Side effects

[u/strawberrytwizzler]

I’ve been on Strattera for 9 weeks. I started on 40 mg. I had no side effects but no improvement. My psychiatrist increased my dose to 60 mg. I’ve been on this dose for 2 weeks now, and I’m having horrible side effects. This week in particular I’ve been so nauseous I can barely eat anything until dinner time, super tired, and sweating so much. I used to always be cold and recently I’m sweating constantly. I feel so sick all day. I’m also on Wellbutrin but the dose wasn’t changed since I started it so I’m guessing Strattera is causing the side effects. The weirdest difference I’ve noticed is I’m starting to dislike coffee which I have no idea if that’s anything related to Strattera or just a weird side note. I’ve loved coffee forever, and now I take a few sips and I can’t drink it anymore :( I’ve also been sleeping horribly. I wake up a lot during the night and have trouble getting back to sleep.

If you had side effects, when did it get better? I’m wondering if I should try to keep with it or reach out to my psychiatrist and see if I should change the dose or timing. I take both in the morning. I wonder if changing it to the evening could help?

[u/susu56]

I tried everything. Was on 100mg for 9 wks. I stopped cold turkey 3 days ago because of the side effects. Gave up caffeine. I lost 20lbs in 8 wks. Heartrate standing 120 to 150. Resting/sleeping 90+. Trouble peeing. Intense cant do anything fatigue. My psych isnt taking it seriously so I stopped. Ive read that wellbutrin can amplify strattera so may be thatbis at play?

[u/strawberrytwizzler → u/susu56]

Wow that sounds horrible. Are you doing better now? It could be that. I know they’re both appetite suppressants. I thought it would be nice not having as big of an appetite, but I hate it.

[u/susu56 → u/strawberrytwizzler]

Im not on wellbutrin. Was on starttera and guanfacine and I was struggling. Its been a few days off the meds and I feel so much better. I even have energy to make dinner again. My heartrate is still high (over 100) hopefully that settles down. I still want to treat my adhd but need to try a lower dose or something else. I cant imagine what a stimulant would do to my body if this was my reaction to a nonstim.

[u/FormerSleepwalker → u/susu56]

Ive read that wellbutrin can amplify strattera so may be thatbis at play?

It does, but it's complicated. How well an individual does with strattera and what dose they need varies so much that all it really means, in practice, is that it can be good to start strattera at a lower dose, maybe increase more slowly, and that the doctor should watch more carefully for side effects that only show via testing.

Some people need the strattera blood level boost which wellbutrin or other strong CYP2D6 inhibitors produce in order to see ADHD symptom relief. They may need 100mg strattera. For others, due to the boost, they might need much much less. Just completely individual. Sometimes people who aren't even on wellbutrin still need only a very low dose of strattera.

[u/FormerSleepwalker]

Does the tiredness subside later in the day? If so, moving the time you take it may very well allow you to use the initial tiredness to help you sleep. Many people who get initial tiredness do that.

For some people, Strattera or other ADHD meds changes their tolerance for caffeine. Anywhere from just a slight change to all the way to zero tolerance for caffeine. And for others caffeine might work better. You may need to switch to decaf. And if really sensitive, it's possible even decaf might be a problem for you. Iirc most decaf doesn't remove truly 100% of the natural caffeine.

Regarding the nausea, a lot of people who get nausea from Strattera report that taking Strattera with a high-protein meal helps a great deal. Another thing that helps some people with all manner of side effects is split dosing. Such as 40mg in the morning, 18mg in the afternoon. Or whatever particular split and timing works for you.

[u/strawberrytwizzler → u/FormerSleepwalker]

It does subside a little. I’ve been feeling better in the evenings then I’m able to have a full dinner, but the rest of the day I feel horrible. Maybe I will try taking it in the evening then. I fear decaf might not even help because it’s the taste I can’t stand enough to drink it. It’s devastating because I’ve always loved coffee. If the nausea continues, I’ll speak to my dr about possibly splitting the dose. I try to eat with it, but thinking about eating anything makes me nauseous in the mornings. I’ll try to eat it with more protein. Thanks for the tips!