Reply To: Newly diagnosed, atomoxetine not helping

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Scatterbrain, did your doc give you a reason why he/she chose to start with atomoxetine/Strattera instead of a stimulant?

I asked my psychiatrist what he thought of Strattera, and he explained that it’s a failed antidepressant that happened to have a modest ability to mitigate ADHD symptoms in some people. His experience with it is that it’s generally not as effective and has a low rate of success compared to stimulants. He prescribes it if stimulants don’t work/can’t be tolerated/are refused, so yeah, it’s his last choice.

That said, my psychiatrist’s first choice is Concerta (and methylphenidate in general). He likes starting patients with it because methylphenidate is tolerated a bit better than amphetamines and the extended release format of the Concerta makes for a smooth ride and easy comedown. I was super lucky because Concerta ended up working wonderfully for me (once we found the right dose – 36mg is amazing, but 54mg turned me into a raging bitch with insomnia), so I didn’t have to experiment with a ton of different meds (many people do).

As for non-stimulants, I recently started taking Wellbutrin (bupropion, an NDRI) for seasonal affective disorder. While I was ramping up, my Concerta lapsed and I was running on just the Wellbutrin for a bit. I definitely experienced its weak stimulant effect and didn’t completely fall apart while lapsing (like I’d done in the past). The Wellbutrin has so far been excellent with pretty minimal side effects – I’m no longer tired all the time, motivation is back up, and my mood is much improved. I started feeling it in full at about four weeks, with improvement in energy levels occurring a bit earlier. If the Strattera isn’t cutting it/has bad side effects and you’re not able to try stimulants for whatever reason, you might consider asking your doc about Wellbutrin.