Newly diagnosed, atomoxetine not helping

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    • #109721
      Scatterbrain
      Participant

      Hi. I’m recently diagnosed with ADHD at 45. Just finishing up my first month of daily 80mg atomoxetine. I’m trying to give it a good try, but I don’t think it’s really doing anything. I’m slightly less hyper, but that’s about it. The only positive is being able to remember big chunks of dreams in the morning, which I like. And the negatives (cotton mouth, daytime sluggishness, poor sleep, irritability) aren’t really an equal tradeoff. I realize they’re not miracle pills, but I think I should feel some main symptom relief (brain fog, lack of concentration). I’ve pushed up my next appointment to have a chat about the situation. I’m paying for them myself so I feel like I’m wasting money right now. The pharmacist said I should stop taking them. Has anyone had a similar experience? If so what did you try next? I’m not on, nor have I ever been on anything stronger than penicillin when I was a kid. I’m also in pretty good shape and have no other health issues. And, as you can tell, I enjoy a good ramble.

    • #109728
      Angelacawein
      Participant

      I took it years ago for about 8 months. It did nothing for me but make me have to go to the bathroom every 30 minutes and made me more hyper. They say it is non-addictive but after I quit taking it. I had bad headaches and the shakes. I believe that lasted for a week, maybe less. My doctor told me that she had other patients complain about the bathroom thing and affects the kidneys. My son was on it too and did the same thing. I tried Ritalin, Dexedrine, Adderall and Desoxyn. I was on Desoxyn for almost 4 years, then insurance wouldn’t pay for it anymore. I have been on Adderall XR now for about 7 years. I can’t live without it. The difference with and without medication is like day or night. I thought how can medication really help me, I was 35 when I was diagnosed. This was after 3 of my boys had been and medicated. I wish I would have been medicated when I was in grade school.

    • #109803
      Penny Williams
      Keymaster

      Straterra can take 4-8 weeks to see full results.

      Atomoxetine Hydrochloride

      Non-stimulants don’t work for the majority though, so it may simply not be the right medication for you.

      Penny
      ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism

    • #109810
      Scatterbrain
      Participant

      Yep. I’ve researched a bunch and read it can take a while, that’s why I’m riding it out till the Dr. visit, even though everyone is telling me to stop. I figured if it was working there would be small improvements until it hit full potency. But as of five weeks in I am now only having side effects. I am new to this world so I appreciate all the info and personal experiences.

    • #109833
      Fluttermind
      Participant

      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.

    • #109840
      Scatterbrain
      Participant

      I’m not sure why. She said it’s what she usually prescribes first. Maybe because it’s a stimulant? Stimulants have a stigma with some doctors from what I’ve heard from other people. I know someone who’s new doctor refused his prescription for vyvanse for that reason. And this is funny, when I filled the first prescription the pharmacist didn’t have any atomoxetine, he said he hasn’t had any in a while and had to order it.
      I have a good tolerance for stims so I will see what she thinks I should try next. I have a family member that takes Wellbutrin with Foquest, which is also a methylphenidate. Who knew that fixing something as simple as the human brain would be so complicated! Of course I kid. Thanks for the input.

    • #109841
      Fluttermind
      Participant

      Yeah, I’m aware of the stimulant stigma, and the “silly grownup, Ritalin is for kids” attitude. When I started suspecting I had ADHD (was diagnosed as an adult), I heard tons of horror stories about doctors (including psychiatrists) not believing in adult ADHD and/or thinking that stimulants are the devil and such, new doctors not continuing prescriptions or even accepting an established ADHD diagnosis, and more. I wanted to avoid that and was able to find a good psychiatrist via word of mouth recommendation. This guy is worth his weight in gold – he understands the insidious nature of ADHD (I suspect he has it himself), isn’t cagey about stimulants, does appointments over the phone, and takes me seriously and has never treated me like a drug seeker.

      If I were in your shoes, I would explain to the doc that the atomoxetine isn’t working out and that the side effects are unacceptable (tiredness and brain fog on top of ADHD? That sounds miserable, and like a good recipe for getting written up/fired if it persists). Hopefully she’ll let you try a stimulant next. Also, is she a GP or psychiatrist? If GP, you also might want to ask for a referal to a psychiatrist.

    • #109892
      Scatterbrain
      Participant

      I’m not sure how the diagnosis process usually works. The whole thing was bordering on accusatory. After a while I was thinking, maybe I don’t have it and I’m just dumb. It wasn’t enjoyable that’s for sure.
      She’s a gp. I’ve been told to do as you suggested with the referral to a psychiatrist if it doesn’t work out. I’ve bumped my follow up by two weeks to get it sorted. I’ll be tossing the rest of these in the trash after my Appt.

    • #109896
      Fluttermind
      Participant

      That doesn’t sound pleasant. I never got the accusation vibe during diagnosis, but I got it a bit from my parents because to the uninformed, ADHD looks an awful lot like character flaws/moral failing/plain old laziness, and seeking a diagnosis then looks like finding a cop-out excuse for sucking at everything and not just trying harder.

      Anyhow, as for how diagnosis works, it seems to vary a lot. In my case, I went straight to the psychiatrist with my concerns, and during the first appointment, I shared past medical records/evaluations that had noted behavior/socialization issues as a kid and teenager, and discussed my turbulent academic career and past and current symptoms. He diagnosed me in half an hour, saying I was a poster case for a girl with inattentive ADHD, and it was appalling it hadn’t been identified earlier. I would think that without the old records to back me up, it would have involved more questioning and symptom discussion. I was then sent to my GP to be examined for fitness for taking stimulant meds, and after the all clear, returned to the psychiatrist and got the prescription.

      From what I’ve heard, that seems be kind of middle of the road for diagnostic process. Some folks have had it as easy as going to the doc and whining about not being able to concentrate and walking out with a stimulant prescription (this is how lots of students who may or may not actually have ADHD get their study drugs, and make actual ADHD sufferers look like frauds to the deniers). On the other end of the spectrum, you could be subjected to an involved (and expensive) evaluation process that includes stuff like a long multiple choice test about all your symptoms and then interviews with/questionnaires filled out by family members and current or former teachers. Sometimes you might get diagnosed in an indirect way. For example, my MIL was diagnosed by a neurologist – she had hit a stressful point in her career and had become extremely forgetful and unfocused, so we feared the worst and she got an evaluation for early-onset Alzheimer’s, which identified the long-undiagnosed ADHD that had finally overpowered her coping mechanisms, and found no sign of Alzheimer’s.

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