ADHD Medications - Part III - Atomoxetine (Strattera)
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- เผยแพร่เมื่อ 22 ส.ค. 2024
- The past 10-15 years have witnessed a number of major developments in the medications and delivery systems available for the management of ADHD. Dr. Barkley here discusses the types of medications now available to ADHD management and the various delivery systems developed to extend the effectiveness of the medications across the day. For each medication, he will present the major beneficial effects and side effects. He will also discuss various issues clinicians should consider in selecting particular medications to use with a patient with ADHD, such as those issues related to the social context, the patient’s characteristics, and any comorbid conditions that may exist.
Part III focuses on the non stimulant medication, atomoxetine (Strattera)
Atomoxetine changed my life. I love it! Three years strong 💪
Good news, did it help you academically?
@@amiraheikal193It's sure helping me academically! 😊
I'm no longer so impulsive that I don't follow through with my To Do lists (or any plan, for that matter). I can far more easily organize, self-regulate, and conceptualize the steps needed for long-term plans!
@@amiraheikal193 It can definitely improve focus, 1st time and boom!
@@amiraheikal193Yes, it did help me academically.
No medication works for everyone but after being diagnosed with ASD and ADHD it's been a total game changer for me.
I've already been diagnosed with ADHD but I suspect that I have a high functioning form of ASD on top of that because of my sensitivity to loud noises and weird voice pitch and repetitive movements. Can you describe how your ASD manifests in combination with your ADHD and how atomoxetine helps with that? I would appreciate it a lot.
I’ve been taking atomoxetine, and I’ve noticed my mood has improved dramatically. Even my co workers and family noticed it. Some days but rarely I take two capsules. But it’s rare
Could you telle me what dose did you start with ? And stayed on it for how long?
@@snperchannel3242 I’ve been on it for about 4 months now. 40mg daily, I do take it with nuvigil since I have narcolepsy as well.
Hope that helps. Definitely talk to your doctor and see what works best for you.
With peracitam, atomoxetine will be more effective.
@@snperchannel3242 40mg daily
@@Daddy-cb3qh oh nice, I haven’t looked into it.
I would recommend anyone with ADHD (sp. inattentive-type) and a family history of Alzheimers Dementia look into this. I was prescribed Atomoxetine for my ADHD and eventually noticed a marked improvement in my cognitive functioning which had been declining at an unsettling rate for my age, particularly given a strong family history of AZD.
I started being able to follow conversations again, hold information in my working memory, and retain and retrieve information with an ease that felt "normal". It was subtle and took time to build up, but it was noticeable to myself and others.
Something in my gut told me this could help against dementia and I found out it was already being tested for that with positive indicators (though not reversal).
Good news, how long did it take to see a difference?
@amiraheikal193 It took about 4 months total. 3 months to get to my effective dose (60mg, max for my size), and about one month on that to notice a marked difference. I tapered up very slowly because I was experiencing nausea (taking it with protein/food helps). Good luck!!
I was just prescribed this today. I need to do a two week low dose to see if my body will tolerate it then she’ll raise it to a therapeutic dose 🤞🤞🤞.
My 13 yo’s doc prescribed her methylphenidate and it seems to be slowly helping her. So we’ll see…
Same here. afraid Im getting early Alheimers at 55. Started this med 1 mo ago while it does help I still forget a lot way more than I should but better than it was for sure . At least some things are getting done, before it was a big fat zero
@@gordocarbo stick with it! It takes about 4 weeks to really feel the full benefit after reaching the maximum effective dose, which may vary from 60-100 depending on your size. It may still be subtle, but to your point, some functional benefit is better than none.
Really useful, as an ASD/ADHD combo
What helped me with the slight numbness/ sedation like effect, is taking a cdp choline supplement it also seems to improve it's effect a tiny bit(male , age 37 ; 76ish-kgs ; 80mg dose)
I've just been told I'll be starting titration this month after a long 3 year journey of diagnosis and awaiting treatment (diagnosed at 34). I believe my prescriber has placed me on Atomoxetine due to addiction issues in the past. I'll keep you posted on how it goes. But just so happy to be proceeding with treatment!!! 🎉
Would love to hear how you are going a couple weeks in. I started a few days ago!
Dr. Barkley, I truly admire your work and appreciate experts like you who educate the world about ADHD.
I was on Methyphenidate 10mg, but the wear off and short effectiveness led me to request atomoxetine as an alternative.
Despite your praise for Methylphenidate, my doctor has concerns about potential abuse.
