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Dr. Bob is Robert Hsiung, MD,
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Posted by BekkaH on January 19, 2003, at 23:50:23
In reply to Re: Strattera Allergic Reaction, posted by jodie on January 19, 2003, at 22:26:43
Jodie,
Did you or do you have a fever?
Posted by BekkaH on January 20, 2003, at 0:10:23
In reply to Re: Strattera Allergic Reaction - Jodie, posted by BekkaH on January 19, 2003, at 23:50:23
Jodie,
Are you familiar with the medicine, Lamictal? Lamictal is an anticonvulsant that has been used very successfully in many depressed patients, primarily for antidepressant augmentation. It is also used successfully for treating bipolar depression. The reason I'm bringing it up here is that a rare but dangerous rash has been associated with Lamictal, and apparently the likelihood of the rash occurring is greatly reduced if Lamictal is started at a very low dose and increased very, very slowly over many weeks. The rash is also less likely if Lamictal is NOT combined with other anticonvulsants. Lamictal is also associated with many other, benign rashes. We know so little about Strattera, but I'm wondering whether rashes will prove to be less likely if the dose is started very low and increased very slowly, and if the medicine isn't combined with too many other meds. Perhaps the comparison is not a valid one since the two medications have such different mechanisms of action. I'm just thinking "out loud."
Posted by jodie on January 20, 2003, at 0:45:14
In reply to Re: Strattera Allergic Reaction - Jodie, posted by BekkaH on January 20, 2003, at 0:10:23
> Jodie,
> Are you familiar with the medicine, Lamictal? Lamictal is an anticonvulsant that has been used very successfully in many depressed patients, primarily for antidepressant augmentation. It is also used successfully for treating bipolar depression. The reason I'm bringing it up here is that a rare but dangerous rash has been associated with Lamictal, and apparently the likelihood of the rash occurring is greatly reduced if Lamictal is started at a very low dose and increased very, very slowly over many weeks. The rash is also less likely if Lamictal is NOT combined with other anticonvulsants. Lamictal is also associated with many other, benign rashes. We know so little about Strattera, but I'm wondering whether rashes will prove to be less likely if the dose is started very low and increased very slowly, and if the medicine isn't combined with too many other meds. Perhaps the comparison is not a valid one since the two medications have such different mechanisms of action. I'm just thinking "out loud."BekkaH-
No I didn't have a fever at the ER. I have a digital ear thermometer. I took my temp. a couple of hours b4 I went, it was 100.5.
Yes I am familiar with Lamictal. I hadn't heard about the rash. It is very possible that it could be the strattera causing the rash, especially since I started at a high dose, after only 3 days my pdoc had me on 80 mg's. I'm 120 lbs, 5'5", so maybe it was just too much. I would seriously consider trying a lower dose and gradually increasing, but I know I could not tolerate a rash like this again. I'm scared of the medication now. Thank you for your "thinking out loud" because I have the same thoughts. I just wish I knew for a fact what caused this horrible rash.
Posted by jodie on January 20, 2003, at 0:57:58
In reply to Re: Strattera Allergic Reaction - Jodie, posted by jodie on January 20, 2003, at 0:45:14
Another thought of mine is maybe its not even medication related. I don't recall eating anything unusual. I have no food allergies that I'm aware of. I always freak myself out over these kinds of things. I have been on the internet all night looking for possible diagnosis. You wouldn't believe some of the diseases I've been reading about that a rash can be a symptom. I decided to quit looking at diseases and symptoms for the night, I'll end up giving myself a panic attack. I did that once. I was having chest pains, so I got on the internet and convinced myself I was having a heart attack. I started gasping for air, and almost passed out. We had to go to the ER. It turned out to be acid reflux, and a panic attack!!! Well I'm off to bed, after I cover my body with benadryl gel :-)
Posted by BekkaH on January 20, 2003, at 1:02:29
In reply to Re: Strattera Allergic Reaction - Jodie, posted by jodie on January 20, 2003, at 0:45:14
I think that Lilly, the company that makes Strattera should know about this rash. I wonder whether your pdoc and/or the ER you went to should report it. I wonder whether this has happened to many others.
Do you feel sick in any way, other than the rash? Is your temperature normal now?
Posted by jodie on January 20, 2003, at 11:38:18
In reply to Re: Strattera Allergic Reaction - Jodie, posted by BekkaH on January 20, 2003, at 1:02:29
> I think that Lilly, the company that makes Strattera should know about this rash. I wonder whether your pdoc and/or the ER you went to should report it. I wonder whether this has happened to many others.
