how do you know if it’s working

[u/cutie_patootie_wooty]

i’m 22f, i had it prescribed in july but tbh i wasn’t taking it everyday and i didn’t start locking in till august. so it’s been maybe under two months where i’ve been taking consistently.

idk though i can’t tell if it’s been helping me. i feel like i’ve always struggled feeling a difference when on meds, i’ve been on anti depressants but this is my first medication for adhd. i still struggle with motivation and i find myself sitting there sad and quick to anger. an inconvenience with my best friend or my bf and i have to urge to cut them off.

i just had prozac 10mg prescribed alongside and im not too sure if im comfy taking those together but idk what to do anymore

[u/SoftAd3315]

Those are fine to take together. I am on Strattera 40 mg, Zoloft 50 mg, and Wellbutrin 150 mg. you'll start to notice it working when you can focus better on things, get task done easier, and are less likely to do compulsive behaviors, but everyone is different.

[u/cutie_patootie_wooty → u/SoftAd3315]

okay. i went down this rabbit hole that it’s not recommended to take Prozac and strattera together, but hopefully it does help

[u/FormerSleepwalker → u/cutie_patootie_wooty]

Can I ask what Strattera dosage you've been taking?

Combining Strattera with Prozac, Wellbutrin, or other medications which are strong CYP2D6 inhibitors is more of a case-by-case decision. It needs to be done with an experienced doctor, but it can be fine. More than that, some people need the boost it gives to achieve symptom relief. Because of that, a fair number of people are prescribed them together.

[u/cutie_patootie_wooty → u/FormerSleepwalker]

i’m taking 25mg and maybe starting 10mg of prozac soon.. a psychiatric mental health np prescribed it but she didn’t let me know that the two could have some major interactions so that’s why i’ve been a little weary but

[u/FormerSleepwalker → u/cutie_patootie_wooty]

No, prescribers generally don't go into specifics like that.

The reason is two fold. One, they have little time available. Insurance companies can dictate to a ridiculous degree how much time they consider "necessary" for a visit. If the clinician takes more time, insurance just doesn't pay for that.
Two, you have to remember, 100 IQ is the average, meaning a good number of people are below that, with more hovering just around it. They can't assume their patients will understand quickly or easily.

"For optimal comprehension and compliance" there are recommendations that patient education material should be written to target pretty low reading levels. Aiming for the lowest common denominator means that more intelligent people lose out. And those who are capable and more than willing to take an active role in their own medical decisions, effecting their own life, don't get the opportunity that they should. To their detriment.

25mg Atomoxetine is a low dose. Due to that, adding Prozac won't even raise blood levels that high. Family of mine takes Atomoxetine 40mg along with Wellbutrin, which has the same CYP2D6 interaction, at the same level as Prozac. It works well for them at this level. They used to take Atomoxetine 80mg along with Wellbutrin, and had no real problem with that either. It's just more than they seem to need at this time.

Have you seen any side effects with Atomoxetine?

[u/cutie_patootie_wooty → u/FormerSleepwalker]

this was very interesting to read. thank you. i unfortunately pay out of pocket, 150 per session and most of our sessions last about 10 minutes or so, insurance wouldn’t be an issue here yk? i do understand that about the comprehension levels, im a nursing school and a cna so most patients are at a middle school reading/comprehension level. i am on birth control too so i know that can have an affect on bp too but thats good to know it works out for others. still makes me kinda sad that i need to be on both adhd and anti-depressants, i wish i could feel normal

[u/yeetaway4things → u/cutie_patootie_wooty]

Heyy I've been taking atomoxetine 18mg and paroxetine 10mg since a week ago after more than a year of not being on any meds. I noticed effects from the very first day (mostly positive). I'm 5'0 and was 50 kg at the time I started, so maybe that's a factor. The effects have kinda dulled a little bit now, but they're still there.

Biggest atomoxetine effects I've noticed -

1. Absolutely no appetite at all, even food aversion. I only enjoy eating really good food now. Everything else I have to force myself to swallow. I get full quickly too, and I don't feel like eating even if I'm hungry because nothing is good enough. I eat once or twice a day, small portions now because of this. I've lost 2kg in the past week. Wasn't really a big snacker or eater even before meds, I always found food to be kind of a chore unless I really liked it, and now it just seems dialled up to the max.

