Volume 2, #10, April 2004

Dear Dr. Quinn:
I hope I'm not bothering you by asking you a couple of questions regarding the treatment of my "newly diagnosed ADD." After being treated for depression for the last 8 years, I am now completely convinced that I was originally misdiagnosed and have ADD. My doctor (family practice) has agreed that I have an overwhelming number of symptoms and characteristics and has started me on Strattera. Although it has only been a few days, I have noticed some change in my mood and I am definitely more observant of my surroundings (example...hearing specific words to songs whereas I have always just heard music, not as distracted when my kids are asking me something-not needing them to repeat themselves 2 or 3 times)!

But with the good I have been feeling tired, nauseous, had daily headaches, vivid dreams, hot flashes and "rubber legs." I'm a little concerned that this med has only been out a short time and that I'm feeling so many side effects. In your opinion, will these side effects subside after time or should I encourage my doctor to let me try a different med that may have the benefits without the "yucks"? I respect my Dr. but think he may not have a ton of experience with adult ADD; I don't want to disrespect his knowledge and second guess him which is why I would like your opinion to help me advocate my own treatment in a knowledgeable way! Thanks for any help you can give.

Sincerely,
LM

Dear LM:

Thanks for writing. I would be interested to see how you are doing now that a little more time has passed. Most women report the symptoms you describe when they begin Strattera. Some report extreme dizziness and nausea. These symptoms should subside as the dose is gradually increased, but go slowly. It can take two months to reach effective levels without side effects. You may need to go very slowly with this trial.

However, I would also warn that many women report that they do not feel Strattera alleviates the cognitive problems they have with focus and organization. It also does not control the hyperactivity very well in some children. Therefore, many physicians are prescribing a stimulant in addition to the Strattera, or changing patients’ medication to a long-acting stimulant. These women take the stimulant in the morning and the Strattera at bedtime. Most report that they do quite well on one of the newer, long-acting methylphenidate products such as Metadate CD, Ritalin LA, or Concerta.

Patricia O. Quinn, M.D.

Next: AD/HD Survery Results>>