more, adults generally need less.

What this comes down to is that strattera's titration levels are too aggressive. They go 40 to 80 in a matter of days to weeks. Very few people can tolerate this without feeling zombified, angry, depressed, etc etc.

So, you have to take less for starters, take 20 mgs for a month, 40 mgs for a month. I have taken dexedrine and strattera as well as adderall and strattera.

Dexedrine helps me sleep but I hyper focus too much on it or I should say it does not help my hyper focus that is already present. It calms me down though. Not in a euphoric way but better than that, I feel content.

The issue is I feel so content i'm motivated to do nothinh rather than before where I felt discontent with everything and therefore motivated to do nothing. (Meds are tricky)

I've tried all the doses of dexedrine, i've tried adderall and the rest at all doses.

The truth is the best med I've found to augment my other meds is exercise. When I exercise consistently I don't get rebound effects as bad and my meds work better. I also find exercise alone is very effective.

I'm not trying to down play adhd as a made up disorder but I am saying the only thing I know that worked.

Also, much of the info listed above, such as memantine, magnesium, and the like are more urban legend than science. Magnesium has a degree of of effect on the dopamine receptors and does not decrease tolerance but simply adds more dopamine. You can get the same effect (except better) with L tyrosine if thats what you want.

Tolerance can be a sign of too high of an original dose. Another aspect of tolerance is that it's a misperception as you do not always know what a med is doing for you while its doing it.

Strattera was the first med I tried. Like others I thought it did nothing till I looked back when I was working and saw the strides I was making with ease and without thought. Often times we think we must be aware of our meds working for them to work but this is not always the case.

My advice for you, is to go on a high protein diet, exercise by lifting weights at ten pounds below your max for each exercise and do 20 repetitions. Do not do a home gym, your adhd self won't be as motivated unless people are around. What will be difficult is getting there and doing it everyday.

I promise you this though, when you see how good you feel improving your body, your depression will fade over months. Your adhd will fade a bit too. But may still be present. Exercise is clinically proven just as effective as anti depressants and has a better long term effect. The issue is it takes a few months to reach anti depressant levels and so therefore lags behind on the list of treatments given. (Truely belueve depressed people need to be sent to rehabilitative personal trainers than given depression meds off the bat)

Wrote a lot hope it helped good luck

[Street__Pharmacist]

Twice a year I stop taking Adderall for a couple months and substitute it with Straterra and a little bit of Ritalin so my tolerance would drop. My doctor wants me to stop taking Adderall completely and take Straterra but because I have narcolepsy I need that 'Stimulant' effect more then people with ADD/ADHD.I don't consider Stratera 'useless' in fact a family member who was on a high dose of Concerta is now more focused and concentrated thanks to Straterra ( And as somebody noted previously the older you are LESS is better,. And besides HORRIBLE anxiety I also have Major Depressive Disorder (10 years) and my shrink has classified it as Treatment Resistant Depression for the last 6 cause nothing works. Just to let you know that back before antidepressants hot the market Stimulants were commonly used for 'depression' and are still used today in some cases. My Adderall doesn't do anything for my depression. Any opiate/ opiod however gets rid of my depression and anxiety (Oxy especially) amazingly. I usually a hermit in social situations but give me an opiate and I can be a ****ing social butterfly. Unfortunately my doctor doesn't believe me or if he does he has to give me a 20minute speech on the dangers of narcotics right before he writes me prescriptions for benzos and Adderall
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