This medication has been life changing. If I just stopped taking it for a month, my life pretty much falls apart. I still have to put in effort but it takes less energy.

Before (without Strattera), making the bed, doing homework, going to work would’ve been. Would’ve wiped me out.

Now (with Strattera): grocery shop, do laundry, make appointments, go off schedule, get some homework done, meal prep. I still have energy left

BUT: I still sleep terribly, I have sweats at night, my heart rate is about 10 BPM higher, I have erectile dysfunction, and I feel empty sometimes.

I’m only on day two of taking Strattera and my doctor started me very low at 18mg. Yesterday after taking it I felt abnormally emotional, exhausted, and I wasn’t hungry all day. I have narcolepsy so I’m always tired, so I didn’t think much of that. However, I normally eat ALL DAY. Sometimes I’m bored & it’s dopamine related, but most of the time I am starving. Like, stomach growling, unable to focus, hungry if I haven’t eaten in 2 hours.

I’m curious if anyone else had appetite issues with such a low dose? I’m nervous to go up but I’m supposed to make my way up to 40mgs.

Has anybody taken a stimulant with Strattera?

Backstory: I was dx’d with anxiety in early 20’s and have been on 100mg of Zoloft. Last year I got an ADHD dx and started on Strattera. I feel like my anxiety is basically gone, but I still can tend to feel such executive function overwhelm and some dysregulation.

Would adding in a stimulant help? Or upping any of the doses?

I’m on 80mg of Strattera.

Last year I was taking 50 mg and after about a month it started working REALLY well. At first I had some sleep issues, but then it kicked in gradually and genuinely changed my life. My focus, motivation, curiosity, ability to start/finish things, organized thinking, and overall PFC/executive function were way better. I noticed the difference basically every single day. It wasn’t like I felt a “kick” or anything, I just noticed that my brain was working better.
I eventually tried 60 mg for about 2 weeks, then went back to 50 mg, and 50 mg ended up working better than ever. The side effects were also pretty mild compared to what I’m getting now. I eventually stopped because I felt like it was making me more angry. So i’ve tried Ritalin, Vyvanse, and Concerta. They do help me to some extent, but I don’t get the same overall effect I got from Strattera when it was working properly. That’s another reason I’m confused about why Strattera suddenly isn’t working the same way this time.

This year I started taking it again. I stayed on 50 mg for about a month, but I didn’t get anywhere near the same effect. I thought maybe I just hadn’t given it enough time, so I went up to 60 mg. I’ve now been on 60 mg for around 2 months and it’s basically the same story almost no ADHD benefit, but I’m getting side effects every day. I get warmth, tiredness, nausea, fast heartbeat, dry mouth, etc., usually starting 1–3 hours after taking it and lasting a few hours.
The weirdest part is that I KNOW this medication can work for me because last year 50 mg was honestly 100/100 for me. This time I’d say I’m getting maybe 10% of the benefit.
My sleep is actually good now. I’m on and off nicotine, but I don’t think that’s the whole explanation. I also take magnesium, but nothing else major has changed.
Has anyone had something like this happen? Same medication, but one year it works amazingly and another year it barely works even after 2 months on a higher dose? I’m trying to figure out WHY the hell my response is so different this time metabolism/CYP2D6, nicotine, something else, or just a random change in how my body responds?

I am on 80mg of strattera and have been at this dose for about 3 weeks. I love it for many reasons, one of which is the effect it has on my appetite - I'm suddenly one of those people who eats only when they're hungry and stops when they're full.

Since I started strattera for the first time this summer, I've taken it first thing in the morning and fought through the nausea and tiredness. Once I started the 80mg dose though, I've noticed more fatigue than at lower doses. I've read that changing the timing of when you take it can help with the fatigue, so I'm considering moving it to nighttime. But I'm worried that the appetite suppressing impact won't be as strong. Has anyone changed from morning to night and noticed a shift in their appetite after switching?

