Is that true for anyone that strattera didn't work?

[Raja86]

I m posting my feelings first time about my recently diagnosed mental illness called as ADHD comorbid with depression. I m suffering from depression for at least 14 years but I didn't have idea that more than my depression, an other condition cited above is causing a lot of problems for me like labile emotionally, fatigued easily and feeling pressure sensation in neck. I have been taking strattera along with Remeron 30mg, and Wellbutrin XL 150mg for 25days but I don't know why does my condition not improve?

[STEM_Dad]

Strattera doesn't work for everyone with ADHD. I can remember hearing Dr Russell Barkley saying that it can work for about 70% of people who have ADHD, while stimulants can work for over 90%.

Strattera worked much better for me than Adderall XR did. Wellbutrin works slightly better, because it also treats my anxiety. (I'm still waiting to see if it keeps me from experiencing depression again, like the last three winters. I think I have started experiencing Seasonal Affective Disorder, like my mom does.)

My doctor switched me from Strattera to Wellbutrin, not on both. My pharmacist explained that there is a risk of interaction between the two.

I have done my own research into the two medications. Strattera is a selective norepinephrine reuptake inhibitor (SNRI), while Wellbutrin is a dopamine and norepinephrine reuptake inhibitor (DNRI). So, there's an overlap in how the two work, which I'm sure is why the interaction warning exists.

~~~~~

A nerve will release a neurotransmitter to be received by a neighboring nerve. Then, the transmitting nerve will reabsorb (reuptake) any leftover amount of the neurotransmitter. A reuptake inhibitor delays the reuptake, giving more time for the receiving nerve to absorb the neurotransmitter.

ADHD stimulant medicines work very differently. As dopamine agonists, they increase how much available dopamine is released, to be able for transmission.

Stimulants increase the supply. Reuptake inhibitors prolong the transmission time.

The individual needs of people with ADHD very between us. ADHD is caused by inadequate dopamine, norepinephrine, or both.

It can take months or years of medication trails working closely with a doctor or psychiatrist to find what works best for you, and you might need to make occasional medication changes.

[Raja86 in reply to STEM_Dad]

Thanks a lot dear for deep insight of drugs I m taking.

[STEM_Dad in reply to Raja86]

Have you tried taking a stimulant ADHD medication before? If so, did it help more with your ADHD?

I have read about some people with ADHD who were taking both a stimulant and Wellbutrin. This makes s sense to me, because the stimulant would increase available dopamine and Wellbutrin would delay reuptake of the dopamine.

I'm not a doctor, so I am just basing my opinion on what I could understand about these medications from a layman's perspective.

Aside from that, there are other things that can affect attention which you can address. (The amount needed of each of these will vary by the individual.)

• Getting an adequate amount of sleep

• Balanced nutrition

• Regular exercise

• Managing stress, depression, anxiety

• Meditation &/or mindfulness practices

[Raja86 in reply to STEM_Dad]

I haven't tried stimulant before.

[STEM_Dad in reply to Raja86]

Consider talking to your doctor about it. Your doctor will know your medical history the best and the potential medication interactions.

Things to keep in mind:

Stimulants are controlled substances, because of the potential for abuse or addiction, so it's typical to have to get a prescription for one month at a time.

You didn't mention what country you live in, but where you live will determine what ADHD medications are available options. Some countries are much more strict than others. (I think I've heard that some countries don't allow any stimulant medications to be prescribed.)

• Methylphenidate, aka Ritalin or Concerta, is more widely available.

• Amphetamine based medications, like Adderall or Vyvanse (lisdexamfetamine), and generally more heavily regulated. (These are available in the US, but banned or extremely limited in certain other countries, much moreso than methylphenidate.)

Regardless, many, many research studies have found stimulant medications to be effective at treating a higher percentage of people with ADHD than any of the non-stimulants.

[anna1421]

Hello and thanks for sharing your concerns. Having taken ADHD medication since 2008 (both non-stimulant and stimulant), I can share my opinion and experiences.

I started on Concerta in 2008-9. In 2010 I switched to Strattera, which had mild success for me. In 2012 I got on Vyvanse, which I believe is a wonder drug - I won’t say it cured my ADHD, but there was a high elimination of symptoms and challenges. I was operating and functioning as normally as possible.

