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    Old 07-24-2008, 10:36 PM   #1
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    Strattera disappointment, am I weird?

    Hello all, this is my first post though I've been lurking for the past few weeks. Please let me give some background. Last month I asked my GP if my problems could be due to ADHD, since I seem to be a textbook case since like age 2 and even have had some of my psych professors actually ask me or mention to me if I have it. My GP agreed my traits seem to indicate ADHD and said to try Strattera, since at age 40 and never diagnosed, I never took any medicine for it before. I apologize for this post being long. If it's too boring you can skip it.

    I started at 25 mgs b/c meds usually affect me more strongly than usual, and after 3 weeks went up to 40 mgs. The first 2 weeks had terrible headaches, nausea, always sleepy, torture thirst, ferocious hunger, had to pee every 2 hours, but in between had such an amazing mental quietness it was like I could almost hear an echo inside my own skull. I was so relaxed that my perpetual trapezoid charley horses went away by themselves, and I even almost stopped all foot wiggling, knuckle cracking, etc. I could not just sit and read again, but could hyperfocus so long and intensely like I haven't been able to do since getting sidetracked from studying in my college days. I thought it was working so well.

    The side effects mostly went away except for the thirst and hunger, so went up to 40 mgs. After the past week on 40, I have been getting progressively more drowsy, headaches, slightly drunk feeling, etc. but also more irritable and short tempered, until yesterday and today the bad mood was so pervasive I decided I just can't stand to feel like this any more. I've been snapping at people which I've never done much in my whole life. My self-defense feelings are out of proportion to the actual demands people have made. They are used to me being so easygoing and willing to do whatever all the time, and now I'm saying, NO, forget it, I don't want to, and holing up in my room to get away from everyone. I can put up with headaches, nausea, etc. to get to the part where it helps, but not with losing control of my temper like this, snapping before I even realize I'm that annoyed.

    Worse, my fidgeting is back and my scatterbrained forgetfulness way worse than ever b/c this medicine seems to interfere with me remembering how to use my usual coping patterns and self-reminder habits. My mental stream of chatter that usually runs in the background, necessary reminders being cycled through like on the news scroller at the bottom of the tv screen, so every little while I'll re-remember something I'm not supposed to forget, and then my normal behavior patterns that keep me from losing things, etc., seem to be turned off by Strattera, so now in spite of the benefit of calmness, it is ultimately maladaptive for me. I even forget to make lists like usual.

    So my GP called me back this evening and agreed that I can stop taking it, after a few days on the lower dose to taper down. But, he also said, he isn't quite sure exactly what my real problem is, he can't quite put his finger on it b/c he thinks I may be depressed, so he does not want to try any regular ADHD medicines. He wants me to get counseling to see if I'm depressed before he tries to treat the ADHD any more. My thyroid test also came back showing low thyroid, so that could cause some of my problems with memory and being inattentive, can't concentrate, etc. He agreed it can also make me have some depression symptoms. The ADHD is not in question. He seems to think the regular ADHD meds will cause harm if I actually am depressed.

    He also said Strattera has a side effect of reducing hunger, not increasing it like it did for me, and he thinks there's something else going on. Normally I get interested in something and I can forget to eat all day long. It is very unusual for me to be so HUNGRY all the time like in between the nausea on this medicine. Has anyone else on Strattera experienced an increase in hunger like this? I can't quite believe it's not the med. but I don't know.

    Also, has anyone else had a good result for a while, then started getting irritable and short-tempered later after thinking it was the right thing for you? I had a couple of times where I got so frustrated feeling that I couldn't do anything but cry. I am not really like this, I might cry easily at sappy movies but not due to a sense of losing control of myself. Strattera is taking my optimism away. I am so disappointed that it isn't working out. I was so hopeful that there would be something that would help me get organized, pay attention in conversations, be less scatterbrained, manage time better, etc. I have had a lot of setbacks in my life but I never felt like I wouldn't be able to figure out a way to succeed eventually.