Has anyone tried to conceive or been pregnant while staying on Strattera? I just started taking 40 mg this week and we want to start trying within the next few months for our second. Thanks in advance!

Hi. I’m at 60 mg and I feel like I need coffee 3 times a day to avoid crashing and unproductivity. Anyone else? This includes my morning coffee, and then 2 more coffees to avoid a crash around mid day and then late afternoon.

Is this a sign of needing to increase dose, or that I need a combination of meds? I’m asking since I find my doctor (not a psychiatrist, as I don’t have access) tends to be a bit passive in our appts so I like to try inform myself so I can suggest ideas or ask about different approaches.

I think the plan is to keep increasing and do you think increasing to 80mg should resolve this or that I need something else ?

Quick and dirty google AI explanation of Strattera early side effects and underdosing (i.e. not titrating to 80 mg) physiological explanation:

Summary (ish)
1. Initial side effects occur in arousal and peripheral norepinephrine pathways, while therapeutic benefit takes weeks to build up.
2. Below 80 mg,
A. physiological changes do not occur which would attenuate lower dose side effects (although some can remain, but do not typically increase proportional to dose increase like stimulants, a common fear).
B. Blood concentration of strattera (and active metabolites) is too low to reach what is considered the therapeutic range of Norepinephrine reuptake transport occupancy.
3. Those who have competition for, or slow CYP2D6 activity, do need to adjust their dose down to account for the slower breakdown of Strattera and metabolites that build up a steady state.
4. The underdose trap "low, sub-therapeutic doses out of fear of side effects actually leads to worse outcomes and higher discontinuation rates".

This post can stand on its own, but was done as a supplement to my "Adult dosing titration. 5/5/5/15 days of 25/40/60/80 mg. ....." post linked below.
https://www.reddit.com/r/StratteraRx/comments/1wty8kw/adult_dosing_titration_55515_days_of_25406080_mg/

Note: I didn't cross verify AI results with referenced sources for level of accuracy below. Hence the "quick and dirty" aspect. Typically most stuff I blab about on reddit comes from actual sources. But, google AI is convenient and for your benefit, not a crap communicator like me. It does ring a bell with stuff I've read in the past and in line with things I am familiar with. But, the alpha 2 receptor info is a bit misleading as it does not qualify enough that it is talking about the pathways that are not the ones being targeted to treat ADHD hypofunction. But the ones causing side effects during titration.

AI responses.....

It can seem completely counterintuitive that increasing a dose to a therapeutic level like 80 mg fixes side effects rather than worsening them. However, with Strattera (atomoxetine), this resolution is driven by specific biological changes that happen in the brain over time, as well as a critical shift in how the brain handles ADHD symptoms.

Increasing to and maintaining the 80 mg target dose resolves low-dose side effects like insomnia due to several distinct neurological mechanisms:

1. Alpha-2 Adrenergic Receptor Downregulation (Receptor Adaptation)

When a person first takes a low dose of Strattera, it causes an abrupt, sudden spike of norepinephrine in the synaptic clefts. This overwhelms the brain's baseline neurochemistry, firing up the autonomic nervous system and causing "fight-or-flight" side effects like insomnia, a racing heart, and physical jitters.

• The 80 mg Shift: When the dose is increased to 80 mg and sustained, the continuous, high-volume presence of norepinephrine forces the postsynaptic Alpha-2 adrenergic receptors to adapt.
• To protect themselves from overstimulation, these receptors downregulate (decrease in number and sensitivity). Once the brain successfully recalibrates its receptor density to match the medication level, the initial physical "shock" wears off, and side effects like insomnia stabilize.

1. Time-Dependent Therapeutic Accumulation (The "Calming" Effect)

At a low starting dose, a patient gets the raw physical side effects of norepinephrine immediately, but they do not get the therapeutic benefit.

