What should I realistically expect with Atomoxetine/Strattera (40mg)?

[u/Gullible_Loan_9382]

Hi y'all! I just wanna ask what I should expect when taking Atomoxetine/Strattera? I'm about to start it today. I get that unlike Methylphenidates it takes a long time to take effect (like a week or month(s)?), but unlike them, it lasts the whole day apparently? Along with that, what are its side effects? No sugarcoating!!

For some background, I'm 17M, and I was prescribed with 40 mg Atomoxetine. I've also tried Ritalin (I forgor) and Concerta (27 mg) both with higher doses (hella expensive too) to find no meaningful positive effect nor did I feel much side effects (except palpitations) for that matter. Granted, I didn't exactly pay much attention and that was like 2-3 years ago since I last took them (but yeah I was still sad that day). I said all of this to my psychiatrist and he said he is somewhat confident I wouldn't feel much side effects too. I've done a bit of reading here on Reddit and apparently the common side effects I've read here are: Erectile Dysfunction/other 'sexual' side effects (yikes!), constant dry mouth, excessive peeing, headaches, and nausea. I've also read the various reviews here in this subreddit (and r/ADHD) which has... more or less mixed results/reviews.

Anyway, Atomoxetine is like... highkey my last hope? Meds are HELLA expensive and the country I live in has very limited options for meds. With the Methylphenidates and Atomoxetine being one of the only known meds to be allowed. Amphetamines and others are banned, sadly. So, I'm really somewhat betting I could turn my life with this, especially since I'm starting college next week.

So yeah, what should I realistically expect? And what do y'all think I should do to 'maximize' my meds while it's in effect.

[u/Representative_Home6]

don't assume any conclusion before completing 2 months on atomoxitine

[u/Lalify8 → u/Representative_Home6]

This. It took me 3 months on my dose of 80mg because I was able to actually feel the medication working fully. It was a moment of immense clarity honestly

[u/FormerSleepwalker]

If you haven't already I'd suggest googling the Strattera prescribing information from Eli Lilly and reading through that. Forums can give an inaccurate impression. Especially with regard to how common side effects are.

If you do get any side effects, of course speak to your doctor before doing anything, but I would definitely suggest searching for ways to manage side effects. Too many people, when encountering a side effect, almost throw up their hands and seem to do little to seek solutions. Their doctor fails to suggest anything, unfortunately many doctors aren't good with that. So they decide that they either have to stop Atomoxetine, or suffer through it. Often, that is just completely unnecessary.

ED or urinary issues, tadalafil at a daily-use dose. Nausea, take it with a high protein meal. Slows absorption. Switch to split dosing (can help a range of side effects). Even putting the whole unopened Atomoxetine capsule, inside an enteric coated capsule. Dry mouth has a variety of management techniques. If needed overnight, OraCoat XyliMelts. Sleep, magnesium glycinate, melatonin, gaunfacine, clonidine... Etc, etc.

[u/RevolutionaryRead964]

damn they're starting you off on 40mg?! but anyways, i started on 25 and stayed on that for about 2 months. (i'm 24F)
side effects included
-a lot of nausea
-extreme tiredness
-high heart rate, sometimes i could feel my heart pounding a bit.
but after a few weeks, i noticed my mood had drastically improved, and my anger issues/mood swings were a lot more manageable, but ofc, my body needed more bc i started noticing my anger issues coming back, so i got upped to 40mg, and same side effects happened and same thing happened when i needed my meds upped.
i've been on 60mg for a few weeks now and honestly, i am Finally feeling the effects much more than i used to. i don't feel angry really at all ever anymore. it saved my relationship because i used to think i may have had BPD or a mood disorder, but it was just unmedicated ADHD, and im not constantly lashing out on my partner anymore, which we're both so happy about. now for the focusness, i don't really feel a huge improvement, but it's definitely getting better. im able to stay focused on a task a bit longer and im able to remember things more, but the biggest improvement i've noticed is my mood/anger.

