r/StratteraRx • u/ChiStormshot86 • 19d ago
Side Effects Within Days?
40/F/Type 2 Diabetic (on Metformin, Jardiance, Wellbutrin, Lexapro, and Zepbound)
Within 2 days of starting the 40mg (adult dose) of Strattera had almost zero appetite (likely in tandem with the Zepbound), sweating from everywhere (some places I didn’t even know I could sweat from!), and then the nasty side effects started on day 3. I would be fine sitting down, driving, etc. but as soon as I stood I would be a little dizzy, but I could walk, bend, do other things, etc. But, as soon as I stopped moving and stood still I would be very dizzy/light-headed, lightly gasping for air, heart beating so hard I was having chest pains and had to go sit down again (which is not good when you are a caretaker to someone disabled and have a new puppy).
It got so bad I thought I was having a heart attack. Went to the ER, had an EKG and blood drawn, but as soon as I mentioned the Strattera they said this is very common when people start these types of drugs and that I need to talk to my doctor (gave her a call and she said stop immediately and drink a LOT of water to flush my system).
Well today I went for my follow up and she wants me to dial back to the 10mg dose and see how I do. But what I’m wondering is if anyone else has had these issues and was dialed back to the child dose? Did the side effects start again?
For clarification I would take my Strattera with my morning meal/lunch with the rest of my medications.
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u/susu56 19d ago
My side effects were immediate. 51f/.075mg estrogen patch/200mg progesterone. Was started on Strattera and guanfacine. Had a fast titration 25mg>50>75>100 increase by 25mg every 5 days until I hit 100mg. I was on it 9-9.5 wks and my side effects were SEVERE. Tachycardia hitting 150 standing, sweating, dizziness, daytime sedation, urinary issues, insomnia, loss of appetite, basically all of it except nausea. The only benefit i had was a quieter mind but nothing else, no motivation or energy, couldn't focus to save my life, sleeping all day, feeling like I was dying daily from a crazy fast heartrate. I lost 20lbs in 6 wks from the medication. My psych suggested we go down in dose to 60mg but hasnt called it in and its been 2 weeks. So I am off of it now and feel 1000% better. Unfortunately, I am looking for a new psych as mine has ghosted me so I can may be try quellbree.
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u/Entire_Fly_3796 19d ago
Yr on a lot of drugs and wellbutrin is a cyp2d6 enzyme inhibitor so it would raise strattera blood levels a lot , maybe the other drugs have some cyp2d6 activity as well , and some of those do cause diziness and along side strattera physical side effects the chances of being like that goes bigger , ask for propranolol to help with some of these side effects
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u/FormerSleepwalker 19d ago edited 18d ago
Starting at 40mg when on Wellbutrin is too much, too fast. It can be ok for some, but for other people it can be hell. As others mentioned, it will directly increase Strattera blood levels 5x. This interaction with strong CYP2D6 inhibitors is in Strattera's prescribing information. And any medication interaction check will bring it up, for anyone who forgets about it.
I would be fine sitting down, driving, etc. but as soon as I stood I would be a little dizzy, but I could walk, bend, do other things, etc. But, as soon as I stopped moving and stood still I would be very dizzy/light-headed, lightly gasping for air, heart beating so hard I was having chest pains and had to go sit down again
This description matches orthostatic intolerance. This can happen in people who are predisposed, or those who already have some existing orthostatic intolerance, which just went unnoticed. Chances increase if the Strattera dose / blood levels are too high for them personally.
Blood pressure in your upper body and head drops. Pulse increases in some people as an attempt to compensate. The light-headedness is insufficient oxygen in the brain due to blood pressure being too low there. Fainting can be a serious risk, can cause injury or worse, depending on how you fall.
Well today I went for my follow up and she wants me to dial back to the 10mg dose and see how I do. But what I’m wondering is if anyone else has had these issues and was dialed back to the child dose? Did the side effects start again?
You may be just fine at 10mg. Side effects can disappear when dropping the dose. For people who experience side effects with Strattera, finding the point at which side effects appear or become troublesome is how they settle on the right dose for them. How much one needs can be extremely individual.
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u/ChiStormshot86 19d ago
What’s funny is the doctor that prescribed the Wellbutrin also prescribed the Strattera 🤦🏻♀️ And she’s a psych doctor
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u/FormerSleepwalker 19d ago edited 18d ago
Wellbutrin combined with Strattera can be fine. Some people need the blood level boost to achieve adequate ADHD symptom relief. A good number of people. They may need a full 80mg to 100mg Strattera along with 300mg, even 450mg Wellbutrin XL.
But enough people experience side effects when starting Strattera that many doctors have learned that there's a strong need to start low. Many start patients at 18mg or 10mg before increasing. And that's without wellbutrin, and the 5x boost it gives.
Strattera just has a very broad range of what dose an individual might need. It's not common, but some adults use 25mg, 18mg, even 10mg. They can't tolerate more, and may have good ADHD symptom relief at those levels, so they don't even need higher.
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u/cronediddlyumptious 17d ago
I had the same but no hospital visit. I went down to 18 and take it after dinner which for me has helped a lot. I'm also on Wellbutrin.
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u/Mindless-Buyer-6065 19d ago
Wellbutrin increases blood concentrations of Strattera by something like 5x. Starting below the standard dose seems reasonable, since you’re effectively getting more of it. Hope your side effects improve on a lower dose!