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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by KimberlyDi on September 15, 2003, at 10:59:23
I've been on Strattera for a week now at 2x40mg daily. Once in morning and once at 2 p.m. Even with Trazadone, the insomnia is killing me. This weekend, I even skipped the 2pm dosage to help me sleep that night. No bueno. I was hyped, pupils were huge, and felt like toothpicks were holding my eyes open. I'm on 3rd day without sleep. Since Fall swept into Texas with several cool fronts, my allergies have been going haywire. Has anyone had an adverse reaction to Claritin-D and Strattera?
Does the insomnia problem fade any? Can I take 80mg in the morning, instead of breaking it out? I'm also taking Effexor 2x150mg.
KDi in Texas
Posted by utopizen on September 15, 2003, at 11:10:33
In reply to Strattera Help!, posted by KimberlyDi on September 15, 2003, at 10:59:23
> I've been on Strattera for a week now at 2x40mg daily
I don't understand why docs are so in a rush to titirate with Strattera.
They make and offer 10mg samples, if I were to go on it (I may soon) I would ask to go on at 10mg once a day at bedtime for a week, then increase to 10 mg twice a day for a week, adding 10mg each week after that.
I'd stop at 40/day for two weeks to notice effect.
If I was okay with the side effects and it wasn't working, I'd continue adding 10mg per week. Max at 80, wait two weeks, then up to 100 if necessary.
And you can keep a stimulant with the Strattera while you're uping the dose, all the more reason why there's no reason to go up so quickly.
If your doc really wants you off a stim, he should go slowly enough so you don't get such side effects.
Posted by KimberlyDi on September 15, 2003, at 11:49:59
In reply to Re: Strattera Help!, posted by utopizen on September 15, 2003, at 11:10:33
Thanks for your feedback. I've never been on a stim. I can understand that the dialated pupils could indicate that the dosage is too high? I was only supposed to be on 1x40mg for 4 days. It's expensive (my insurance doesn't cover much) so it can't hurt for me to keep it down to 40mg for a few weeks.
> > I've been on Strattera for a week now at 2x40mg daily
>
> I don't understand why docs are so in a rush to titirate with Strattera.
>
> They make and offer 10mg samples, if I were to go on it (I may soon) I would ask to go on at 10mg once a day at bedtime for a week, then increase to 10 mg twice a day for a week, adding 10mg each week after that.
>
> I'd stop at 40/day for two weeks to notice effect.
>
> If I was okay with the side effects and it wasn't working, I'd continue adding 10mg per week. Max at 80, wait two weeks, then up to 100 if necessary.
>
> And you can keep a stimulant with the Strattera while you're uping the dose, all the more reason why there's no reason to go up so quickly.
>
> If your doc really wants you off a stim, he should go slowly enough so you don't get such side effects.
Posted by Peter N on September 15, 2003, at 12:50:46
In reply to Strattera Help!, posted by KimberlyDi on September 15, 2003, at 10:59:23
> I've been on Strattera for a week now at 2x40mg daily. Once in morning and once at 2 p.m. Even with Trazadone, the insomnia is killing me. This weekend, I even skipped the 2pm dosage to help me sleep that night. No bueno. I was hyped, pupils were huge, and felt like toothpicks were holding my eyes open. I'm on 3rd day without sleep. Since Fall swept into Texas with several cool fronts, my allergies have been going haywire. Has anyone had an adverse reaction to Claritin-D and Strattera?
>
> Does the insomnia problem fade any? Can I take 80mg in the morning, instead of breaking it out? I'm also taking Effexor 2x150mg.
>
> KDi in TexasI have had the *exact* same problem. If you haven't already been diagnosed, you may be bipolar. I'm bipolar, and the Trazodone made my sleep *worse* -- it's an anti-depressant, which can make bipolars go manic, and I kept waking up after 3-4 hours of sleep on the Trazodone. My story with the dialated pupils and insomnia gets even more twisted -- I was in rehab for drugs and then a recovery house, and my eyes have dark circles from not sleeping for days on end and the dialated pupils had others thinking I was HIGH!
I take Lamictal for my bipolar disorder and when I had the dosage on that increased, those hyped-up side effects went away. Despite this, I still couldn't sleep well. I've finally been able to sleep recently since the doctor gave me Seroquel. It also kinda numbs my thinking, so my next visit with my doctor I'm going to talk about reducing the Strattera dosage.
As for the Claritin-D, my only experience is with Claritin, since I'm a recovering substance abuser. I avoid anything with pseudophedrine, since it's a mild stimulant. (May not be good for the bipolar folk anyway.) I had no adverse reactions taking Claritin with Strattera.
Posted by Kacy on September 15, 2003, at 13:26:58
In reply to Strattera Help!, posted by KimberlyDi on September 15, 2003, at 10:59:23
Maybe you need much smaller doses, Kimberly.
I took 50 mg a day for four days (because the 40 mg samples weren't available) and then began taking 80 mg, all of it in the morning. I didn't have any problems going up to that dose the quick way.
I never had any insomnia. It was just the opposite; I'm fighting an afternoon sedation problem. At 80 mg, that problem went away in about six weeks. At 100 mg., it's not passing.
I don't think a week is enough time to get over side effects of these types of drugs, but I would still call that doctor and at least leave a message that you are really wired on it. Ask for advice.
Posted by sadmom on September 15, 2003, at 14:42:54
In reply to Re: Strattera Help!, posted by Kacy on September 15, 2003, at 13:26:58
I went 3 days without sleep when I started Strattera. I've now been on it for 3 weeks and I can fall asleep on my own about 1/2 the time but wake up wide awake in the middle of the night after a 3-4 hrs of sleep. The pdoc is prescribing this for my depression since I've tried several other A/D's that didn't work. Strattera isn't helping my depression much, it helps control my appetite, and helps me from crying all the time or getting ticked-off real easy.
Posted by KimberlyDi on September 15, 2003, at 17:05:53
In reply to Re: Strattera Help!, posted by sadmom on September 15, 2003, at 14:42:54
Posted by Viridis on September 16, 2003, at 3:35:53
In reply to Strattera Help!, posted by KimberlyDi on September 15, 2003, at 10:59:23
80 mg/day is a large dose to start out with.
I've been taking Strattera for a few months now (along with Adderall and Klonopin), and started at 25 mg. After a few days I increased to 40 mg and had some side effects (nausea and muscle aches, mainly). Those went away after about a week. Then I tried 65 mg and had the same side effects for a few days. Now I'm at 60 mg and will probably move up to 80 mg. The only remaining side effect is slight dry mouth, and that's not a big deal -- I just drink more water.
I've tried 120 mg/day and that made me a feel a bit weird/wired, although that may just have been too much of a jump all at once.
For me, at least, this is a drug to increase gradually. And, some people here have reported success at doses as low as 18 mg/day. Like all these meds, response is highly individual, and Strattera may take a while to get used to. I don't understand why some doctors want to begin with the supposed "optimal" dose of this and other drugs -- it can scare people away from something that could otherwise be beneficial if titrated gradually.
Strattera comes in free starter packs with a mixture of 25 and 40 mg pills (and maybe other combinations). The drug reps hand these out -- maybe your doctor has some and could set you up to try a more gradual strategy. Strattera can be quite helpful, but side effects are common, especially if you start at a high dose immediately.
Good luck!
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