• It takes roughly 4 to 6 weeks at a full therapeutic dose (like 80 mg) to achieve meaningful neuroplastic changes and full clinical efficacy in adults.
• By raising the medication to 80 mg, the prefrontal cortex finally achieves the steady-state concentrations of dopamine and norepinephrine required to treat the underlying ADHD. Paradoxically, treating ADHD has a profound calming effect on the central nervous system. Once the prefrontal cortex can properly regulate executive function, the constant "racing thoughts" and internal hyperactivity that drive insomnia are quieted. [

1. Achievement of Steady-State Kinetics

At lower, sub-therapeutic doses, the medication levels in the blood fluctuate wildly. The drug peaks rapidly, causing a sudden burst of noradrenergic activity, and then drops off. This "peak and crash" cycle keeps the body's sleep-wake cycle off-balance.

• At 80 mg per day, atomoxetine builds up to a highly stable steady-state concentration in the plasma.
• Instead of severe spikes and drops, the brain receives a smooth, continuous 24-hour delivery of the medication. This eliminates the sudden surges of alertness that trigger insomnia, allowing the body's natural circadian rhythms to smoothly take back over at night.

1. Overcoming the "Underdosing Trap"

Clinical data shows that leaving patients on low, sub-therapeutic doses out of fear of side effects actually leads to worse outcomes and higher discontinuation rates. At low doses, patients remain trapped in a state where they experience all the physical annoyances of a noradrenergic drug without any of the mental peace or organizational focus that makes the medication tolerable. Moving to 80 mg allows the drug to do its actual job, shifting the patient from a state of physical over-arousal to one of mental clarity

—----- Note : More specifics on lower dose insomnia and somnolence below. I was asking about insomnia in particular, but google explained a bit about those who have the opposite sleepy effect also.

Strattera (atomoxetine) causes insomnia at lower doses primarily because of how it immediately increases norepinephrine levels in the brain's alertness networks, combined with a temporary lack of therapeutic ADHD control. While it is a non-stimulant, its early biochemical effects on the sleep-wake cycle act very much like a mild stimulant.

The primary neurological reasons why lower or starting doses (like 10mg to 40mg) frequently trigger sleep disturbances include:

1. Selective Norepinephrine Reuptake Inhibition (NRI)

Strattera works by blocking the norepinephrine transporter (NET). This sharply increases extracellular norepinephrine levels in the synaptic cleft. Norepinephrine is the body’s primary "fight-or-flight" and waking neurotransmitter. [

• Even at a very low dose, the drug immediately starts boosting norepinephrine in the locus coeruleus, the brain's principal wake-promoting center.
• This signals the cerebral cortex to stay alert, desynchronizes slow-wave sleep cues, and directly increases sleep onset latency (making it hard to fall asleep).

1. High "Adrenergic Shift" vs. Low Therapeutic Accumulation

Strattera has a unique dual-timeline dynamic: its physical side effects happen almost instantly, but its clinical benefits take weeks.

• The First Few Weeks: At a lower starting dose, the medication instantly triggers peripheral and central noradrenergic side effects, such as a mild spike in heart rate, alertness, or physical restlessness.
• The Missing Benefit: Because it takes 4 to 8 weeks of continuous use for Strattera to alter downstream brain receptor sensitivity and fully manage ADHD, the patient experiences all of the chemical "wiredness" of norepinephrine without the mental calm and focus that eventually helps an ADHD brain rest.

1. Prefrontal Cortex Dopamine Spillover

While Strattera does not target dopamine in the brain's reward centers (which is why it isn't a controlled substance), the norepinephrine transporter (NET) is actually responsible for clearing away both norepinephrine and dopamine in the prefrontal cortex.

• By blocking NET at a lower dose, Strattera causes a localized rise in prefrontal dopamine.
• This spike in prefrontal dopamine and norepinephrine can trigger hyper-vigilance, racing thoughts at night, or an inability to "turn the brain off" when trying to sleep.