An update, my bladder control is heavily affected by atomoxetine, as I increase the dosage.
The pain and control loss is so severe that I must pause it and reduce the dosage to 18mg daily.
@@BhargavAcharyHow are you doing now?
Thanks for checking, I am still facing the same challenges. Sticking to doctor's recommended dose, and skipping if side effects (urine retention and pain) are on the higher side.
@@BhargavAcharyhola apesar de ese efecto secundario, cómo han sido los efectos sobre tus emociones y la concentración y memoria ?
@@fernandofran2360 It is close to 3 months now with atomoxetine. I had a urine bladder infection because of high urine retention.
Now, I am kind of stable at 18mg dose. I have been diagnosed with Asperger's as well with a significantly high score.
The co-occurrence of ADHD and Asperger's answers more of my questions as to why my life has been a struggle all along.
The overall moods are better, and relationships are better with people. We have a 2+ year-old baby, and my patience in handling her tantrums has increased.
I still need some time to comment on the productivity increase, as I still don't have any significant changes noticeable.
On the memory front, I feel more confident because of reduced anxiety, but there is not much change in the low working memory challenges.
How long does this increase in improvemnt of the symptomes happen? Also for years? And can you maybe do a more deep dive into Atomoxetine and the latest research on it in future? Thanks for the information!
Adderall worked great for me but my doctor took me off it and wanted me to take Strattera but the thing with Strattera is you can't cold turkey it without getting physical withdrawals whereas with Adderall I can cold turkey it with no physical withdrawals I'm just tired for a couple days, I'm not willing to do those kinds of meds anymore been through withdrawals more than once because a doctor decides to take it away or want to change the med to something else or I lost my insurance and couldn't afford the medicine and now they are having a medication shortage so what happens when a person can't get their medicine??? There is going to be ALOT of people going through withdrawals and they can be brutal, I'm not going through that NO MORE!!!!!!!!
Breath of fresh air.
In the instructions for the atomoxetine medication, it says that effects begin to appear between 6 and 8 weeks, other sites say that after 2 or 3 weeks, what is your opinion about it? Another question, the effects are gradual as what are the weeks going by? I would appreciate your answer, thank you very much
Initial results are often evident in 2-3 weeks but max benefits may take longer to be apparent.
If someone is interested in talking to someone who takes it and it helps them - you can ask in the comments, i can tell you about my very positive experience on it
Dr., in your opinion, would Atomoxetine be a better drug than to take than stimulants in case of comorbid anxiety and depression for adults?
I cannot give personal advice. But some studies show that atomextine helps with anxiety more than stimulants. Talk to your prescribing doctor about your concerns.
@@russellbarkleyphd2023hi there and doctor has my Gp or psychiatrist?
Damn I kinda wish I'd started on this instead. My girlfriend says that my emotions are less bubbly when I'm on methylphenidate.
Hello, so I’ve tried Atomoxetin at 85mg-100mg but for me it did the opposite of what I’m trying to achieve which is to help with my inattentiveness. I would get too drowsy to even think and focus with my daily activities and I end up just taking a nap through it. So what would be an ideal dose for an adult to not get the drowsy side effect and actually work for me as intended? The reason why I’m asking it’s because I want to give it another go but this time at a different dosage maybe much lower
Interesting 🧐
Thank you.
Is mixing atomoxetine and amphetamines helpful ? Currently taking sertraline…
Same here, and I'm interested to know the potential route for treatment with minimal medication interactions. I was put on sertraline prior to ADHD diagnosis due to prevalent anxiety/depression, and we were discussing stimulant treatment as opposed to non-stimulant for adult ADHD. I was told that atomoxetine has a lower percent chance of working over a stimulant, but the risks of starting on it and later having to stop taking it are minimal, so moving to a stimulant would be easier than doing the reverse (moving from the stimulant to a non-stimulant). But would there be a situation where taking atomoxetine and a stimulant type medication would be effective at managing symptoms? Or would one always be favored over the other depending on circumstance and never be taken in tandem? How does atomoxetine compare to stimulants in regards to drug interactions?
Yes I take all 3 you listed
I take all 3 as well
No
Dont mix meds let your Dr handle it .Take sertraline and Strattera pretty good combo
Afraid of the hard px stimulants, dont want anything addictive destructive or spiking blood pressure
I was diagnosed with ADHD-PI as an adult, but my symptoms match more closely with Sluggish Cognitive Tempo. Strattera is substantially more effective for me than amphetamines. I was on Strattera for a year or two but ultimately couldn't deal with the side effects. Is there research on the effectiveness of non-stimulants vs. stimulants in treating SCT?