    I am sorry if this is too long. If you actually read it all I am amazed. If you have any input, good, bad, or ugly, then even if it makes me cry again I'll still appreciate the feedback. Thank you to anyone who ends up responding.


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    Old 07-25-2008, 07:00 AM   #2
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    Re: Strattera disappointment, am I weird?

    Hi, Greencandy, welcome to the family.

    (Jane pictures us all living in the same house. This picture lasts about 3 seconds, then the lens breaks.)

    Yes, it often does happen that a drug works for ADHD for a while, then either it stops working, or intolerable side effects develop. It's extremely frustrating.

    Here's what I suggest doing, preferably in this order:

    1) Get the thyroid hormones balanced, this may require seeing a good endocrinologist.

    2) If attention problems are still bothersome, see a psychiatrist with experience in ADHD to find you the right med. It could be you do need a stimulant, it could be that's the wrong choice for you. The nice thing about stimulants is that if you take one for a couple weeks and decide you can't stand it, you can just quit, and it wears off in about 8 hours.

    3) I usually suggest that once people find the med that works, or make the decision not to medicate (both are valid) they find an ADHD coach. This is someone who helps you figure out how to organize your brain and your life. It sounds like you have effective coping mechanisms already in place, but you might still benefit from a coach.

    Old 07-25-2008, 09:19 AM   #3
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    Re: Strattera disappointment, am I weird?

    Thank you for your reply, it is really helpful to get encouragement and some practical advice too. After my long history of various medicines not working like they're supposed to, I have doubt that the "regular" ADHD meds will work on me either. I'm on thyroid med. to help that, but I'm sure you're right about getting some coaching on coping with the ADHD. I got a referral from my GP to a psychologist (not psychiatrist) and so I'll try that. I hate feeling consciousness-affected or doped up (I never even drank or smoked pot in my youth) so non-med. is probably the best route for me anyway.

    Thanks again for your response and caring welcome. It sure is nice not to feel so alone.


    Old 07-25-2008, 10:14 AM   #4
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    Re: Strattera disappointment, am I weird?

    Listen to Jane, she knows her stuff.

    I don't have a lot to add, but wanted to voice my support, as I see a lot of myself in you and know that things can get better, because they're getting better for me.

    I will wonder out loud though, I'm not sure I understand your doctor's belief that stimulant ADHD meds will do you harm if you're depressed. While stimulants generally aren't considered antidepressants, they are used for depressions that don't respond to standard depression meds, and they've been used in the past for treatment of depression. This might be something you discuss with your psychologist (while they're not psychiatrists, he or she may have some insight).

    Old 07-25-2008, 10:44 AM   #5
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    Re: Strattera disappointment, am I weird?


    I think your GP is doing a good job - very rare opinion for me. The thyroid problem is to me the monkey wrench in the stimulant approach gears.

    As far as Strattera goes, I have to admit it has helped some, for me it was among my worse nightmares. No energy, lots of appetite, less focus than no med at all and it was ruining certain aspects of my marriage. NASTY STUFF strattera is - for me. Seems like you too.

    Before you board the stimulant train get the thyroid thing worked out. Stimulants will most likely help you with your ADHD. Incidentally, you describe textbook DSM-IV symptoms. Glad to hear your doc recognizes them.

    That brings me up to four doctors that have a brain that I know about. Golly goober, maybe they're not all dumb after all.

    Jane tried to fix my overly cynical attitude. She failed.


    Old 07-26-2008, 08:32 AM   #6
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    Re: Strattera disappointment, am I weird?

    Hi Donna & Welcome!

    I agree with what you've been told above.

    Jane's suggested treatment plan is "right on" and I agree wholeheartedly with the order of treatment that she's recommended. Your first step is to get your thyroid levels corrected. It isn't uncommon for antidepressants to be ineffective when thyroid hormones are off. Hypothyroidism can also cause ADD symptoms.

    I also agree with Thunor's musings about the use of stimulants in depression. I assume the doctor who thinks the two are incompatible is a GP and a not a psychiatrist because it simply isn't true.