In 2018 I developed high blood pressure (I am 53), and Vyvanse was no longer an option. I was put back on Strattera. It was hell for 4 years - I was constantly disorganized and late for work (fired 3x for prolonged tardiness). I had racing thoughts which were very unmanageable. I was operating and functioning far below my intelligence and potential and it was extremely frustrating.

Then in 2022 a miracle happened - my psychiatrist suggested QELBREE (technically a non-stimulant, but it acts like a mild stimulant) and I tried it and am having GOOD SUCCESS with it. Qelbree is a relatively new medication I believe (not sure about this). I have a medium amount of racing thoughts, but can manage them far better than I can on the Strattera. I am semi-organized and am EARLY to work and life activities. My functioning is medium to high level, and my brain isn’t struggling too much to operate.

Given my heart health concerns, Qelbree has become my solution. I would recommend it.

[Raja86 in reply to anna1421]

Qelbree is not available in my country

[STEM_Dad in reply to Raja86]

That's probably because it's so new as an ADHD medication. Strattera was first approved to treat ADHD over 20 years ago, but Qelbree came along only a few years ago.

As far as I know, it's only available in the US and maybe a few other countries, so far. Hopefully it won't be too long before it is available in your country, because at least the first studies done with Qelbree have found it to be more effective at treating ADHD than Strattera (and with fewer side effects) in many people in those studies.

[Strattera worked really well for me, so I wonder if Qelbree would be any better. But I'm happy with my switch to Wellbutrin, so far. Obviously, even the combination of Wellbutrin and Strattera hasn't been effective enough for you.]

[STEM_Dad in reply to anna1421]

Qelbree is much newer, and is technically a selective norepinephrine reuptake inhibitor (SNRI), the same type of medication as Strattera. However, Qelbree has been reported to have less chance of side effects and also reported to be generally more effective for more people than Strattera. (Especially for children and teenagers.)

I'm glad to learn that it's working so well for you.

[PrettyinTeal]

i have used Straterra for many years now. It helps me with emotional lability: It narrows the band of highs and lows to a more managable range. I also use adderall xr for concentration.

Meds - snri and ssris take a while (a few months) to titrate up and only a few days to titrate down if not taken.

Genetic testing- Not everyone absorbs or processess meds the same. There are genetic tests that can identify meds that may be more or less effective.

Specialist- I had a psychiatrist and later a nurse psychiatrist dial in meds and now my general practitioner prescribes. Many GPs know very little about adhd.

Skills- pills without skills is going to only get so far. The two,(meds and therapy) work exponentially together (refer to ncbi for research)

Environment is huge. Birds in water and fish on land cant force their environment to be the right fit does your life, work, environment friendly to the way you think?

Education and Good Therapy can work wonders. It can take a few tries to find a good fit. Good Adhd Coaches can also be helpful AND they cant “treat” the depression and anxiety. The education requirements for adhd coaches are not regulated..certificate can be as little as two weeks (vs 6-7 years for a therapist)

Shout out to the comments below. Sleep, diet, exercise, meditation, skills to manage depression/anxiety symptoms. All necessary for living your best life.

[Raja86 in reply to PrettyinTeal]

Thanks a lot

[Tigger4me]

Hi Raja86, Welcome to the community. You have gotten some great advice STEM_Dad, anna1421 and PrettyinTeal (like your use of the word titrate when talking about these meds, thanks). I have had good results using stimulates to help with attention modification combined with Wellbutrin for better emotional stability. Note my use of the qualifiers "help with" and "better". Although these meds can, and did for me, seem like a cure, I also very much needed the behavioral, sleep, diet and exercise changes I've worked on through the years to try and reduce the long term effects of ADHD. Best wishes for your journey.

[Raja86 in reply to Tigger4me]

Tigger4me Thanks

[Great_Artiste]

11 years ago I tried free samples. I couldn't afford the brand name when that was the only way you could get it. And before I could see if it had any good effect, the side effects were intolerable. Mainly urinary effects. So no, it did not work for me. YMMV

[Raja86 in reply to Great_Artiste]

Thanks for responding.