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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
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Experience:  MD Psychiatry
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I was put in methylphenidate after being diagnosed with add.

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I was put in methylphenidate after being diagnosed with add. I am a 62 year old female. I took 5 mg. 3'xs daily for a month. The improvement of executive functioning was excellent but unfortunately this medication also induced anxiety attacks. My internist took me off this drug and 2 weeks later started me on Strattera. I am seeing no benefit and have become extremely irritable. Would it have been better if my doctor had switched to another stimulant like adderal or vyvanese since the symptom improvement was so excellent?
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 5 years ago.

Hi there,

 

Welcome to Just Answer !

 

Well, the fact that your doctor took you off from a psychostimulant drug such as Methylphenidate and had put you on Strattera ( atomoxetine) , which is a non stimulant drug , also used in the treatment of ADHD, was not a wise decision, as it would have been better, if he had chosen another psychostimulant such as Adderall ( Amphetamines ) instead, as it is better than non stimulants such as strattera , and also has a faster action. Also, the usual practice is to first use a non stimulant for ADHD, such as Strattera , and when this drug is not effective , then we put the patient on Psychostimulants such as Adderall , ritalin, focalin, etc , So, if you see, in your case it is the opposite that has been done , as you have been shifted from a much stronger drug to the less stronger one.

 

However, now that you have been placed on strattera, you shall continue it for at least 3-4 weeks, because this drug requires atleast 3 weeks to show its effect in ADHD . But, if after 4 weeks , there is not much help from strattera , then i suggest that you talk to your doctor and get swithched onto Adderall. You can switch to Adderall even now also, but then , after stopping strattera , you will again have to wait for 2 weeks or so, for the drug to get cleared from your system completely and only after that you may start Adderall.

 

So, i have given you two options -- one is to continue on strattera for atleast 3-4 weeks and wait for its action to take place and second option is to stop strattera , wait for 2 weeks so that the drug clears from your system and then start on Adderall. If you choose to continue on strattera , then for your irritability you may take clonazepam , an anti anxiety drug , which has no adverse interaction with strattera.

 

As for , vyanese is concerned , no doubt it is very effective in ADHD , but it causes insomnia as a side effect, which may add to your anxiety.So, instead if at all you choose to start on a psychostimulant , i would recommend you start on Adderall , and second option would be focalin.

 

I hope my answer serves your query according to your satisfaction.

 

Regards...

 

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4017
Experience: MD Psychiatry
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