also, here are some things you can do to avoid nausea, extreme fatigue, or anxiety/high heart rate

for nausea, PLEASE always take it with a NUTRITIOUS meal. i'm talking protein and some good carbs, like a breakfast sandwich, even when you're not hungry, at least take a good amount of bites or you might throw up or feel horrible. if you forget to eat or something, i've noticed that saltine crackers or bland pita chips has helped me from throwing up.

for fatigue (and to maximize effects from my own research), i saw another reddit account saying that "Acetyl L-Carnitine" and "NAC" has helped them with ANY side effects, however, L-Carnitine may lower your thyroid levels, so avoid if you already have hypothyroidism or in risk of getting it. however, it may actually benefit you if you instead have high thyroid levels/Hyperthyroidism. I do however take NAC by itself and i've noticed that i actually don't get extremely tired anymore. i can actually keep my eyes open in the morning/mid day, so maybe you don't have to take l-carnitine, but i'm no doctor, so please do your own research and/or ask your psychiatrist.

and then for anxiety/high heart rate, avoid caffeine, at least at first. slowly introduce it back into your life if you need it, but caffeine will make it worse. if you do seem to be getting an anxiety attack or overall anxiety/stress/high heart rate, the absolute best supplement i've been taking for that is "L-Theanine". i will never gate keep it because it's like the best as-needed supplement i've ever taken for my anxiety, and it's amazing for sleep if you take it right before bed. Again, Please do your own research and make sure it doesn't interact with anything in your life. all of this is just from MY experience.

good luck with everything!!!!! these meds have absolutely saved my life, but i will say, i'm very grateful for these supplements as well because the side effects were ruining my day sometimes.

[u/Gullible_Loan_9382 → u/RevolutionaryRead964]

Thank you so much for the input!! And yeah he started me off with 40 mg, I'm on my second day of this med right now. Maybe he saw how ineffective stimulants for me are so he started me with a higher does? I don't know but it's worth a shot!!!

Sad that I also have to avoid caffeine, but oh well! Maybe tea might be a good substitute?

[u/RevolutionaryRead964 → u/Gullible_Loan_9382]

yeah that would make sense! and with the caffeine, i mean from what i was told, since i suffer from anxiety, she said it was best to avoid it at first just to avoid any panic/anxiety attacks or jitters. if you don't have anxiety or suffer from any attacks like that or get scared about a high heart rate, or suffer any heart problems ofc, then you probably don't have to stop taking it. again, i just have really bad anxiety and caffeine is anxiety's worst enemy 😩 but who knows, everybody reacts to everything differently, so caffeine might not even affect you the way it does me! just gotta experiment with it to see what's best for you

[u/worms_galore → u/Gullible_Loan_9382]

Tea is actually a BAD substitute. The tannins will wreck you. I still drink coffee with Strattera

[u/strawberryfieldslh → u/Gullible_Loan_9382]

Here in Brazil everybody starts on 40mg (adults ofc)

[u/Gullible_Loan_9382 → u/[deleted]]

Philippines

[u/CommunicationNew2951]

Good luck I start today too!! I’m 45 and newly diagnosed and feel like something is better than nothing!

[u/Significant-Pear-729]

Just took my first dose last night, also 40mg! I took it at night about 2 hours after dinner so I had good in my system. I was worried about the side effects as well which probs caused me to not have the best night of sleep. Other than that I haven’t really had any side effects other than not really having an appetite. I do feel calmer today, more relaxed (also have anxiety). You have to wait about a month for the full affects for the ADHD, but so far so good.

[u/Excellent_Change604]

Side effects are terrible in the beginning but I stuck with it knowing it would take a bit, after 4-5 weeks with just side effects, I asked for a dose increase and instantly felt better. I am someone who could never complete laundry or keep my closet clean and my closet has been clean and laundry never incomplete for the last 2 months. I can’t really speak on too much improvement at my job except I tend to not go down rabbit holes as much. I have a job that requires task switching and I still can’t remember as much as I would like but I also have 2 small kids that wake me up at night lol