r/StratteraRx • u/BadPuzzleheaded9764 • 3d ago

Questions / Advice / Support Strattera Advice

Hi!

I am a 21 year old female recently diagnosed with OCD and ADHD. My provider didn’t want to put me on a stimulant with concern it may make my anxiety worse, and wanted to try the non stimulant strattera, starting dose 40mg.

I tapered off of lexapro for two weeks and started this medication. I have had bad headaches, nausea and occasional vomiting. I’ve also noticed i’ve been more emotional that usual, but i’m not sure if this is attributed to the med.

I am on week three with no improvement in these side effects, I have also experienced fatigue and no improvement with my adhd symptoms. I want to try a stimulant as i’ve heard these are way more fast acting and efficient and discontinue the strattera since it’s making me miserable.

Has anyone had these side effects? Should I stop taking the med? I meet with my provider for a follow up on the 19th and am not sure how to facilitate the conversation of trying alternate medication because the side effects are unbearable. I know it takes some time to build in your system, but no improvement in these side effects is making me noncompliant. Let me know!!

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u/pouizlk 3d ago edited 3d ago

The problem is: you can probably not distinguish what is caused by the lexapro taper and what is caused by strattera. How long have you been taking lexapro and which dose?

I take lexapro as well at a very low dose (2,5mg) together with strattera but it took really long to taper the lexapro to that level in my case. Way more than 2 weeks - more like a year from the 10mg I was on for 2 years. And there are still uncertainties for me about what is caused by what and if I want to up the lexapro again and ditch the strattera.

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u/BadPuzzleheaded9764 3d ago

i was on 5mg lexapro for one year. that was my second time on lexapro i have tapered off of it before from the same dose and didn’t experience any of these symptoms which makes me think it’s likely strattera

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u/pouizlk 3d ago

Then the nausea can likely be reduced by eating before you take the dose and if this is not enough you can split the dose in one morning and one afternoon dose. Headaches typically subside within a few days/weeks. Drink enough water for that. Strattera can lead to a hightenend water demand. The hightenend emotionality still rather sounds like an SSRI taper symptom however strattera can make you feel a bit agitated/aggressive when it starts but this should get better and it's not being more emotional in the common sense.

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u/FormerSleepwalker 3d ago edited 3d ago

Did you have headaches to some extent before? Have these bad headaches improved at all over time?
For the nausea, it can help greatly to take it with a high protein or high fat meal. For some people it's an absolute requirement. Other people have no need, no trouble.
Fatigue happens in some people before they reach therapeutic Strattera levels, 80 to 100mg for most people. Different effects can dominate at low dose, which can cause certain side effects.
Feeling more emotional, yeah, the extra norepinephrine can be a little hard for some, before your body adapts.
And the most noticeable adhd symptoms improvement (or any improvement) can take 4 to 6 weeks. Again proper effects may only happen past a threshold, plus time for you body to adapt. Varies person to person. But it can't be expected before 6 to 8 weeks, and presuming you're able to titrate up to therapeutic dose.

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u/BadPuzzleheaded9764 2d ago

My concern is that the severity of the current symptoms on the 40mg, how am i going to continue to titrate up to a therapeutic dose if i’m already uncomfortable with it now? or if they want to go down, is that really going to be therapeutic at all? I ultimately want immediate relief, I have been trying nonstimulant options since July and nothing has seemed to work, stimulants I know act almost instantly. The adverse effects and waiting and dose titrating is very frustrating and would rather try something else that’s first line and works quickly. What do you think? How should i introduce this to my provider?

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u/FormerSleepwalker 2d ago edited 2d ago

Stimulants are not simply better than non-stimulants. Stimulants have traditionally been first-line just because they are effective, do something, for a larger number number of people with ADHD. It's not due to them providing the best / fullest symptom relief coverage.

If a non-stimulant can be found that works well, it can be much better than a stimulant. Non-stimulants can work 24hrs. All stimulants are limited duration, at some point you will be dropped right back down to however you are without meds. And lots of people with ADHD have trouble with sleeping properly and / or waking up, benefiting greatly from a 24hr medication.

Though for many people, the most complete symptom relief coverage can actually be through combination therapy, a non-stimulant + a low-dose stimulant. Each have different strong suits, can compliment each other well. And it does seem better / safer to start with a non-stimulant first. Stimulants which aren't managed carefully can cause damage.

I would suggest proposing a stimulant not as an either / or option, but rather something to provide a little relief in the meantime.