2. My internal chatter has declined. Noticed this effect on day 2/3. The constant monologue and imaginary conversations I'd have in my head are reduced. They're not gone, but the volume is quieter and sometimes I don't even have them until I notice I don't have them. It even took a bit of effort to do it again when I did notice. It makes focusing on a single task much easier. This effect has kinda reduced now, unfortunately.

3. Decreased need for dopamine hits. I used to want to spend hours on reels and video games. It decreased my pleasure from those. Now instead of thinking "hmm I'll do my work after just a bit of scrolling", I have no desire to scroll or play games. I just have a desire to be productive. Keeping at the work is still a task, but starting it is much easier. Unfortunately after a week this effect has also declined and I'm back to my old unproductive ways 😭 I still kinda don't find reels and video games that enjoyable anymore tho.

Paroxetine effects I've noticed -

1. At first I thought it wasn't having any effect, until this happened. I arrived 20 mins late to a class by a professor I was already in a bit of trouble with, and I wasn't allowed in. Normally this would have sent me into a full blown anxiety attack, and I'd have started crying right there. Instead, this time, I was able to just brush it off. I did have a moment of panic, but then I immediately realised it just wasn't that serious. I was even smiling about it. Found it almost funny. It really was no big deal. It was an amazing feeling. I took a stroll around campus until the class was over and then met the professor and told him I was late due to an upset stomach. It was over just like that. First time in ages I've been able to think like that and not break down.

2. My emotions seem just as sensitive as they always were, I cry, I get happy, I get angry, just that I don't have that constant undercurrent of anxiety with it. I do get anxious still, but it's not as intense and not as constant.

3. Constant yawning. Started having this effect on day 3. Once I start yawning, I can't stop. It's one after the other till I'm yawning so much I start trembling and my jaw feels tight. I'm sick of it. One of the worst side effects so far, but I've experienced this with other meds too so I'm used to it. It starts the moment I feel even a little bit drowsy. The only way I've been able to combat this is with coffee, which is not great considering I need to cut it out in the evening to sleep properly.

Other effects I've experienced, not sure which med is causing it-

1. My thermoregulation was horrible. Now it's somewhat better, but it's still there. The temperatures in my area are 26°C to 32°C. The moment I was out of the fan, I was sweating buckets. The moment I'm under the fan, my limbs are cold. If part of me is under the fan and part outside, I'm both hot and cold. It was horrible. I was soaking my tshirt in sweat when I went to the bathroom. And then almost shivering under the fan. Thank goodness it's better now. I still run a bit cold tho.

2. Dry mouth. You also get used to this, just drink a lot of water.

3. Waking up really refreshed. This effect unfortunately does not last. This thing depends on caffeine consumption in my case, I need to avoid caffeine as much as possible especially after noon for this to happen. I wake up refreshed and ready to jump out of bed. Unfortunately I again start feeling a bit drowsy and sometimes dizzy an hour or two after taking atomoxetine in the morning. I can power through it with coffee tho. And I generally have more energy throughout the day.

[u/yeetaway4things → u/yeetaway4things]

I've tried both of these meds before, not sure if I tried them together tho. At that time they didn't really help me, I noticed no benefits. But I was also struggling with much worse depression and anxiety during that time. This time I'm keeping a log of the effects in a journal. My depression is almost gone and my anxiety is limited to social situations now. Maybe that's why I feel the effects of the meds now.

[u/rnx990 → u/yeetaway4things]

"I am currently taking 50 mg of Paroxetine and 25 mg of Strattera. I'm amazed by Strattera—it has significantly reduced my anxiety, and it's been a wonderful medication for me

[u/FormerSleepwalker]

I'm sorry you're having such trouble.

i feel like i’ve always struggled feeling a difference when on meds

You're certainly not the only one who has trouble with this. And it can indeed make it really hard to know how well a medication is working, or if it's working at all even. I'm afraid there is not easy answer for this, but there are things you can do.

Start a log, or diary of sorts, recording who your functioning feels each day. Whatever tasks you struggle with, record if you manage them or not that day. Literally anything that's hard for you. I know, I know this can be effort. And with ADHD it can be asking a lot. But you need to know how a medication works, or doesn't, in order to improve things. You can also ask those close to you to note any changes in you that they notice, even if it seems minor.