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Has anyone ever taken a combination of Strattera & Adderall?  If so, what kind of results did you have?

 

I would appreciate ANY feedback on this subject - Below is REALLY long, so I wanted to warn you first.  There is a lot of detail about my particular situation, so if you can't read it all i totally understand & would love for you to just answer the above question if you have any experience w/ Strattera & Adderall.  THANKS!!!

 

THE REST OF THE STORY:

 

Strattera/Adderall seems to be the combination that gives me the best results.  Here's the problem:  most of the reading that I've done says that Strattera is virtually non-effective for most people w/ ADHD & my psychiatrist seems to agree with that & continues to encourage "stimulant only" medication management.  The original dr who diagnosed me 5 years ago started me out on 60mg Strattera (I was a college student at the time).  It didn't really help much w/ concentration but made me calmer & less anxious - sort of had an antidepressant affect on me (I had taken Zoloft several years before when my dad died). After taking Strattera for about a month, he added 10mg AdderallXR, and BAMM!!  It was like everything came together for me.  I felt better, did substantially better in school, and I finally felt like the mystery of why I could never seem to keep up in any area of my life had been solved (or atleast things were finally moving in the right direction).

 

The Strattera/AdderallXR combo worked great for almost 2 years.  This is where things get a little hairy.  I got pregnant & had two children back to back, so I was completely off any medication for almost 3 years.  Let's just say, the choas of pregnancy, breastfeeding, & new motherhood in general minus medication is a whole other post in itself, but I digress.  Anyway, when my youngest was four months old, I was in serious need of drugs.  Unfortunately, I no longer had access to my former dr because he was affiliated w/ the university & I had already graduated by this point.  So, after several failed attempts w/ several different doctors (general practitioners) to get the Strattera/Adderall combo back -- because that's what worked in the past, not because I'm some nutty pill popper as the doctors seemed to suspect, I wound up in a new psychiatrist's office.  There's A LOT more to this story that I've vented about in another post - I'll try to find the link for those who want more details instead of elaborating here in order to spare those of you who don't.  (gonna have to get the link for you later - pushed for time)

 

My current doctor, for the most part has been great and has a good bit of experience treating ADHD in adults, although I'm beginning to wonder if I'm the first female w/ ADHD that he's treated.  Again, that's another post.  By the time I got to him, I was so frustrated that I was willing to try anything he suggested.  Well, he really convinced me to begin with the stimulant only approach, being that it is very likely that the Strattera was not doing anything & the good results I had previously had been solely from the AdderallXR.  This approach was also in line w/ everything i had read in my own research.  He also felt that since AdderallXR had worked before, that we should begin with this stimulant.  He started my doses low & increased them gradually.  He had me take notes on my mood/concentration and we discussed this at each appt.  I met w/ him almost 1x per week until we hit the right dose.  At my last appointment, I told him that my concentration was better but I felt irritable & edgy a great deal of the time.  Actually, I mentioned this to him at most of my appts, but he kept insisting that while we were still working out the dosage of the stimulant, it would be to my advantage to be patient & then possibly look at adding something to counter my irritability.

 

So, for about the last 2 months, I've been taking 10mg Generic Adderall (regular, not XR) first thing in the morning, 20mg AdderallXR 3 - 4 hous later, and if I have a really long day or something that requires major concentration, I have the option of taking another 10mg Generic Adderall in the evening.  This seemed to work relatively well for the first month.  When I reported back to my dr after taking this combo for a month, he wanted to leave everything the same for another month.  Well, about a week & a half after my appt. I started to feel awful - very irritable, moody & emotional, & as always, I CAN NOT wake up in the morning. Adderall by itself has not helped at all w/ waking up in the morning. In hindsight, I should have called my dr immediately, but instead I still had almost a full month supply of Strattera (40mg) left that was prescribed from one of the GPs I had seen before being referred to my current psychiatrist, so I just decided to take it & see what happened.  I felt better almost instantly.  I no longer needed the 10mg booster in the morning after taking the Strattera for a week.  A big part of the reason I didn't go back to my psychiatrist had to do w/ money.  I'm spending a fortune trying to get this all worked out, and I'm really broke right now.  I also have been really limited w/babysitter options recently & last time I had to take my 11 month old w/ me which makes it difficult to concentrate during the appt.  I have had to reschedule several drs appts for the last 2 1/2 weeks due to some sitter issues & then my dr has been out of town, so I'm out of Strattera & I have about a week left on the Adderall.  Oh, btw, I was planning to tell him that I took the Strattera even though I agreed to stick w/ Stimulant-only treatment.   Also, when I realized I was running low on Strattera, I gradually weaned myself off of it cause I know stopping it cold turkey can have some negative effects.

