Information, Ideas, and Insight into Adult ADD and related issues with the occasional inclusion of other insundry, unrelated rantings.
Treatment experiences with the only FDA approved medication for Adult ADD
Published on April 28, 2004 By mrperky In Health & Medicine
Strattera is the only FDA approved medication for treating ADD in Adults. There are several methods for treating ADD affecting either dopamine, seratonin, or norepinephrinelevels. Strattera affects norepinephrine levels and, in general, drugs like Ritalin affect dopamine and/or norepinephrine levels.

When a neuron releases norepinephrine, it immediately tries to retrieve (reuptake) the neurotransmitter to prevent overstimulation of the receiving neuron. In the case of Adult ADD (and also depression), too much of the neurotransmitter is reuptaken, resulting in a chemical imbalance that causes the altered brain activity. Strattera limits (blocks) the reuptake process, thereby resulting in "normal" functioning. A similar drug, Wellbutrin, works by inhibiting the reuptake of dopamine, serotonin, and norepinephrine.

Knowing whether you should affect dopamine, serotonin, or norepinephrine is one of the problems with medication. It is unlikely that an Adult ADD sufferer would have the correct medication at the correct dosage as first prescribed. A more thorough explanation of how Strattera works can be found here. An additional discussion on Brain Chemistry, including neurotransmitters, which uses a nice baseball analogy can be found here.

As a treatment method for my ADD, my GP (General Practitioner) prescribed Strattera for me. I received my prescription and a "free" initial 18 day trial starting at 40 mg for two days, then increased to 60 mg for the remaining 18. My counselor had mentioned the benefit to taking medication early in the day, but the doctor did not mention it. There was no indication of when to take the medication on the prescription label.

My GP's appt was mid-morning, so my first dose was taken close to lunch time. My experience that day was a little nausea, but nothing else. Strattera needs to be taken for a 4 week period or so before it's effects are noticable and regulated. So I didn't expect any lessening of the ADD symptoms to occur for a few weeks.

That night, however, began my trial by fire for Strattera. My sleeping was miserable. I had a great deal of difficulty falling asleep. Where it usually takes me less than 15 minutes to fall asleep, that night it took more than an hour. Through the night I awakened very frequently, I estimate I had 30 or so wakeful periods. I normally have 5 or 6.

The second night was much worse. I woke up constantly, could not fall asleep again easily, and woke up feeling as if I had been kicked in the head by a mule.

The third night was worse than the other two combined. I felt as if I was losing my mind! My brain would not stop racing, and was distracted by even the slightest thought. Where I usually fell asleep immediately, now my sleeping was a gradual decline into sleep, often taking more than an hour. I woke at 3:30 AM and could not go back to sleep. After an hour of trying I rose again and surfed the net for Strattera side effects.

Over the next several days I backed the medication time to 8:00 AM and this helped with the sleeping, but it still took nearly an hour to get to sleep and I awoke far too often to be refreshed in the morning. On top of the problems, the dosage increased to 60 mg on the third day, creating a further increase in severity.

Problems with sleeping appears to be on of the larger side-effects of Strattera, although Lilly lists is as uncommon. The nausea I felt was somewhat relieved by eating breakfast before taking the medicine, however the prescription label clearly states ", THIS MEDICATION MAY BE TAKEN WITH OR WITHOUT FOOD."

Over the next 21 days I battled with the sleep disruption and eventually stopped taking the medication. I understand that many side effects take a few weeks to settle down. While the sleep issues did reduce minimally, they were not eliminated over time. Finally, on the last day I took the medication I felt totally lethargic. I was tired as if I hadn't slept for three days or as if I was sick with the flu. That was the last straw for me.

I am currently working with a local neurologist to rule out any sleep related issues before I begin seeking medication again for the ADD.

Comments
on Apr 29, 2004
Your problem is first of all that your G.P. presribed it. G.P's know very little about specialized medications. I took a drug that cause nausea. My doctor prescribed an acid blocker at the same time, so my nausea was minimal. In addition, it took me four month to get up to the therapeutic dose. I suspect that Stattera is a good drug, but you would need to take it more slowly. Why are you going to a neurologist instead of a psychiatrist? They are much more familiar with ADD.

I sympathize with your difficulties with medications, psychtropic medications have a lot of side effects and finding the exact right one is difficult. It can be, however, the difference between being able to function so it is worth going through different medications to find the right one.
on Apr 29, 2004
Actually, my counselor recommended a non-stimulant medication for treating the ADD. Welbutrin and Strattera are two of the more popular medications in that class. The doctor accepted the recommendation and prescribed the Strattera. My counselor has since stated that she would rather I used the Welbutrin, so maybe I'll look to that in the future.
on Aug 27, 2005
Have you heard of combining Strattera with Dexedrine?