>
> Do you feel sick in any way, other than the rash? Is your temperature normal now?I thought about that. I'm going to mention it to my pdoc about reporting the rash. I don't feel sick, just tired. Benadryl really knocks me out! I don't have a temperature now.
Posted by jodie on January 20, 2003, at 15:46:26
In reply to Re: Strattera Allergic Reaction - Jodie, posted by jodie on January 20, 2003, at 11:38:18
> > I think that Lilly, the company that makes Strattera should know about this rash. I wonder whether your pdoc and/or the ER you went to should report it. I wonder whether this has happened to many others.
> >
> > Do you feel sick in any way, other than the rash? Is your temperature normal now?
>
>
>
> I thought about that. I'm going to mention it to my pdoc about reporting the rash. I don't feel sick, just tired. Benadryl really knocks me out! I don't have a temperature now.
Well, I just spoke with my pdoc, she said her Lilly Rep. will be in tomorrow, and she is going to let her know. She said she agrees that I should stay off the Strattera. I have an appointment coming up soon, she said we would discuss other options, like stimulants. She said she has had great success with her patients and Adderall. She told me to continue with the Lexapro for now. She said Strattera is just so new right now, and I'm not the first complaint of allergic reactions on Strattera at their office. She thinks it would just be risky for me to even wait for a while and start at a lower dose. I had mentioned that possibility to her. So I guess it will be stimulants for me.
Posted by Jim Boardman on January 20, 2003, at 15:57:28
In reply to Re: can this thread be attached » Jim Boardman, posted by Dr. Bob on January 19, 2003, at 18:53:57
certainly it can, Robert... it's your board! I just didn't see the other string when I posted.
Jim
Posted by tia on January 20, 2003, at 18:48:53
In reply to Re: Strattera Allergic Reaction - BekkaH, posted by jodie on January 20, 2003, at 15:46:26
Well I dont feel any different accept that my bladder has not stopped hurting. Not sure if its the medicine aggervating it or if it is IC. I go on 60mg tomorrow. Oh just so you all know nothing really dry, no rashes, actually really nothing but my bladder problem. Will keep updating.Anyone else have any different problems with the strattera?
Tia
Posted by BekkaH on January 20, 2003, at 20:16:57
In reply to Re: Strattera Allergic Reaction - BekkaH, posted by jodie on January 20, 2003, at 15:46:26
> She thinks it would just be risky for me to >dose. I had mentioned that possibility to her. >So I guess it will be stimulants for me.
>
**********************************************Hi Jodie,
Well, even though this has been a disappointment, at least your doctor is willing to consider other options. Perhaps you are one of those very sensitive individuals who needs to start medications at very low doses and increase very gradually. I'm sensitive that way, but I have even more difficulties with med combinations. I can't combine anything with anything -- not even antibiotics. For me, it's either one drug by itself or none at all.I hope your rash goes away quickly so you can get some relief from the other options your doctor is considering. Please let us know how you're doing.
Bekka
Posted by BekkaH on January 20, 2003, at 20:24:57
In reply to Re: Strattera Fourth Day, posted by tia on January 20, 2003, at 18:48:53
> Well I dont feel any different accept that my bladder has not stopped hurting. Not sure if its the medicine aggervating it or if it is IC. I go on 60mg tomorrow. Oh just so you all know nothing really dry, no rashes, actually really nothing but my bladder problem. Will keep updating.
*************************************************
Hi Tia,
I was interested to see that you were at such a high dose already. Do you feel that your bladder hurts more than it did before you began the medicine? I think you should definitely mention this to your doctor. I must mention that I know two women who have interstitial cystitis and, oddly enough, they were prescribed highly anticholinergic medicines for the purpose of causing urinary retention!! They were given Elavil, which is an old-fashioned antidepressant that is notorious for causing urinary retention. This was done intentionally, to counteract the sense of urgency they had from the IC. I was always stunned by this, but apparently this is/was common practice for treating IC.I hope you feel better soon.
Bekka
Posted by zenclear on January 20, 2003, at 20:37:08
In reply to Re: Strattera Fourth Day, posted by tia on January 20, 2003, at 18:48:53
>
> Well I dont feel any different accept that my bladder has not stopped hurting. Not sure if its the medicine aggervating it or if it is IC. I go on 60mg tomorrow. Oh just so you all know nothing really dry, no rashes, actually really nothing but my bladder problem. Will keep updating.
