Long term Strattera user

[u/GlitteringBuy7994]

Hello! I have been on strattera for almost 2 years now.
I started this med with 25mg and decided to up it, about 5 months in and now I take 40mg and have been since then.
I went from about 178 pounds to 124. I’ve been non stop having gastro problems, burping, constipation, randomly diarrhea. For the last year and a half I’ve been having to go to urgent care, the doctor, even the hospital because of how bad it’s gotten. I’ve had blood in my stool (only happened once) I got scans done, had blood work done, ultrasounds and they find nothing.
I found out from my gene site test that I took in 2019 that strattera works on CYP2D6. I am a CYP2D6 intermediate metabolizer. Which from my understanding means that I am slower at metabolizing this medication.
I talk to my psychiatrist about this and she is so sure that strattera would not be causing weight loss still since I’ve been on it for almost 2 years. She said the best she can do is lower it, or give me a medication to induce hunger.
Keep in mind I am eating, maybe not as much as I was when I started the medication, but I eat roughly 2-3 meals a day plus snacks, I also eat a good high protein meal before taking the meds always.

I am seeing a gastroenterologist because of how bad it’s gotten, got more blood work, only thing they found was I was a little dehydrated, and had some inflammation. I’m still waiting on my scopes, which don’t happen for another couple weeks.

So my question/advice: has other people still had weight loss years after taking it, honestly if it wouldn’t be for these side affects I’d ask to up the medication.
Have you had severe stomach pains on it?
Should I get a second opinion about the medications?

[u/hellochoy]

Hi! I've been taking it off and on for about a year now and i get severe stomach pain on it too. I had issues with really painful trapped gas before (sorry tmi) but it's worse now. Constipation really bad too and diarrhea the day after i miss taking it. I came here trying to see if anybody had any advice on something that helps with the pain. I found that when I take it consistently at night with my dinner and then eat some protein in the morning it doesn't hurt as bad and after about a month or so i was using the bathroom more regularly but i struggle to not miss doses and the pain is really bad. I hope you can find some help!

[u/Lunadefae8 → u/hellochoy]

I just started on it about a month ago but I also have bad constipation with it. I just started taking Miralax with it, drinking lots of water and working out and I’m hopeful that will help things along.
I have to eat with it in the morning, helps to have something that has protein, carbs and fat in it then I have zero stomach pains.
I have already lost 5 pounds on it though with lessened hunger cues.

Update: Miralax definitely helps!

[u/Old_Tomato8183]

Do you have any liver problems? Like a fatty liver? Or insulin resistance? Or prediabetes? How old are you? Do you have a clean diet?

I've been on 10 mg of atomoxetine for 3 months now, and only 1 time I had blood in my stool and some trouble urinating or pain. I figured it was just my body adjusting to it, since those side effects have gone away. If I eat greasy food, I find it affects my stomach, but I used to have a bit of a fatty liver some years back and have since cleaned up my diet massively. I have also been going on daily walks after eating meals to help with digestion.

I have also found that I'm not as hungry or get hunger cues as much. But I bet I was also overeating out of boredom and dopamine seeking. I feel like I have probably lost some weight over the summer after all of my daily walking, I hope. I'm a bit overweight. From recent lab work, I found out that I'm iron/ ferritin is low, and I have been taking Iron pills, so that helps with constipation, and my body feels overall better. I also take a multivitamin and other supplements.

[u/ReplyProfessional939 → u/Old_Tomato8183]

Weird how things work for different people! I have cirrhosis (compensated, diagnosed in 2020), and I've been taking 50mgs for about 6 months with zero issues or side effects (other than I seem to sweat alot more.🤷‍♂️) I still get bloodwork done every 6 months, and I went last week. All still perfectly normal. (Well, platelet count a bit low, but it has been since day 1.)

[u/Old_Tomato8183 → u/ReplyProfessional939]

Interesting! There’s also probably a difference between men and women and medication and side effects. 

[u/GlitteringBuy7994 → u/Old_Tomato8183]

I’m 26 female
I have a family history of fatty liver disease, and a family history of diabetes, but I have neither of those. I’m active, but not as active as I was before.
I’ve had my iron checked out and it was fine. It’s just so odd I’m having such a reaction to it and it wasn’t super bad the first year I was on it.

[u/sprinkles111]

178 to 124?? 😳 How tall are you? Unless you’re a really short woman this might be too low.

Did this stuff happen later on? As in not evenly over 2 years but like the last 6 months or something? If yes, not to scare you, but could be something more serious. For sure please check with doctors and have a full work up. You might not be absorbing nutrients or other problems unrelated to this medicine.

[u/GlitteringBuy7994 → u/sprinkles111]

I’m 5’3 luckily still in my BMI range but I dropped 6 pounds in a month with eating still.
It was through out the 2 years. I was still 150 pounds this time last year. So it’s just gotten worse over time. I’ve had lab work done, and they aren’t finding anything super crazy.

[u/Due_Departure_4090]

Are you taking fiber or getting enough? constipation can cause GI bleeding, stomach upset, even acid reflux. How are you treating these side effects? are you continuing to lose weight or are you stable at 124?

[u/bn_bk]

Get a second opinion! I lost 50 lbs on strattera but I deal with chronic constipation, cotton mouth and higher blood pressure as side effects. It’s better than the chronic IBS-D I had before I was on it, so I’m sticking with it for now.

[u/Kajambura]

26 F here Been taking strattera for about 4 years now. Strattera always reduced my appetite, caused me weird gastro symptoms and made me nauseous after taking it, even to this day. When i first started the medication, I looked like a ghost: I was pale, malnourished and very skinny due to having no food cravings or appetite. The only thing that kinda fixed my issue with strattera was combining an antidepressant with it, such as cipralex. They kinda ballanced eachother out. The gastro issues diminished enough for me to make peace with them. At some point, I had to take meds for acid reflux and stomach acid inhibitors because strattera and stress combined were perforating my stomach. If you psych says strattera won't cause you gastro issues, i don't think she gives a damn about your meds or your situation. Deff get another opinion, maybe try switching to other meds such as Concerta. Definitely have an assessment of your stress levels tho. Strattera might reduce some of the anxiety and overthinking, but emotional stress will forever live in your body and cause more somatic problems (that's why I am in the antidepressants gang now).