How does Strattera Work?

I have recently started posting to this blog. I have really appreciated the great response to it, and I am watching the comments to find questions which may be worth answering on the blog. As my subscribers know, I have a database of thousands of questions on ADHD, and I will use these as well to draw for content. To become a subscriber, please go to: The ADHD Doctor.

Tim wrote a comment the other day with a question: “I’ve recently started taking Strattera (2 weeks ago). Would you please comment on its effectiveness, how long it may take (should I already be noticing a difference if it is right for me?), why its not prescribed for kids (or is it or when it might be acceptable to use it if it is effective), and what I should be looking for in regards to figuring out whether or not it’s working?”

Let’s answer this one.

Strattera is the first non-stimulant medication which has come out for ADHD. It is FDA (and Health Canada – for us Canadians ;-)) approved for the treatment of ADHD from the age of 6 years old and up. It is approved for Childhood ADHD, Adolescent ADHD as well as Adult ADHD. As a Psychiatrist who deals predominantly with children and teens, I occassionally like to smile at the idea of there being ‘Geriatric ADHD’. While I cannot comment on that at length, I am aware of adults who have started Strattera in their sixties with good effect.

Stratter’s other name is: Atomoxetine.

How does Strattera work?

Strattera selectively blocks the reuptake of norepinephrine (or noradrenaline) in the brain. This, in and of itself, can increase the ability to pay attention and improve hyperactivity. The interesting thing is that Strattera gradually has a downstream effect on the dopamine in the brain, specifically in the frontal lobe. Now, I am throwing around a lot of medical terms very quickly here. Allow me to explain:

The frontal lobe is the ‘command center’ of the brain. This is the area that new brain imaging studies show is most affected in individuals with ADHD. This command center allows people to use their ‘executive functions’, which are the thinking skills which allow for: sustained concentration, impulse control, delayed gratification, etc.

Norepinephrine and Dopamine are called ‘neurotransmitters’. These are little brain chemicals which jump from one nerve cell to the next in the brain to carry a message through the brain.

In individuals with ADHD, research shows that they have ‘underactivity’ of the dopamine and norepinephrine in the frontal lobes.

ADHD medication generally increases the activity of the brain chemicals dopamine and norepinephrine in the frontal lobe, and in so doing, they increase the attention, and decrease hyperactivity and impulsivity (i.e. they increase these ‘executive functions’.

So, coming back to Strattera.

Strattera brought some very unique features to ADHD treatment which were not there prior to its release.

The benefits of strattera include:

  • 24 hour symptom control – although it takes the medication about 3-4 weeks to ‘kick in’, when it does, it works 24 hours per day, contrary to the stimulants which work up to 12 hours per day
  • No abuse potential at all: because there is no increase of dopamine in the part of the brain called the nucleus accumbens, Strattera cannot be abused to provide any pleasure
  • No increase in tics: because Strattera doesn’t increase dopamine in the part of the brain called the striatum, there is no increase in motor or vocal tics with its use. So, for people with ADHD and Tourette’s, this is likely the best ADHD medication
  • Good for ADHD + Depression or ADHD + Anxiety: A recent study showed that Strattera helped depression and anxiety (when they were present in combination with ADHD) and the ADHD. This can often mean that someone could take one medication for their condition – i.e. Strattera, instead of needing to take two medications – i.e. one for ADHD and one for the anxiety or depression
  • May help for nocturnal enuresis: Strattera causes some ‘urinary retention’. This means that for some children who wet themselves at night, this medicine may lead to more dry nights. This is not a main treatment use for strattera, but it can be a side benefit
  • May not cause ‘personality changes’: Some of my teenage patients complain that their stimulant medicine helps their concentration, but may take away their personality, or spontaneity. Strattera is a good option for this, as it does not clinically appear to cause these results

Strattera works for approximately 75% of people who take it. There are some data which suggest that if one takes it after having had treatment with a stimulant, that this may yield a slightly lower response rate. Why is this? It is my clinical impression that this does not relate to the fact that the stimulant has ‘changed the brain’, but rather the fact that as in many conditions in medicine, if something doesn’t respond completely to the first treatment used, it is much less likely to respond to the second treatment – i.e. it is ‘harder to treat’.

How can you tell if strattera is working?

Generally, one should notice an improvement in concentration, and a decrease in hyperactivity and impulsivity. The benefits should generally last for 24 hours -and be more ‘steady’ than they are with the stimulant medicines. As mentioned above, it takes about 3-4 weeks for Strattera to start working, so one needs a little patience.