>
> Anyone else have any different problems with the strattera?
>
> TiaTry calcium citrate (not carbonate!) for the IC. It's a well-known Sx reliever, and also good for your bones!
Posted by jodie on January 20, 2003, at 22:02:43
In reply to Re: Strattera Allergic Reaction - jodie, posted by BekkaH on January 20, 2003, at 20:16:57
Well my rash is much better. Still have little red dots, but not inflamed like they were. I haven't been itching much either. I'm usually not sensitive to medications. Never have been to antibiotics. Benzo's have never affected me very much. I usually do decent on high or maximum doses of any meds. For my rash I am taking 50 mg's of Benadryl every 4 hours, Medrol (methylprednisolone) Pack, its a steroid. I'll be on that for a total of 6 days.
Yes, its nice that my doc is considering other options. Many pdoc's aren't willing to put adults on stimulants.
Thanks again for caring!!!
Posted by jodie on January 20, 2003, at 22:22:23
In reply to Re: Strattera Fourth Day - tia, posted by BekkaH on January 20, 2003, at 20:24:57
> > Well I dont feel any different accept that my bladder has not stopped hurting. Not sure if its the medicine aggervating it or if it is IC. I go on 60mg tomorrow. Oh just so you all know nothing really dry, no rashes, actually really nothing but my bladder problem. Will keep updating.
> *************************************************
> Hi Tia,
> I was interested to see that you were at such a high dose already. Do you feel that your bladder hurts more than it did before you began the medicine? I think you should definitely mention this to your doctor. I must mention that I know two women who have interstitial cystitis and, oddly enough, they were prescribed highly anticholinergic medicines for the purpose of causing urinary retention!! They were given Elavil, which is an old-fashioned antidepressant that is notorious for causing urinary retention. This was done intentionally, to counteract the sense of urgency they had from the IC. I was always stunned by this, but apparently this is/was common practice for treating IC.
>
> I hope you feel better soon.
> Bekka
>
>Hi Tia
Sorry to hear about your bladder. I have had problems with urinary retention in the past. It can make anyone miserable, just like being constipated!!
If you read the package insert or go to Strattera.com it says for children and adolescents over 70 kg body weight and adults: Strattera should be initiated at a total daily dose of 40 mg and increased after a minimum of 3 days to a target total daily dose of approximately 80 mg, and after 2 to 4 additional weeks the dose may be increased to a max of 100 mg. I asked my pdoc about this on the phone this morning. I questioned if maybe I was taking too much for my body weight. She said no, that for adults its pretty much standard, for children they go by weight. I was up to 80 after only 3 days. Everyone was questioning why I was on such a high dose. Of course after my rash, I agree it seams smarter to start out on a low dose and gradually increase it to 80.
Hope you feel better soon!!!
Jodie
Posted by tia on January 21, 2003, at 7:34:03
In reply to Re: Strattera Fourth Day - tia, posted by jodie on January 20, 2003, at 22:22:23
I am now taking 60mg starting today. I stopped doing the slimfast drink today to see if it that was bothering my bladder. I dont think it is because i was doing slim fast two weeks prior of my bladder hurting.
I will se how the 60mg of strattera works today and tomorrow until i see the doctor on thursday. I know one thing i HATE IC! Its a pain (LOL). I have to make a joke some how. Anyways i will write at the end of day if i have any different changes with taking the higher dose.
Hope everyone has a wonderful day.
Tia
Posted by jodie on January 21, 2003, at 12:56:07
In reply to Re: Strattera Fifth Day - tia, posted by tia on January 21, 2003, at 7:34:03
I have been on the slimfast diet a couple of times, it never bothered my bladder. I'm sure it's the Strattera. You never know, maybe it will get better when you increase your dose, some meds are strange like that. Hope you get to feeling better!!!
Jodie
Posted by mom2mbcb on January 21, 2003, at 13:46:34
In reply to Re: Strattera Fourth Day - tia, posted by jodie on January 20, 2003, at 22:22:23
> > > Well I dont feel any different accept that my bladder has not stopped hurting. Not sure if its the medicine aggervating it or if it is IC. I go on 60mg tomorrow. Oh just so you all know nothing really dry, no rashes, actually really nothing but my bladder problem. Will keep updating.
