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Re: Strattera and Strattera users

Posted by zeugma on September 26, 2004, at 18:22:53

In reply to Strattera and Strattera users, posted by jms600 on September 26, 2004, at 15:51:44

> Hi,
>
> Looking at a thread on ADD that I posted a few days ago, most people recommend Strattera (Atomoxetine).
>
> However I do also suffer from depression (currently on 40mg Prozac) and I also get fairly severe anxiety (this manifests iteself as social anxiety; GAD; moderate panic attacks; and co-morbid depression). I'm on 800mg of Sodium Valproate for anxiety but it does little to help.
>
> My question(s) are - Does Strattera help depressive states? And, does Strattera have any effect on anxiety problems (i.e. can it make it worse as well as better?)
>
> Thnaks to everyone!

Strattera is to all intents and purposes an antidepressant that has a beneficial effect on ADD symptoms. There was a point, when I was on Strattera, nortriptyline (a TCA) and Buspar, that I literally felt like I was incapable of becoming depressed. Of course that didn't last, but no AD is magic and mood elevation is a tricky beast. I did not find Strattera anxiolytic, but others have, and my anxiety is quite intractable- only Klonopin helps, and that only to a degree.

However, I did find that after almost a year on strattera I found that it was causing severe dysphoria. This could be due to an action of its metabolite, 4-hydroxyatomoxetine, which is a partial kappa-opioid agonist- dysphoria is a known s/e of other kappa agonists. I think that in part this effect is dependent on concentrations of 4-hydroxyatomoxetine that build up in the bloodstream. I know that I am a fast metabolizer of drugs mediated by CYP 2D6, so this would imply that atomoxetine would be converted rapidly to the metabolite.

bear in mind that this effect did not manifest until almost a year later. I do not regret having gone on strattera as it did make possible many things for me.

-z


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