The long acting nature of strattera means that the benefits of the medication last into the evening – meaning that if a teen has homework or a project to be done, they can still have the benefits of the medication to help them late at night.
Also, there are a lot of data that people with ADHD have many more troubles driving – increased tickets, motor vehicle accidents, etc. So, if a teen (or adult) is going to drive home late at night after a party -it is better if their ADHD medication is still working in their system.

The last part of your question, Tim, was why this medicine isn’t prescribed for kids. The answer is (as I am sure that you have gathered by now) that it is used for kids too.

There are some safety issues with Strattera, and these will be addressed in an upcoming blog post.

Thanks for the great question Tim, and I encourage other readers of the blog to comment on this or any other post. Please remember, that I cannot comment on every question, or every post, but I will try.


  1. I have ADHD and used to take strattera a long time ago and it worked but now I am in Collage and the symptoms of ADHD are for some reason more prevalent now. I can’t really live in the moment if you know what I mean. I try but for some reason my mind always stays busy. It’s like there is a constant inter monologue or threw line going on in my head and I can’t just relax. If I take Strattera again would this possibly go away?

      • I have the same symptom that i cant live in the moment and i have it for a long time ,, is that an adhd symptom or another mental disorder ?!!

        • I feel the same way…. I’ve felt like this for 2 weeks now and still waiting for it to go away it feels like I’m unable to enjoy life

        • wow so strange I feel the exact same way… its a struggle to live in the moment… mind racing… I do suffer from anxiety and add but I am in my 30′s not a kid.. so yes I struggle to live in the moment as well… hummm thanks for the post..

          • I felt like Devante, Traci, Ahmed, and Jon. Mind racing and could never enjoy “now” because I was always worried about everything i should be doing and would never get anything done. I’ve been on strattera for 4 weeks and about 3 days ago I noticed just how different things have become. No more mind racing, totally focused at work, anxiety decreased and I was able to read the whole article above w/o stopping. I love it. CoPay is high, but well worth it.

    • After reading ALL the articles i have concluded that i could of written them all. i was self diagosed adhd after i tok cocaine and instantly felt relaxed and would just go straight to sleep. i researched this subject and eventually went to the doctors who sent me for the test. I had one of the highest scores she had seen and instantly put me on strattera. For me it has been a weird road to travel down.. My concentration is 10x better and my desire is equally increased. My impulsivness is reduced. I self medicate with cannabis ( which i believe is a 100x better than any med ) but sometimes it can make me a bit slow. (still faster than everyone else) but i find i can listen to someone, think of a answer, reply and have a totally different question or answer ready before they have even finished their sentence. -but now im too bored or impatient to answer them ,as i have already done it once… i am currently qualified as a tennis coach football coach, fitness instructor .i also am a plasterer who does oil paintings. i am interested in physics and all sciences. i run 5 miles everyday, am superbly fit (39bpm 40 years old) i run my own business travelling around the country -sometimes abroad. i have travelled to australia,spain holland italy all on my own just to experience the pleasure that i can do it all on my own. And now somehow at 40 i have a son who is like me. and this is why i am writing this. I AM PROUD TO BE TALENTED IN SO MANY THINGS AND IF MY KID ASKS ME ABOUT SOMETHING I CAN SHOW OR TELL HIM. so the conclusion i have is that i would not want to be like all the miserable boring people that i see everyday. It seems to me that they are having the opposite mental anguish that i had as a kid. i wanted to do everything but not sure what, and social pressures place a reat stress on people. but the NORMAL people just done 1 thing, did it well but hit late 30′s and see theit dreams and aspirations have dissappeared, to be left with resentment and miserablitis (as i call it) you only live once so i figure the more i learn the easier it is to answer my boy whe he asks me that special question “why” So a message to parents “is it your ignorance and ego that gets frustrated when you cant keep up with your kid?” or is it the kids fault HE WANTS TO KNOW EVERYTHING !!!! i hope i have answered some of the questions and i am currently “thinking” about taking a course to help kids learn to deal with adhd. genius or madness? its you who will decide that for you child… just be patient… any questions feel free to contact me at

      • I have a 7 yr old daughter who I’ve just pulled out of school to Homeschool her and evaluate some more detailed things for this semester, due to some troubles in school not necessarily her grades. But through this evaluation process and talking with some field related specialists it seems she may be a “gifted” or higher IQ child. I can definitely see both the ADHD tendencies and gifted ones which can have similiar qualities. Both of these things run in our family and it seems like the gentleman and his son majorly are in the “gifted” catagory and not so much ADHD. Tons of people have been misdignoised especially years ago. I suggest looking that up for you and your son. If “gifted” adult or child is the case you do not want to be medicated.