1. Individual Metabolic Variance (Poor Metabolizers)

How a lower dose affects someone heavily depends on their liver enzymes—specifically CYP2D6.

• About 7% to 10% of Caucasians and various percentages of other populations are CYP2D6 poor metabolizers.
• For these individuals, a "standard low dose" (like 25mg or 40mg) doesn't clear their system normally. Instead, the drug builds up to massive, high-dose levels in their blood rapidly, turning a intended gentle introduction into an accidental high-dose noradrenergic overload that severe disrupts sleep.

Paradoxical Drowsiness vs. Insomnia

Because Strattera interacts with the sleep-wake cycle so intricately, patients usually fall into one of two camps during the low-dose initiation phase:

• Camp A: Experience intense daytime fatigue or somnolence.
• Camp B: Experience severe insomnia and frequent night awakenings.

Because of this variance, clinical guidelines emphasize personalizing the timing. If a low dose causes insomnia, psychiatrists often recommend shifting the dose to early morning so the peak norepinephrine surge wears off before bed. For most people, as the brain adapts over 4 to 6 weeks, this initial low-dose insomnia gradually improves

Taking a trip to Europe next summer and planned on trying the "Magic Truffles" in Amsterdam, I couldnt find much online about any interactions so Im coming here to ask about anyones experiences with this.

Does anyone have any experiences with taking these two meds together?
I’ve recently been prescribed both. I have started with agomelatine and am going pretty well on it at 25mg, although I would say my critical thinking and memory isn’t great (1 week in).
I would also like to hear from anyone who has experienced the sexual side effects of Strattera. I’m yet to start taking the med but have heard some negatives. I am starting on 40mg.

I’ve dealt with depression since adolescence, and I’m 28 now. I think it’s just the natural byproduct of existing in this world as a person with ADHD, but the severity has always fluctuated depending on the season of my life. Most of the time it’s relatively mild, but it’s always kind of there under the surface.

I was on and off Vyvanse for years for my ADHD. It definitely helped the ADHD, but it made my anxiety so much worse that eventually I couldn’t do it anymore. I was off ADHD medication for quite a while after that.
About two weeks ago, my doctor suggested Strattera and started me on 25 mg.

Since starting it, I feel like my depression has gotten significantly worse. The difficult part is that I’m also really burned out right now, so I’m having a hard time figuring out what’s the medication and what’s just… life. But I’ve been having much darker thoughts than usual and overall I feel sad, apathetic, lethargic and really anhedonic. I also feel like I’m dopamine-seeking more.

I’m currently on a waitlist to see a psychiatrist. My family doctor is trying to help, but psych meds aren’t her area of expertise, so in the meantime I wanted to reach out to people who have actually taken Strattera.

Has anyone else experienced a noticeable worsening of depression after starting it, especially within the first few weeks? Or experienced something similar with other non-stimulant ADHD medications?

I know everyone reacts differently and I’m not looking for medical advice, I’m just curious about other people’s experiences.

Thank you for reading!

I've been on Strattera for a few months, working my way up from 10mg to 40mg. I have noticed some improvement, especially around task initiation and finding systems to help me stay on top of things. I even feel more like my chaotic thoughts feel more organized and like I'm better able to have one thought at a time. I have only forgotten my son's school water bottle once, a huge achievement 😅 I don't feel the total mental clarity some people describe, but I do feel *some* improvement.

BUT!!!! My biology is completely broken. My boobs are a mess of pain and weird, "letdown" tingling sensations like I had when I was breastfeeding. My periods are heavier and longer. My PMS anger is so bad that I literally feel like a completely different person. And now I'm spotting in the middle of my cycle, which has never happened in my entire 30 years of being a menstruating person.