 

Now I feel worse than ever.  The last 2 days have been hell. I'm still on the Adderall, but it is not helping w/ concentration (although, as I'm typing this, I think it must be helping more than I think it is cause I'm able to articulate & write everything that's in my brain AND sit still long enough to do it).  But....I'm really moody & impatient.  My kids (who are napping at the moment) are driving me nuts today, and earlier while making lunch, I just felt like everything was coming at me at once - just a very bizarre feelng.  I adore my kids & honestly, considering their ages (1 & 2 1/2) they are pretty easy.  Also, my husband & I had a huge fight yesterday & again this morning, and I could NOT shut up.  I was pretty much just raging on him and couldn't stop myself.  I've been trying to get an appt TODAY w/ my psychiatrist but I haven't been able to get in touch with him.  My husband who is about at his limit with my mood swings kindly volunteered to call the dr for me and explain everything that's going on.  He finally got in touch w/ the psychiatrist & is waiting for him to call back.

 

I'm sorry for such a long post, and even if no one reads it, i think it has helped me just to write it.  The conclusion that I'm coming to is that Adderall-Only does NOT work for me.  Strattera/Adderall combo seems to work great.  I know my psychiatrist is going to suggest that I try another stimulant, and I just don't know that I want to do that right now.  All this experimenting is wearing me out.  I realize that trying different meds is a necessary evil when it comes to treating ADHD, but I just can't do it anymore right now.  If he is not willing to do the Strattera/Adderall combo or possibly another antidepressant instead of the Strattera (but not zoloft - tried that from advice from another dr & it was AWFUL) as I've read this sometimes works well, then I'm going to have to stop the Adderall altogether because these ups & downs make things more difficult than they are w/out medication altogether.  that is of course, unless there's a medical reason not to mix Adderall & Strattera, and I haven't been able to find one.  By the way, I'm very healthy - no blood pressure probs, etc.  I am a little underweight & sometimes have a hard time keeping my weight up on ADHD meds.

 

Any comments are greatly appreciated.  Thanks!!

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I take Adderall XR 20 mg every day and have just in the past month started taking 10 mg first thing in the morning just as you say you do. I really think that helps a lot for me. It is interesting to read about the addition of Strattera and how it helps. Makes me want to try that combo too.

I hope your doctor will listen to you and you have done an experimental approach to know that it works on you. It's not like you're just saying I want to add this. . . a professional had you do it and you now know how it worked well for you. You actually could print your post to tell him everything. If he won't do it, then find another doctor. Strattera is not a stimulant so it isn't like you're seeking more real "drugs". I suspect that a general practitioner may not prescribe both and would leave that for a psychiatrist to do.

It is expensive though you are right. Between monthly MD appointments and medicine and therapist appointments and feeling like you're a sick person because I feel like I'm always at the doctor's office - it's a pain.

I look forward to hearing what happens. Maybe someone else has some experience. Good luck.
Thanks for the response, Susan. Do you take the 10mg in the morning WITH your 20mgXR, or do you take the 10mg, wait a few hours, and then take your 20mgXR? My dr told me to experiment both ways to see what worked better. I think it might work better for me to take it all at once (at least that seems to help w/ my AM groggyness) but that left me with a really bad crash midafternoon. I'm starting to wonder if maybe I need a higher dose in general, but I'm not willing to risk upping it in case it worsens my mood. Just curious how you've handled this.