    • So interesting. As I read this, and I have a husband with ADD minus the H, I thought , That isn’t ADHD, that’s just a woman’s brain. Mutli tasking our forte’. I’m just kidding, but my husband is on Strattera and it has REALLY helped him. He is 60 and we have been thru the mill with all the various meds. But Strattera helps with concentration, without the dry mouth issues or the falling asleep and lack of initiative issues. You should try it.

    • I was on adhd medication, bipolar medication and an antidepressant. Basically all of the doctors knowledge is based on what works and what doesn’t. If they really knew exactly what was wrong with everyone then there would be no more mental health wards. I was hospitalized after being prescribed adderall and for months I couldn’t sleep. I tried strattera after and it didn’t have any side effects. While I was in the hospital I was tested on 5-10 different medications. The truth is I have ADHD and bipolar 1 disorder. Lately I have been taking prozac because my symptoms have changed from manic most of the time to depressed due to a car accident and the sudden death of my father. I decided to search for a reason for all of this. My findings are that symptoms change due to surroundings, triggers, and nutrition. If you are experiencing worsening symptoms and try a pill to “save” you it may not work. I found that a lot of the problems with mood disorders, depression, anxiety, bipolar, and worse conditions could be very well a lack of magnesium. Magnesium deficiency is prevalent in all cases of mental health and it is the one calming natural mood stabilizer, anti anxiety, adhd, antidepressant and it’s all natural. I prefer to take a supplement powder called CALM and I have recommended it to several friends and clients and it is immediate in results. My boss was severely adhd and it was hard for her to concentrate on one task or get anything done and all the workers were frustrated. One day I made her a calm drink w water and a half dose of the powder and she left to run errands. 2 hours later she came back and was extremely impressed with how relaxed and calm she felt and she was so happy she felt like she wasn’t racing all over the place. I was able to get off my antidepressant while taking magnesium, however I did have trouble because I developed an extreme anxiety panic disorder from taking an antidepressant for 7 years. So unfortunately now I have to take a small dose of it or I get terrible anxiety and panic attacks on a daily basis. All of which is gone after I take magnesium, but I believe the drug has messed up some natural function in my brain so now I have to be on it. Which is ok because I don’t have any side effects and I am not having any panic attacka which in my opinion is the worst of all mental health problems. At least bipolar you feel up half the time I mean who doesn’t like finishing 15 projects at once all while dancing and making the most money you ever have! Look up magnesium deficiency symptoms and if you are on a budget you can buy Epsom salt at any grocery store for 3$ and do foot baths or regular baths for 20 min a day and it will regulate your magnesium levels to wherever it needs to be that day. Also magnesium oil by dr teals is very effective and immediate for anxiety attacks. Good luck

      • I also give my daughter who has adhd dr teals Epsom salt bubble baths and she has a full day of being relaxed calm, and no mood swings. It is life changing when you feel the calling effect of magnesium. It feels like how you were supposed to feel. Normal doses are around 325 mg a day but some people need 6-700 mg in order to have an effect due to being severely deficient however if you were to take a high dose like that it would give you diarrhea, which is why I use the oil and Epsom salt baths when I’m feeling stressed.

    • For a long time I suspected I had Adhd, i almost always struggled to pay attention 90% of the time , but I could hyper focus to things I’m interested in. I became a welder because it was something I could stay focused doing. Then I chose to become a high school welder instructor to spend more time with my wife and kids and I suffered keeping up the pace of lesson planning, creating assignments, grading homework and tests, professional development, keeping work organized, sped documentation, field trip documentation,budgets for shop supplies, ect.. I missed deadlines was very unorganized. And I knew my mind was not right, although I have a high IQ I could not stay focused on anything uninteresting and I would spend long hours working on tasks that’s should take one hour . My wife diagnosed me to have adhd and I called a psychiatrist. The psychiatrist diagnosed me with severe ADHD and in the same visit prescribed me Strattera. I’m on my second week and so far have not noticed anything yet, I hope it’ll kick in soon because my boss won’t deal with my mess another year. I hope this medicine will help clean up my life and give me the focus I need.

  2. in addtion to my last note my son still is ADHD today and age 28 but deals with it in other ways besides taking meds. Yes it can be done.

      • Wow, I was thinking the same thing. I’m not even on the med a week and she made me feel like shit. That’s your son and good for him, I’ve been like this since grammar school and only getting help now at age 44
        I couldn’t do it alone and maybe you better double Check with your son. I’m sure he has symptoms. Also, for him that is wonderful to. Everyone is different lady.