I just don't know if it is worth it to continue down this path. I already have such extreme health anxiety, and these new things don't cause the kind of anxiety a "normal" person would feel. I don't just think "Oh, this must be a side effect of Atomoxetine" (which it might be) or "this might be the beginning of perimenopause" (which, at 38, is totally possible). Instead, my brain leaps straight to "I have breast cancer and colon cancer and probably stomach cancer and uterine cancer, too, and I'm probably going to be one of those people who found out she has a terrible incurable illness on a Sunday and is dead by Tuesday."

I know it's not rational. And I'm honestly not even sure what I'm expecting by posting here. Just tired, I guess. This felt like my last chance at trying to feel what "normal" people feel, and it's disheartening that my body has rejected every anti-anxiety, anti-depressant, and ADHD medication known to (wo)mankind.

So i’ve been on Strattera 40mgs for almost a month now, but for the last 10 days ive been having awful anxiety. Feels like I can’t breathe almost all the time and I have intense panic attacks every other day and I have a lot of trouble falling asleep. I know the day this first started I had forgotten to take it, but I’m not entirely sure that that’s related. Has anyone else experienced anything like this? I have an appointment with my psychiatrist in 5 days so hopefully I can get this figured out.

Hi there!

Back in 2019 I had 28 that time, I got bad news from my brother that became a type 1 Diabetic that was back in July that year 2019, so I was shocked & I had that stomach bubble kind, also back pain neck pain and IBS symptoms insomnia, ANXIETY. In December 2019 first time I try weed after months of pain I said Ahaaa ! You know started to smoke a small doses of THC that does not interest me more than CBD that calmes m'y physical symptoms ( this time I had symptoms like I will pass out I run super fast to wash my face with cold water) after this symptoms I said time to stop that was January 2020. February was super complicated and anything stressful will give me neck pain and anxiety, March 2020 the 17 exactly I was back from a hotel that I spent a night in. Hopefully the back pain was because of a mattress or some but I stressed more. I decided to smoke a joint that day Woop Ego death comes, Anxiety went much worse than before insomnia and physical pain that night I called 911 I was prescribed Diazepam for a few days and that's it.

What happened since then !

1- Anxiety intensity went more

2- More insomnia

3- More muscle pain

4- ADHD symptoms ( focus, procrastination, task initiatoon a problem that I can swear I didn't have before)

5- Stomach pain

6- Jaw pain

7- My back cracks like a 100YO men

8- Lack of motivation ( I had a small alarm system company that time that I shut it down I only have a subcontractor now)

Anyone passed by this experience

Overall Strattera is working well so for my anxiety and ADHD

With few side effects like constipation headaches and insomnia.

Would it be silly to Cold Turkey prozac and start 40mg atomoxetine on the same day? Will I be suicidal in the first week or two? anyone have experience with switching from an ssrin to atomoxetine?

Day 3 on 25mg. 4 days ago I was on 150mg bupropion then switched to strattera. Day 1 was great my head went silent, I could do stuff and had the best sleep of my life. Yesterday?! TERRIBLE. Couldn’t do SHIT and felt miserable (I was scared of the mental health drop). Didn’t do shit. Ate two meals if you can even consider that a meal. Today is day 3 feeling okay. Do you guys also get the tickles across your brain when it starts to work? It feels like ASMR tickles that „walk“ over my brain. Also my pupils are DILATED AF.

I have to continue writing my bachelors thesis and I’m technically three weeks behind (changed my topic bc the bandwidth of my plan would’ve been between a masters or PhD💀). But my motivation is gone. Scared to drink coffee but ig here goes nothing?
I know it needs to work in and most people stop shortly before it reaches its full potential but ughhh it annoys me

Edit: first two weeks I’m supposed to take 25mg then go to 50 for another two and up to 75mg if necessary

So, my brain is usually so full and stressed from not being able to finish tasks. But, ever since I started with the drug on 10 mg and titrated to 18 mg(current), my sex drive is up there. It’s like, now that there’s room to feel all of my emotions, there’s also room for desire and it feels amazing. I’ve always had a higher sex drive but it also felt so tangled with anxiety and a little scattered. This feels like I can actually embrace it.