Also, do you notice any mood swings on the combination you're taking now? Mine is particularly bad the week before I start my period.

Thanks again & that's a great idea about taking this post into him. I've worked w/ a great psychologist who encourages me to write because I seem to be able to communicate better that way. When I talk, my thoughts race too fast & by writing I can go back & make sure what I've said is REALLY what I mean.
I have been taking it separately. I take the 10 mg when I get up about 5:15 or so and then I take the 20 mg XR around 9:00. I haven't done it every day just trying to see if it helps. I used to get up so easily in the mornings - popped out of bed but not since on the meds, I don't. I can hardly get up at all. I oversleep a lot. I think my doctor might've thought I was a drug seeker at first possibly. . . well, I guess he has to have an appropriate suspicion of that, but I keep every appointment and dont come in for extras so I guess I passed he test.

I feel the calm from the Adderall. I don't think it affects my moods really. I am having some things in my life that are difficult right now and that bother me, but I don't think that the Adderall affects it, but I don't know. I know the medicine makes me calmer as I said and it also makes me more talkative and outgoing and less self-conscious. . . it brings me out of my shell.

I also write/type lots. I type my journal and take it to my psychologist to read prior to my appointment. Otherwise I most likely wouldn't even remember anything I wanted to say. All of those thoughts yet I can't remember what I want to/need to say. Needless to say it is why I don't want to speak in class or speak in front of any group. The medicine does help so much though. I would feel bad not to have the medicine again.

My thoughts aren't too coherent right now. My psychologist is great as he reads all of what I write with has been an awful lot. I also kind of get more bang for my buck that way too. I have done a lot of self reflection and I guess it shows I'm motivated. I may just be making up for all of the things I hated to write.

I love to write my journal now but still don't like to write stuff for work - reports, etc. Oh, I am totally not focusing my thoughts right now because I am jumping around but I am so tired I'm not surprised. . . getting ready in the morning must be the most boring thing in the world as I have the hardest time holding still and staying in one place a lot of days. I think the 10 mg first thing helps with that a little. . . make up and fixing hair every day are boring.

Gotta go for now. Past time for bed. I have to go out of town in the AM and I'm not finished packing or making my nephews graduation card - yikes!

Jen said:
Thanks for the response, Susan. Do you take the 10mg in the morning WITH your 20mgXR, or do you take the 10mg, wait a few hours, and then take your 20mgXR? My dr told me to experiment both ways to see what worked better. I think it might work better for me to take it all at once (at least that seems to help w/ my AM groggyness) but that left me with a really bad crash midafternoon. I'm starting to wonder if maybe I need a higher dose in general, but I'm not willing to risk upping it in case it worsens my mood. Just curious how you've handled this.

Also, do you notice any mood swings on the combination you're taking now? Mine is particularly bad the week before I start my period.

Thanks again & that's a great idea about taking this post into him. I've worked w/ a great psychologist who encourages me to write because I seem to be able to communicate better that way. When I talk, my thoughts race too fast & by writing I can go back & make sure what I've said is REALLY what I mean.
OK, I'm on my way to bed, too, but when I read this I had to respond - quickly, that is. :-)

I've also noticed that my ability to get up in the morning is SO much worse when I'm only taking Adderall. Interestingly, I've heard others say that it HELPS them get up. I think I sleep much better on Adderall, but I have a difficult time getting in the bed - like right now. Just like you, Adderall has a very calming effect on me. I just run into problems when it's wearing off - the ADHD symptoms become worse than when I'm not on medication at all.