> > *************************************************
> > Hi Tia,
> > I was interested to see that you were at such a high dose already. Do you feel that your bladder hurts more than it did before you began the medicine? I think you should definitely mention this to your doctor. I must mention that I know two women who have interstitial cystitis and, oddly enough, they were prescribed highly anticholinergic medicines for the purpose of causing urinary retention!! They were given Elavil, which is an old-fashioned antidepressant that is notorious for causing urinary retention. This was done intentionally, to counteract the sense of urgency they had from the IC. I was always stunned by this, but apparently this is/was common practice for treating IC.
> >
> > I hope you feel better soon.
> > Bekka
> >
> >
>
>
>
> Hi Tia
>
> Sorry to hear about your bladder. I have had problems with urinary retention in the past. It can make anyone miserable, just like being constipated!!
>
> If you read the package insert or go to Strattera.com it says for children and adolescents over 70 kg body weight and adults: Strattera should be initiated at a total daily dose of 40 mg and increased after a minimum of 3 days to a target total daily dose of approximately 80 mg, and after 2 to 4 additional weeks the dose may be increased to a max of 100 mg. I asked my pdoc about this on the phone this morning. I questioned if maybe I was taking too much for my body weight. She said no, that for adults its pretty much standard, for children they go by weight. I was up to 80 after only 3 days. Everyone was questioning why I was on such a high dose. Of course after my rash, I agree it seams smarter to start out on a low dose and gradually increase it to 80.
>
> Hope you feel better soon!!!
>
> Jodie
>
> Hi Just found your post about straterra, i may begin it this monday. My main problems is working memory, executive functioning, depression, anxiety,typical adhd symptoms although really severe working memory impairment recently ..do you find straterra has helped with these and what are your side effects. weight gain, to sleepy or to hyper, or any sexual side effects? I am scared to take a new drug as i ave 2 children ages 1 and 2 and I am afraid to start new side effects.
please also forward this to my other email
[email protected]
I may be changing my aol service soon.
Thanks
Deb
Posted by BekkaH on January 21, 2003, at 22:19:45
In reply to Re: Strattera Fifth Day - tia, posted by jodie on January 21, 2003, at 12:56:07
Hi Jodie,
I was wondering whether the rash is almost gone now? Were you able to resume Lexapro or are you waiting until the rash goes away?
I hope you feel better.
Bekka
Posted by jodie on January 22, 2003, at 1:45:06
In reply to Jodie, how's your rash???, posted by BekkaH on January 21, 2003, at 22:19:45
> Hi Jodie,
>
> I was wondering whether the rash is almost gone now? Were you able to resume Lexapro or are you waiting until the rash goes away?
>
> I hope you feel better.
> Bekka
Hi BekkaMy rash is much better, thanks! No more itching, just little red spots where the rash was. I've stopped taking the benadryl. I am continuing with my lexapro. I have been feeling pretty down lately, so I figure I need it. I have been having some pretty strong anxiety, not sure if that is from the steroid that I am taking. I read that it is a side effect. I called the pharmacist just to make sure I could take klonopin with the steroid, he said it shouldn't be a problem. So I am taking my prescribed amount of 2 mg a day. I also have xanax if needed. I haven't used that yet. I hardly ever do.
So how are you doing???
Take care, talk to you soon!!
Jodie
Posted by a261c on January 22, 2003, at 7:14:54
In reply to Re: Jodie, how's your rash???, posted by jodie on January 22, 2003, at 1:45:06
Several questions, if I may...
Currently on 70 - 80 mg of Adderall per day. At 40 mgs a year ago (up from 20 the prior year), I learned what it was like to NEVER get tired or hungry. Three pretty big problems: (1) I'm tired of keeping the schedule of a junkie, (2) I'm easily 60 pounds overweight at 5' tall, and stimulants seem to make it worse, & (3) on adderall, even the smallest dose of stress (especially late in the residual a.m. hours) causes me to perform sadistic acts on my face and hair folicles with a pair of tweezers - at times it has looked like a bad case of chicken pox and at least 5 days a month I'm embarassed to leave my house (I'm not the type of person that gets embarassed easily either).
I subject myself to this torment because without the meds, I really do not function--it's not that I completely cannot, but my unmedicated inefficiency in everything that I do depresses me to a standstill. I know I must be undiagnosed OCD, for as a child I would color code the placement of my underwear in their drawer & have been known to alphabetize my wardrobe by designers at times - so please pardon me if I'm looking for that magic dose of kryptonite that will solve all my woes!
In May I'll finish my masters & will be expected to contribute to society, but between the apathy & the "chicken pox", I'm not too optimistic.
