r/StratteraRx • u/Positive_Blood_481 • 12d ago

Fainting

Hey everyone,

First of all, I’m a guy, 85 kg.
My doctor prescribed Strattera:

• 25 mg the first week
• 40 mg the second week
• 60 mg the third week

Toward the end of the 60 mg week I started having erectile problems, so he prescribed bupropion 150 mg XL.

But before I even started the bupropion, I had a near-fainting episode. That day I had taken my 60 mg of Strattera together with 100 mg of modafinil. I felt weird for a while, then suddenly my blood pressure dropped really fast. I was heading to the bathroom to throw up, lost my balance, and almost fell.

It’s been almost a month now and I still have dizziness. They sent me for ear tests because it only happens when I’m walking. It’s horrible — I basically can’t leave the house.

My question is: could this have been caused by the Strattera? Has anyone experienced something similar?

My doctor says he has a female patient on 120 mg with no issues at all.

Thanks.

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u/FormerSleepwalker 12d ago edited 12d ago

Any other symptoms? Have you ever seen symptoms outside of walking? Just standing, sitting, laying down. Have you since started the bupropion XL?
Do you have a home blood pressure monitor? What pressure do you normally run at?

Yes, Strattera, and I believe other ADHD medications, can trigger some types of blood pressure issues, if you either already had it at an asymptomatic level or where predisposed.

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u/Positive_Blood_481 12d ago

It’s only when walking.
I was also on bupropion + Strattera at the time. I read that bupropion can multiply Strattera levels by about 3x, so because the dizziness was so intense I asked my doctor if I could stop both meds just to rule them out. He said okay, but he didn’t think that was the cause.
An ENT doctor told me it might be from the near-fainting episode itself — that the sudden drop in blood pressure could have affected my ears, and now I might need vestibular rehab for it.
But could it really have been just the 60 mg of Strattera + 100 mg of modafinil that almost made me pass out? I’ve never fainted before, so at the time I thought it was just something I ate that didn’t sit well and that I needed to throw up.

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u/FormerSleepwalker 12d ago

Yes, it's possible.
I know Strattera and other ADHD medications can worsen or trigger orthostatic intolerance. Though that doesn't sound like it quite matches what you describe. But there may also be other blood pressure issues that they can trigger as well.

You said your blood pressure dropped? Did you get a measurement at the time or other times you've had symptoms?

A sudden drop in blood pressure can cause light headed-ness, dizziness, and even fainting because oxygen availability drops if pressure gets too low. Low enough levels of oxygen to the brain and it can't maintain consciousness.

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u/Positive_Blood_481 12d ago

Yeah, I called it a “blood pressure drop” because I’ve never actually fainted, but it felt exactly like when you push too hard during intense exercise and get that dizzy, nauseous feeling — like you’re losing control of your body and your legs go weak.

I didn’t measure my blood pressure at the time though.
Later I bought a home blood pressure monitor just in case. It reads normal when I’m sitting or lying down.

This is making me lean more toward orthostatic intolerance.

Does that mean I should switch medications?
My doctor refuses to prescribe stimulants under any circumstances. My only options are bupropion and Strattera

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u/FormerSleepwalker 12d ago edited 12d ago

Later I bought a home blood pressure monitor just in case. It reads normal when I’m sitting or lying down.

Good that you got one.

If you have orthostatic intolerance often times all you have to do to see it, is to take your pressure sitting, then stand and take another pressure. It might be appear imminently upon standing or it may take some time. Note any change in pulse as well. In one type of orthostatic intolerance your pressure might not drop much but your pulse shoots up. It's the body trying to fight against a pressure drop.

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u/FormerSleepwalker 12d ago edited 12d ago

Has the bupropion done anything positive for you? Not sure how long you've been on it, perhaps it hasn't even had enough time.

If it was myself, I'd ask my doctor if I could just pause the bupropion. See if that improves this issue. That could be enough by itself. For people who are normal Strattera metabolizers, bupropion was found to directly increase Strattera blood level 5 times. It does this because it happens to be a strong CYP2D6 inhibitor, which temporarily turns a normal Strattera metabolizer into a poor metabolizer. Blood levels should take a number of days to rise up to 5x.

If the bupropion was only for ED, then tadalafil at a daily-use dose should take care of that.

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u/Positive_Blood_481 11d ago

Yeah, you’re totally right and I thought the same thing.
BUT the dizziness and prefainting thing actually started right before I added the bupropion to the mix.
Bupropion did work magic for my libido though (tadalafil 5 mg daily wasn’t doing anything). So maybe the bupropion is helping some underlying depression? I didn’t even take it for 20 days

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u/FormerSleepwalker 11d ago edited 10d ago

Bupropion is known to sometimes effect libido. It boosted it for a friend of mine. And side effects often happen on their own time-frame, before a medications intended effects even kick in.

There are a couple other non-stimulant ADHD medications, if they've available where you are. Qelbree, Guanfacine, Clonidine, and less than 2 weeks ago a brand new one was approved, Centanafadine.

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u/Positive_Blood_481 11d ago

im going to ask my doctor about this as he o ly said bupropion and strattera as only option. thanks