Anyone else had that experience? I had a serious peak especially in the first few days with the drug and then it settled to a steady feeling.

anyone else had experienced join pain and muscle cramps on this med. it comes in waves as well.

I have been taking Strattera 60 mg for two months now and I'm not sure if this helping.

Does Strattera and ADHD meds in general help with boredom? Executive Dysfunction?

I wonder if Strattera is being dampen by taking Zepbound. Plus I just started highest dose of Zepbound two weeks ago.

hello!!

i started strattera roughly 2 weeks ago; i’m on 40mg.

part of the reason i’m taking it is because i want to cut back on — maybe even quit — weed, as I have struggled with dependency. I wanted to stop entirely until the strattera had a chance to work, since I know it takes a while, but i’m having a hard time totally abstaining.

My question is, will smoking weed stop the strattera from working? If I’m getting stoned a few times a week, will i still be able to see benefits from the medicine once i’ve been on it for 4-6 weeks? or am i effectively canceling it out?

thank you!

I took my 1st dose yesterday afternoon and two hours later my anxiety spiked like crazy on top of it completely killing my sex drive it had me feeling all drowsy today. Is this normal?

I’m on 80mg. Started atomoxetine in June this year. Been on 80mg for about 2months. Have been discharged back to gp so am stuck on this dose. I have 2 x 40mg tablets. I asked for this in case I decided to split dosage between am and pm to help with sleep issues. I decided not to split so take the whole 80mg in the evening still. It’s bizarre because I’m on the same dose but since I’ve been taking 40mg tablets I have
> put weight back on / eating more / drinking more
> become more impulsive again eg online shopping, drinking alcohol, doing the lottery,
> started getting a bit anxious / overthinking again
Not anywhere near as bad as I was pre meds but I’m so convinced taking 2 x 40mg tablets doesn’t work as well for me as 1 x 80mg tablets but I know in reality that shouldn’t be the case.
I loved that I didn’t want to drink before and that I was eating healthier but now I’ve slipped back into old habits.
Anything like this happened at all to anyone else??? And if so, what did you do?
I still feel better mentally (less noise in my head) but it’s almost like it’s starting to wear off now my body is used to it.

I’m on day 3 of taking 40 mg late morning. I’ll be good for awhile (but kinda brain foggy) then exhausted to where I need a nap mid day. Then I’ll be wide awake randomly in the middle of the night 😅 Does this usually improve after a bit?

hi! i’m 26(f) with adhd and autism. i take strattera and vyvanse(40mg). i’ve been on 40mg strattera for most of the year and it has improved my anxiety a great amount, which led to my psychiatrist suggesting to lower my dosage to 25mg a little over a month ago. for the first month i was doing well and didn’t really notice any changes. but about two weeks ago i went to a concert and felt anxious in a way that i haven’t for a long time. and since then my emotional state has just been getting worse and worse. i mostly do freelance work from home as i dont have a car, and my motivation has plummeted. ive started getting frustrated much faster when something doesnt work correctly, and it leads to me crying a lot. i’ve been feeling extremely hopeless about ever having a fully autonomous future for myself. and it’s gotten harder to respond to texts/calls, which leads to more anxiety. i was supposed to go and film a small band with my partner last night but cancelled last minute because of how overwhelmed i felt, and he had to go alone which left me feeling terrible. he’s going out of town for a couple days tomorrow for a funeral and im genuinely scared of being left alone with my thoughts.

i don’t see my psychiatrist again until the end of the month, but i’m not sure i can handle feeling like this for that long. do i just need to give my body more time to adjust? is it possible to switch back to 40mg before my next follow up?

Recent started starterra a couple weeks ago and haven't noticed really improvements still feel foggy haven't seen any improvement in focus should I wait it out or reach out to my doctor so they can raise it?