Que efectos secundarios tuviste ?
Would you mind listing the side effects you experienced?
Yes please list your side effects it would be very helpful for people like me who just started taking it.
Yes same here.
I have a question about atomoxetine: is it likely to interact negatively with other SNRIs, specifically venlafaxine?
For my part, I had glossed over some of the literature on the topic, and it seems (and I’m probably incorrect) that venlafaxine increases norepinephrine in the brain stem & hippocampus, whereas atomoxetine increases it in the PFC, &c. Is there a danger in increasing norepinephrine across multiple brain regions in that way? Or are any such drawbacks from using both medications unlikely?
I have not seen research specifically on that problem but in talking to my psychopharmacology colleagues, it would make perfect sense that you should not take both as their mechanism of action is very similar as are the regions of the brain they impact. Taking both essentially is like taking a larger dose of either one and thus increasing the risk for side effects.
Been on both for years. I have seen no problems with the combination.
I strongly suspect I have the CYP2D6 poor metaboliser, I find I experience medication side effects and therapeutic effects really strongly at lower doses than average. When I first tried atomoxetine I was titrated up to 60mg and the doctor I was seeing at the time refused to lower me to 40mg when I said it helped a lot without nearly as many side effects as 60mg. They said it 'wasn't possible' to be helped on 40mg and I either had to stay at 60mg or come off it entirely. Thankfully when I moved cities I found a new doc who was happy to trial 40mg and I've been on it for 4 years! Stimulants gave me too many side effects and exacerbated my anxiety, whereas atomoxetine really helps my anxiety.
Is it useful to combine Atomoxetine with a alpha 2 drug for not increasing bloodpressure and heartrate? (Longterm use, cant take stimmulants due to strong sideeffects)
I've been on bupropion for over 2 months now. Taking 300mg of the extended release and 75mg in the evening. It's definitely helped with my depression and energy levels but i still have issues with focus, mainly with controlling it to be exact. I find I can have moments of focus / clarity but usually not when I need it most ie when I'm working or needing to do important tasks. My psychiatrist has mentioned atomoxetine and I'm just wondering if it can be taken with bupripion and how well that would help with being to control my adhd symptoms.
I take 300mg bupropion and it does not help my ADHD at all. I just take it for depression. I take adderall for adhd
im having the same issues! taking 300mg bupropion and my psychiatrist just started me on atomoxetine yesterday. did you go this route? how has it been if you have?
I stopped Bupropion this year after a few years of no affect on focus. After officially receiving ADHD diagnosis I'm starting Atomoxetine today. Focus isn't the only issue, really hope this helps!
@@coldmattyice Hello! It's been 4 months, any updates on how Atomoxetine has affected your day-to-day?
Prof. Barkley, is taking Strattera as PRN helpful ? For example in exams only.
Thanks Prof.
Probably not, unlike stimulants, it needs to build up over time.
If you have a bowel movement after taking Atomoxetine, does it lose its effect or nothing happens?
No effect on the medication absorption to my knowledge.
Would there ever be a case for a formulation that combines Adderall XR and strattera?
While they can be used together to lower the dose of each and provide a wider range of results, they will not be combined into a single for,ulation as they are made by different companies.
i love you
Dr Lawrence Dunn delays prescriptionw for Straterra fbi alert
Bupropion?
All doctors prescribing this drug should test it on themselves first.
That wouldn't really help, what if they are like me and get zero side effects? Should they assume none of their patients will get them? Better to listen to patients (as well as reading the literature, which often mislead , e.g. saying antidepressants have no withdrawal symptoms)
@@therabbithat you missunderstand, if these soo called doctors are gonna prescribed poison to their patients, who usually are CHILDREN, then the least they can do is poison themselves aswell.
Just because you didnt get any side effects, doesnt take away the fact that this "medicine" is neurotoxic and there are papers on it, but big pharma ignored those scientific studies, because, MONEY
I knew a guy who tested on himself and he told me it was an overwhelming success!!! 10giga joules of more brain power I'm not sure but it sounds like a lot!
He was going door to door, trying to find people to invest in his company! He's so excited he tried to sell me a ton of copper scrap that he found leftover from his experiments.
@@nema151 cap
Um, no. Experts are in agreement that the medications for ADHD are very safe and effective and untreated ADHD has many negative consequences. See the International Consensus Statement on ADHD for references.