    In reading your response on a different thread, I have another thought for you. Your description of alternating periods of walking all night with periods of sleeping all the time makes me wonder how cyclical your moods are. Are there times when your depression is alot worse than other times (for no apparent reason)? When you go through your periods of being unable to sleep, are you also very irritable?

    The reason I ask is because I think you should do some reading about Bipolar Disorder. It's a common misconception that to be bipolar, you have to have periods of euphoria. The fact is that many with BPD experience mania as "hypomania" which is not pleasant at all. It is often experienced as insomnia, irritability, racing thoughts, pressure of speech, etc.

    Another flag for me was your non-response to multiple antidepressants. Increasingly, psychiatrists are viewing this symptom as a possible symptom of BPD. I think it would be worth your while to do some reading about Bipolar Disorder. There is an active board on the topic here at Dr Jim Phelps has also published a great deal of helpful information on the internet. But, here again, even if you think BPD fits, the first step in treating it is to correct your thyroid imbalance.

    Good luck to you.

    Old 07-28-2008, 03:18 PM   #7
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    Re: Strattera disappointment, am I weird?

    Thank you all for your replies and info. It is extremely encouraging to me to get positive feedback, input and ideas from people who know.

    I think my GP is very cautious, but truly interested in doing the best treatment for me. So, even though not having a quick solution is frustrating, I know it's best to be patient and follow his recommendations. Now if only the psychotherapist would return my calls. (tapping foot)

    Your insight about bipolar disorder is interesting, but it is pretty clear that it isn't my issue. I have been assessed by psychiatrists and psychologists on more than one occasion, (during a course of grief counseling the year my father, aunt, grandmother, and a close friend all died within a five month span, during another time period when my marriage was breaking up, and the year my daughter was twelve, diagnosed with ADHD, I was dealing with her on my own while going to college full time, and I felt like I was starting to crack under the stress of daily life) but bipolar was never considered a possibility. Also, 10 years ago, my old GP had tried me on different antidepressants for two years (some of which could have initiated a manic episode) before discovering my thyroid was a little low (and Synthroid turned out to be almost a magic cure for the depression symptoms).

    But the idea is interesting, because two of my five sisters have been diagnosed with bipolar disorder. One of them goes psychotically manic periodically, but her depressions are easier to lift. The other is never "nuts" except she has a lifelong drinking problem and can get angry and irrational while drinking. Both of them have had much improvement from taking lithium and other meds for bipolar disorder. I read that Strattera can make an unknown bipolar sufferer become manic, and I almost hoped that if I'm really an undiagnosed bipolar that it would give me an episode, just so I'd know what's wrong with me. Alas, it turned me into a slug instead.

    However, bipolar disorder and ADHD are often found in the same families, even though the genes that are involved aren't the same genes. Bipolar has many different possible genes involved, but for ADHD it's a specific gene, not one involved in bipolar but a completely different one. It can be expressed differently, accounting for the different types of ADHD.

    Also, when I studied psychology in school, it became clear that as a child, I was a textbook case. I could recognize that I was a child with ADHD, but never thought about being an adult with ADHD until other people, including professors, asked me about it. I sort of laughed about it at the time, but the idea that it might be why I am the way I am, stayed in the back of my mind.

    I guess life isn't easy for any of us here on this planet.

    That psychologist still hasn't responded to my message. I guess it's okay to send an e-mail to her, but I don't want to appear impatient so I guess I won't leave another phone message.

    I know a lot of people "self-medicate". The main reason I think I never have, at least with alcohol and drugs, is b/c my sister who's a drunk, started drinking when I was just a little kid. I grew up watching what the booze, pot, and cocaine was doing to her, and by the time I was a teenager I had made myself a vow that I would never abuse drugs or alcohol. My drug of choice as a teen was candy, I guess, which I never considered a drug, but looking back on it, I definitely ate waaay too much sugar. I craved it.

    Okay, that was long-winded again. oops. sometimes in real life i realize i've been yakking on and on and on, too. SORRY (duck tape over mouth now)
    (i mean, over fingers now)

    pfh pfh pfh,


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