Other adderall effects I've noticed are increased urination, perpetual thirst (go figure), short temper, and most significantly - a complete disdain for conversations not vital to the task at hand - I really hate to admit, but I am annoyed by most people most of the time (even ones who should not annoy me to such a degree).
Any responses/experiences would be greatly appreciated.
Posted by Ritch on January 22, 2003, at 8:43:40
In reply to Switch to Strattera? Anxiety SE's?, posted by a261c on January 22, 2003, at 7:14:54
> Other adderall effects I've noticed are increased urination, perpetual thirst (go figure), short temper, and most significantly - a complete disdain for conversations not vital to the task at hand - I really hate to admit, but I am annoyed by most people most of the time (even ones who should not annoy me to such a degree).
>
> Any responses/experiences would be greatly appreciated.
>That's the reason I won't take stims for my ADHD. I get cool-aloof-overserious-quiet-overfocused. It is just too "chilly"(yuck). The job I have now requires a lot of rapid multi-tasking and stims made that (essential) element of my work very difficult. They improved my ability to stay on ONE task, and worked *remarkably* well to eliminate distractability. So, in essence, I evolved into a job that fits someone with ADHD (except for the distractabiity issues with adjacent conversations in the office area). If I could work alone in a quiet area I could function rather well. I would suggest finding a way to get off the stims given all of the overfocus problems they are causing you. You can *add* an SSRI or Effexor to it to help reduce the obsessiveness issues. But perhaps tapering down the dosage and adding something else in like Provigil or Straterra could prove helpful. good luck..
Posted by golfergman on January 23, 2003, at 10:26:10
In reply to Re: Strattera Allergic Reaction, posted by jodie on January 19, 2003, at 19:51:40
Yesterday I took my first dose of straterra 18mgs. Im 47 year old male and I know this is a very small dose. My first day I would have to say Im rather down about the whole ADD thing. I definetly felt an affect. I felt high as a kite and didnt like it at all. My Dr. wants to start out with small doses for 4 days. My feeling is I dont know if I can handle this. Im not taking it today because it made me edgy, uptight, couldnt sleep at night. In other words I didnt feel good about it. The same thing happened when I tried Ritalin. Does anyone have some insight or similar experiences. I feel rather down about the whole thing. I guess I'll just have to live with this the rest of my life.
Posted by SLynn on January 23, 2003, at 12:40:19
In reply to Re: Strattera Allergic Reaction, posted by golfergman on January 23, 2003, at 10:26:10
> Yesterday I took my first dose of straterra 18mgs. Im 47 year old male and I know this is a very small dose. My first day I would have to say Im rather down about the whole ADD thing. I definetly felt an affect. I felt high as a kite and didnt like it at all. My Dr. wants to start out with small doses for 4 days. My feeling is I dont know if I can handle this. Im not taking it today because it made me edgy, uptight, couldnt sleep at night. In other words I didnt feel good about it. The same thing happened when I tried Ritalin. Does anyone have some insight or similar experiences. I feel rather down about the whole thing. I guess I'll just have to live with this the rest of my life.
Hello...I wanted to reply to your post because I do understand how you feel. I do not have ADD, but my son does and he feels the same way when he switches medications or starts a new one. Were you on medication before trying Strattera? If you were, you may be having withdrawal symptoms as well as symptoms from starting a new medication. I know when my son starts a new med, he looks "drugged" and is really "spacy" for the first couple of days. All that I can say is it sounds pretty normal what you are going through and to give it some time. From what I have read, it takes Strattera a few days to begin working (some people have waited at least 7 days). Also, you need to play with the dosage. If it is to high, you will feel bad, if it is to low, you will feel bad. It just takes time to get to the correct dosage for you. My doctor told me that Strattera is dosed by weight. Is this how your doctor is doing it? I know this is very frustrating for you....we have been going through ups and downs for 3 years. It is hard when you are treating a child because their bodies change so much. Hang in there and do not give up! I have read many posts about Strattera working great after some time.
Take care,
SLynn
Posted by BekkaH on January 23, 2003, at 19:39:15
In reply to Re: Strattera Allergic Reaction, posted by golfergman on January 23, 2003, at 10:26:10
Hi. Did you know that Strattera is also available in 10mg capsules? Perhaps your doctor could prescribe those instead and increase the dose very, very slowly over many days. Also, don't take it too close to bedtime. This medication is not technically a stimulant. It is more like the antidepressants, and you probably won't feel better for quite a while. That's the way most psychotropic medicines are. Except for the stimulants (amphetamines and ritalin) and a few other meds, most take at least a few weeks at a sufficient dosage to have a positive effect.