My husband who also has ADHD (more inattentive rather that Hyper/inattentive, which is what I am) has a theory about why Strattera doesn't work for most people w/ ADHD, and although I'm more the researcher, I think he might be onto something. Well, at least this was what he found to be the case for him. The first medication he ever took for ADHD was Adderall (reg not XR) & he immediately noticed a profound difference - as do most who take stimulants. They're pretty instant. In hindsight, his dose was increased WAY too quickly & he has since started the adderall again & has had no problem, but the first go around he was so angry all the time that I pretty much told him to get off the Adderall or I was leaving. Well, then his dr prescribed Strattera for him to try. I thought he was much more pleasant to be around on the Strattera, but after taking a stimulant, HE felt like the Strattera did absolutely nothing for him. So, his theory is that since many people w/ ADHD are impatient (personally, I've found this to be the case more w/ ADHD men than w/ ADHD women) they notice & like the instant results they get w/ stimulants, but w/ Strattera, by the time it takes effect, the ADHD person is already frustrated & ready to move onto something that works better.

Thanks for your input - enjoy your weekend. I've also got LOTS to do tomorrow, so I'm heading to bed

Susan said:
I have been taking it separately. I take the 10 mg when I get up about 5:15 or so and then I take the 20 mg XR around 9:00. I haven't done it every day just trying to see if it helps. I used to get up so easily in the mornings - popped out of bed but not since on the meds, I don't. I can hardly get up at all. I oversleep a lot. I think my doctor might've thought I was a drug seeker at first possibly. . . well, I guess he has to have an appropriate suspicion of that, but I keep every appointment and dont come in for extras so I guess I passed he test.

I feel the calm from the Adderall. I don't think it affects my moods really. I am having some things in my life that are difficult right now and that bother me, but I don't think that the Adderall affects it, but I don't know. I know the medicine makes me calmer as I said and it also makes me more talkative and outgoing and less self-conscious. . . it brings me out of my shell.

I also write/type lots. I type my journal and take it to my psychologist to read prior to my appointment. Otherwise I most likely wouldn't even remember anything I wanted to say. All of those thoughts yet I can't remember what I want to/need to say. Needless to say it is why I don't want to speak in class or speak in front of any group. The medicine does help so much though. I would feel bad not to have the medicine again.

My thoughts aren't too coherent right now. My psychologist is great as he reads all of what I write with has been an awful lot. I also kind of get more bang for my buck that way too. I have done a lot of self reflection and I guess it shows I'm motivated. I may just be making up for all of the things I hated to write.

I love to write my journal now but still don't like to write stuff for work - reports, etc. Oh, I am totally not focusing my thoughts right now because I am jumping around but I am so tired I'm not surprised. . . getting ready in the morning must be the most boring thing in the world as I have the hardest time holding still and staying in one place a lot of days. I think the 10 mg first thing helps with that a little. . . make up and fixing hair every day are boring.

Gotta go for now. Past time for bed. I have to go out of town in the AM and I'm not finished packing or making my nephews graduation card - yikes!

Jen said:
Thanks for the response, Susan. Do you take the 10mg in the morning WITH your 20mgXR, or do you take the 10mg, wait a few hours, and then take your 20mgXR? My dr told me to experiment both ways to see what worked better. I think it might work better for me to take it all at once (at least that seems to help w/ my AM groggyness) but that left me with a really bad crash midafternoon. I'm starting to wonder if maybe I need a higher dose in general, but I'm not willing to risk upping it in case it worsens my mood. Just curious how you've handled this.

Also, do you notice any mood swings on the combination you're taking now? Mine is particularly bad the week before I start my period.

Thanks again & that's a great idea about taking this post into him. I've worked w/ a great psychologist who encourages me to write because I seem to be able to communicate better that way. When I talk, my thoughts race too fast & by writing I can go back & make sure what I've said is REALLY what I mean.
Jen, I am so sorry that you are having this battle with meds, especially since you have found something that works for you and yet can't convince the doctor to administer it. I have experienced exactly the opposite problem with the doctor I have presently. He seems to be opposed to stimulant meds altogether, but then I think I am still seeing him more for sheer convenience at this time because I question the extent of his knowledge of ADHD (which is a completely OT and unbeleivable story for later reference, which you can remind me about if you want to).

