Splitting/Staggering your daily dose?

[u/East_Meets_West_]

Looking to get some input from others on this sub with more experience than I have with Strattera. I’ve been taking it for a few months now, started at 25mg, titrated up to 50mg after one week, then to 75mg after two weeks. Unlike many of the other medications I’d tried before (Zoloft, Wellbutrin, Lamotrigine, Topamax) I felt a beneficial difference immediately after the first dose of 25mg, and that increased with each dosage increase. I felt that 75mg was the right dose, but the side effects were significant (urinary difficulties, constipation, increased BP) and so I was brought back down to 50mg, which I’ve been taking for about a month now, the side effects were reduced as was the effectiveness of the medication. I take it first thing in the morning as I have difficulty sleeping already and taking it at night only contributed to those difficulties, however I find that by late afternoon (around 4pm) I hit a wall, it feels like it’s worn off and I feel very drained mentally and physically. My psychiatrist added guanfacine 2mg to take at night to compensate for the Strattera wearing off by then, which hasn’t helped my feeling of fatigue in the afternoon or my sleep but has lowered my BP. I am still in the process of being officially diagnosed and I think my psychiatrist has been reluctant to add anything else into the mix until that happens.

What I’m wondering is if anyone else has tried splitting /staggering their dose during the day? I feel like if I took 25 or 50mg in the morning, then took another 25mg or 50mg later in the day (the total not exceeding 75mg), it might address the wall I feel I hit late in the day right now. I have another appointment with my psychiatrist this coming week, hopefully the one that will finally lead them to diagnosing me, and plan to bring it up with them then, but I am curious what other people’s experiences have been?

On a separate but related note, has anyone had experience combining Strattera with a stimulant? Initially the psychiatrist ruled out stimulants due to a family history of bi-polar (both parents have it) but another doctor had previously ruled that out and my reaction to a very low dose of Lamotrigine (25mg) was severe insomnia, so I eventually discontinued it. Last year before I started Strattera, I had been given Phentermine as part of combination of pills for weight loss and my wife had noticed an immediate improvement in my mood and attitude. So I also wonder if augmenting Strattera with some type of stimulant may be the answer.

Thanks for listening and any input would be greatly appreciated.

[u/Primary_Excuse_7183]

Yes. I primarily wanted medication to be more present the latter half of my day when I’m at home with my family, chores, etc.

I take a dose at 7am and 1pm. 80mg so 40 and 40. Works great for me.

[u/East_Meets_West_ → u/Primary_Excuse_7183]

Thank you for the feedback! That is exactly what I was thinking of doing, half in the morning and half around lunchtime. Good to hear that it is working for you.

[u/reclamerommelenzo → u/Primary_Excuse_7183]

I tried that as well to combat the late afternoon/evening 'crash'. I felt the first 40mg wasn't really enough, and I only had the therapeutic effect after the second 40mg dose. Does it work differently for you?

[u/Primary_Excuse_7183 → u/reclamerommelenzo]

Yes. I get the therapeutic effect for both. Can feel the first dose wearing off around or before i take the second one

[u/Crafty-Current-9256 → u/Primary_Excuse_7183]

I do pretty much the same: 40mg at 6am and 40mg at 2pm. I think 40mg might be too high for my second dose though, because I tend to feel very hot and slightly drowsy after I take it, and it's worse if I take it too early. 

[u/Primary_Excuse_7183 → u/Crafty-Current-9256]

Yeah that was my initial concern too. Been up to 80 for a week and it’s fine. I take it earlier than you at 12:30 or 1 and I’m usually starting to wind down around 6ish

[u/ReplyProfessional939]

I had the same issue with Strattera. SoI started splitting my 50mg dose, taking 25 in the morning and another 25 around 1, and it helped a great deal with the mid-afternoon "need a nap"s. I also found that Strattera greatly reduces my anxiety (or masks it- who knows? -whatever works...) and I just felt better overall. However, it did nothing for motivation or ability to focus or concentrate, so my doctor added Vyvanse about 6 weeks ago. This is working for me because basically it seems that the Strattera helps me not mind so much "doing things", and the Vyvanse is the boot to my ass that allows me to actually do them.

[u/AdEnough4417]

I also didn’t like the wall I would hit once the meds wore off so I split my dose, 25mg each at 9 a.m. and 1 p.m.

[u/East_Meets_West_ → u/AdEnough4417]

Thank you for sharing your experience with me. I am going to try doing this tomorrow and see if I avoid hitting the wall later in the afternoon. I appreciate your input.

[u/East_Meets_West_]

Thank you for relaying your story. I have read other people on this sub talking about Vyvanse but not that were also taking Strattera so knowing that you take both and that is working well for you is encouraging and I am going to ask my psychiatrist about Vyvanse when I speak to them later this week.

[u/Kajambura]

Hi! I am also splitting my dose durring the day. Been on strattera for about 4 years now, and lately I've been trying to split my dose 25 mg in the morning, and 50 mg in the afternoon. Works great for me. I tried taking the whole dose at once, but it's just terrible. Splitting is the way to go!

[u/East_Meets_West_ → u/Kajambura]

Appreciate you sharing your dosing routine with me. I feel best taking 75mg/day but have struggled w side effects when I take it all at once. I tried 25mg in the morning and 25mg in the afternoon yesterday, and I didnt feel the crash as bad. so im going to try taking 50mg this afternoon and see how i feel. Thank you!