Posted by not exactly on January 24, 2003, at 6:57:13
In reply to Re: Strattera Allergic Reaction, posted by golfergman on January 23, 2003, at 10:26:10
> Yesterday I took my first dose of straterra 18mgs. Im 47 year old male and I know this is a very small dose. My first day I would have to say Im rather down about the whole ADD thing. I definetly felt an affect. I felt high as a kite and didnt like it at all. My Dr. wants to start out with small doses for 4 days. My feeling is I dont know if I can handle this. Im not taking it today because it made me edgy, uptight, couldnt sleep at night. In other words I didnt feel good about it. The same thing happened when I tried Ritalin. Does anyone have some insight or similar experiences. I feel rather down about the whole thing. I guess I'll just have to live with this the rest of my life.
I can sympathize with your reaction. You might be hypersensitive to certain kinds of drugs. I know I am - if I start taking almost any psychoactive drug at a "normal" dosage level, it will send me up the wall. I haven't tried Strattera (not yet, anyway, but I may soon - that's why I'm reading the Strattera posts), but I'm definitely hypersensitive to Ritalin. If I took 10 mg of Ritalin 3 times day (a typical adult dosage), I'd be "wired", irritable, unable to sleep, and convinced it was a "bad" drug. But if I take only 1.25 to 2.5 mg (1/4 to 1/2 of the lowest dose "kiddie" pill) twice a day, I have found it to be very beneficial.
One possibility is that you are a "poor metabolizer" of Strattera. According to the prescribing info:
"A fraction of the population (about 7% of Caucasians and 2% of African Americans) are poor metabolizers (PMs) of CYP2D6 metabolized drugs. These individuals have reduced activity in this pathway resulting in 10-fold higher AUCs, 5-fold higher peak plasma concentrations, and slower elimination (plasma half-life of about 24 hours) of atomoxetine compared with people with normal activity [extensive metabolizers (EMs)]."
The 10-times greater AUC ("Area Under Curve" of the graph of level vs. time, a measure of total drug exposure) is an extreme case of "Your Mileage May Vary"! Oddly enough, they don't give any dosing guidelines if this condition is present (or suspected). I would think that you'd need to take 1/5 of the usual amount half as often in order to get the same level of drug activity that "normal" (EM) folks experience. This translates to 8 mg (10 is the smallest cap they make, probably close enough) once a day as the TARGET dosage; a conservative approach would be to start with half that amount and slowly ramp up! So even though your 18 mg is "a very small dose" it could still be way too much FOR YOU.
Given your reaction, skipping the next day's dose was the right move. Have the negative effects worn off yet? If you're feeling OK in a day or 2, here's what I would do:
Open an 18 mg cap and take only 1/4 of the contents (4.5 mg). If the side effects are tolerable (e.g. sleep is possible), continue taking this amount once a day for a few days. Then slowly increase the dose, a tiny bit more every few days, until either you notice a benefit or the side effects are too much.
[Disclaimer: I'm a chemist, not a doctor. I can't guarantee this will help, or even be completely safe. Don't follow this advice if you're not comfortable with it. Talk to your doctor first.]
Remember that the full beneficial effect might take a week or 2 to kick in, while the side effects (especially those resulting from taking too much too soon) will be evident almost immediately and should diminish over time as your body adjusts. But there's always the possibility that this is simply the wrong drug for you - too many side effects for too little benefit, even with a very cautious dosing schedule. Significant side effects that don't improve with time and worsen dramatically with every small dosage increment indicate an allergic reaction or other incompatibility, and the drug should be discontinued.
BTW, I'm concerned by your closing comments: "I feel rather down about the whole thing. I guess I'll just have to live with this the rest of my life." Of course, this sort of pessimism can result from repeated treatment failures. Have you tried numerous ADD medications with no benefit?
But you might also be suffering from depression along with your ADD. I know what this is like - I have both of these problems (plus others). Sometimes depression can diminish concentration & motivation, and hence be mis-diagnosed as ADD. Have you tried any antidepressants? You might find one of the mildly-stimulating antidepressants, such as Wellbutrin or desipramine, to be helpful. Given your reactions to Ritalin & Strattera, I'd recommend that you start with no more than 1/2 the usual dosage.
Good luck, and let us know how you're doing.
- Bob
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Dr. Bob is Robert Hsiung, MD,
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