Nonetheless, I seem to be the only person on the planet for whom strattera is somewhat effective. The only way I can tell that it helps me, however, is when I read one of the stories such as yours which reminds me of how I once was. Now, on a scale of 1 to 10 I might consider myself a 2 - I still have all of the symptoms, but perhaps I am merely managing them better now.

I have often thought that perhaps the mild anti-depressant effect of Strattera is actually the solereason that it helps me to function better, as you suggested, and that perhaps it just helps me to feel just well enough to deal with the symptoms somewhat more effectively. In the past I recall that I always seemed to have a vaque sadness which had no direct connection to anything in particular. With my first dose of strattera, I was amazed to have a distinct feeling that that lifelong fog began to clear and that that lingering pervasive melencholy mood seemed to fade. With each additional step up in dosage I experienced increasing relief that I could grasp what was going on just a little better each time, and even felt a little dissappointed when I finally reached the optimum level for my wieight. My doctor at that time was wonderfully encouraging and obviously happy for me, but she wouldn't allow me to go past the dosage of 80mg as at the time 100mg was the max and I weighed just over 100 lb.

Adderall magicly woke me up but along with the hyper-alertness came the jitters - which I absolutely hated. So, my dr. was pleased as much as I was that there existed an alternative.
After hearing your report about the strattera/ aderall combo, I am rather intriqued to try it myself, but I, too would get nowhere with my present Dr. Jen, I would look around for another DR., which is not a pleasant prospect, I know, but I am hoping and praying you will find one who will listen to you and allow you to suggest the regimin that was so sucessful for you. (Like you, I lost a very understanding psychiatrist with whom I had a great rapport because she was military and finished her internship. Since then I have found myself chooosing the lesser of two evils.)
Just a thought on your comment about there possibly being a medical reason not to use Adderall and Strattera together. Whenever you have ANY question about ANY medication, the best person to ask is your pharmacist. They have a strong educational background in medications, and there isn't much they don't know about mixing certain meds together. In fact, your pharmacist will know this kind of information much better than your doctor will. My pharmacist has pointed out potential problems concerning taking certain meds simultaneously. I call him whenever I want or need to know this type of information. And he's way easier to get ahold of than my doctor. I can talk to him direct on the phone or cruise into the pharmacy and he's always available. Plus, I don't need to make an appointment!!
You know I completely understand you. Sometimes doctors forget that we know our bodies best and if you have to become extremely persistent and annoying until he gets it then so be it. I was taking wellbutrin before concerta and did wonders for my anxiety and depression and every morning I would wake up with a ton of energy and just felt happy but it didn't help enough with the focus so they changed it but I would bring it up to your doc because some doctors do use it for ADD. I don't think Wellbutrin can be mixed with stimulants but Ive heard of a few people that say they were prescribed both so def ask your doc about it. Also there are things like Effexor that may help the anxiety and depression and can also take with your stimulants that your doctor is so in love with. Good luck and keep me posted.
Jen, I remember that when my son switched from Adderall to Strattera, his Dr. kept him on the two meds together for at least two weeks (but I am thinking it was perhaps more like 30 days), mainly because Strattera must build itself up in the body to the ideal level, which can take that amount of time. But I recall being rather alarmed that the Dr. would not want to remove the adderall instead of overlapping the two meds. Since then, I have also talked to moms with kids for whom the Drs. did the same. Obviously the two can be effective together, because there were no ill effects.

I know firsthand that the Adderall allowed me to remain focused from the instant I swallowed it, so much so that I used to set aside my paperwork until I could take a fresh dose of adderall or I could not complete it at all. I have noticed there is no such drastic change for me or my son with the Strattera. I really would love to find someone who would try combining them because the Adderall was too intense whereas the Strattera is somewhat calming but doesn't appear to help attention span. It sounds like the best of both worlds.
Thanks for all the input,

Pat, that's a really good idea about talking to the pharmacist. I haven't done so yet, but I am definitely going to ask whether she knows of any reason to not take these two together. Perhaps there's been some new research on mixing the two meds, but I'm not too concerned because in '06 the first doctor I ever saw for ADHD treatment used these two drugs together. He was actually a psychologist who specialized in pharmocology & in treating ADHD. He had a great little partnership w/ a medical doctor at the university I was attending. I saw the psychologist 1x per month & he would discuss how the meds were working, etc & then adjust accordingly. He would then send me w/a note to the health center where they would monitor my b/p, weight, etc & give me the actual prescription. I might have seen the actual MD once or twice, but usually it was just the nurse & she would have the dr sign my prescription. It was SO easy, and in hindsight, I guess I took this good, simple system/treatment for granted.

Jo, it's interesting to hear that Strattera helps you, too. From everything you said, it sounds like that separately, the Strattera & the Adderall affect you & I very similarly. Perhaps you would also find good results from a combo of the two. I know what you mean about dealing w/ a dr who doesn't like prescribing stimulants. I have been through about 4 different drs who are the same way. It's ironic that the psychiatrist I'm seeing now PREFERS stimulant-only treatment for ADHD. Before I found him, my other doctors would only prescribe Strattera for adults w/ADHD, but in my case, they all really pushed for me to test different anti-depressants. Even though I provided records from my psychologist stating that I had been diagnosed w/ADHD, they all seemed to think I suffered from depression. I mean, I do struggle w/ minor depression & anxiety & before I was diagnosed w/ ADHD it was much worse, but the ADHD seemed to be the missing puzzle piece & once it was treated, the depression & anxiety improved tremendously. I really think that these other drs would take one look at me (a fairly new mom w/ 2 babies) and were quick to assume that I had post-partum depression. It seems like that doctors who don't have much experience treating ADHD can't fathom that an adult female actually has it. they still only think it's something only seen in kids, particularly boys.

I think this psychiatrist will be willing to work w/ me, but I'm realizing that I'm going to have to be a little bit pushier about what I now know is right for me. The reason I say this is that during my first appt w/ him, after taking my history, he laid out his plan in a very scientific way. He said, "My hunch is that the Adderall (stimulant) is giving you the most effective results, not the Strattera/Adderall combination. So, I would like to test this approach. I want to wean you off the Strattera (this was all I was taking when i first went to him) completely, and then start the Adderall & increase it gradually. We already have an idea of where you are w/Strattera only, so I think we need to get to the correct dose w/ the Adderall & my guess is that once we do that, you won't need the Strattera at all."

Now, looking back at that initial consult, he was so confident that the Adderall only was going to work that I really believed he was right. AND, I was so relieved to finally have an appt w/a dr who seemed to have some knowledge of and experience in treating ADHD, and I was grateful that he actually had an approach, because the GPs I had seen really didn't seem to. However, two months later, I think I've given this approach a good try, and I now know that it's not really working & I need to push for something else. I'm just afraid that he's going to try to convince me to try a different stimulant, and while that might be a good idea, I'm at a point where I can't do trial & error - atleast not right now. Plus, this is all very expensive & time-consuming. And quite frankly, I'm short on time & money these days.

All this writing about this has definitely helped me clarify my goals. Thanks for all the input, Ladies. I'll let you know how it goes. Hopefully I can get an appt. this week.



jo elleman said:
Jen, I remember that when my son switched from Adderall to Strattera, his Dr. kept him on the two meds together for at least two weeks (but I am thinking it was perhaps more like 30 days), mainly because Strattera must build itself up in the body to the ideal level, which can take that amount of time. But I recall being rather alarmed that the Dr. would not want to remove the adderall instead of overlapping the two meds. Since then, I have also talked to moms with kids for whom the Drs. did the same. Obviously the two can be effective together, because there were no ill effects.

I know firsthand that the Adderall allowed me to remain focused from the instant I swallowed it, so much so that I used to set aside my paperwork until I could take a fresh dose of adderall or I could not complete it at all. I have noticed there is no such drastic change for me or my son with the Strattera. I really would love to find someone who would try combining them because the Adderall was too intense whereas the Strattera is somewhat calming but doesn't appear to help attention span. It sounds like the best of both worlds.

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