        • Maybe it’s your attitude that needs an adjustment and not your meds. All she was doing was telling others about her son’s experience don’t be so sensitive. Jeeze. wow lol

    • I’ve had ADHD since childhood. I never took medication until now (34 years old) because I have found many ways to cope with it. However, recently, my job has been laying off and I feel that I’m in the lower end of my ability. I have to work at things twice as hard and take extra steps to reach the same result. There are ways to deal with ADHD without medications, but that will only get you so far in life. Eventually, you become exhausted with all the extra work and just wish you had a normal brain! It’s easy to look down on people who have to use medication if you haven’t been in their situation and experienced their struggles. Please don’t discourage anyone from trying to better themselves.

      • I can relate to what your shared 100%. We are the same age and I have had the same struggles at work. I got so sick of having to re-read stuff etc etc. I’m almost 2 weeks in. I hope this stuff works for me.

      • My sentiments exactly.

        It takes me three times as long to do most things as it does regular functioning people. It is frustrating, hard to explain, and exhausting.

        Regarding Strattera:

        When I first tried it after being diagnosed as “borderline” –
        I was prescribed an adult dose titration schedule but I felt results in what felt 20 minutes.

        My executive functioning skills are pretty poor so I have to hyperfocus or do things immediately after a mere suggestion- just to try to keep
        up. I have four kids. 10-16. Birthdays every year overwhelmed me with anxiety, trying to plan or coordinate most things practically have me hives. I noticed right away that Stratteras greatest benefit was that things that would always overwhelm me with anxiety or high stimulation areas that made it impossible to focus was greatly improved. Problem was the level of meds took me down a level and needed to be adjusted.

        I am on a cocktail of sorts now which has been a life saver. I was really struggling and hard on myself, because I know I can be capable of so much more!

        It is so $$$- I have been relying on the children’s samples from the doctors office.
        Now- Here is a breakthrough effect that more should know about. Taking it at night makes it so much easier to wake up in the morning! 24 hour med right? Still working when you wake up. I think that since it might increase general activity in central nervous system.
        I have been taking children’s
        dosages at night but my doctor is out of samples and I can tell it has made it much more difficult to get to normal functioning mode.

    • It can be done by SOME. Every brain is different for a start and everyone’s extent of AD(H)D is different. The areas affected in people’s frontal cortex are not identical in location nor extent. In addition, people have different personalities, co-morbid conditions, stressors and other factors. So this kind of comment is unhelpful imo.

      Great if some people can manage their symptoms safely without meds but for many they need the meds for their own safety and the safety of those around them.

      Unless one has a scan of the brain it is guesswork best left to ADHD professionals and the individual afflicted.

  3. I have an 8 year old son with ADHD. We have tried most of the stimulant drugs but it seems each one has a side effect. He has been on the Daytana patch which I love, its been great but I’ve noticed an eye blinking tic recently so his neurologist suggested switching to Strattera. I’m nervous to start it but I have no choice since the stimulants bring out tics for him. Do you find this happens a lot?

    • my daughter is 10yrs old and was diagnosed with ADD(no hyperactivity) at age 5. We have tried 7 different meds between then and now and found that strattera has been the best fit. She went off the meds over the summer and is now starting them again and I just had a question about it. She complains about being very tired at school and I wanted to know if giving it to her at night would still be helpful at school the next morning? I was afraid that she will lose the benefits of it during the night.

      • My son was on Strattera for three years for ADD and being socially awkward. It helped with both of those issues, he got great grades in school, make friends and remembered their names and made more conversation with his family. His only issue was stomach upset if he didn’t eat enough before the medication. He was on a light dose of 40 mg per day and we were able to start giving it to him before bed and he had no stomach problems that would wake him up. Since Strattera works for 24 hours, it worked fine when he was at school. He is 12 now and decided he didn’t want to take it anymore. He has matured out of and learned to deal with most of the social issues, but his grades have slipped some. We’ll see, but I would try to give it to her at night, I bet it works. Good luck!

        • My 9 y.o. son is 3 weeks into trying Straterra 40, but also gets nauseous and feels extremely sleepy at school (which he describes as being so bored he just has to close his eyes). Since it’s supposed to last 24 hours, I’m wondering if we can just keep giving it at night with good effects for the school day? Anyone else try this?

    • I had my son also on daytrana patch its seemed to work but he had the eye blinkink tics n also started to stutter in that case it means its too much for them (he is 5) he a 5 mg then to 10 n then 15 but we did not noticed any help just tics. So we r now taking strattera n I’m on day 4 n noticed it causes him to be very sleepy we take it at night before bed n so far we are doin good but the doctor told me to give it a week to notice any changes but no tics with this he dont stutter no more like he did on the patch n it also burned his poor butt n dried him out so give it a try I was nervous to but it seems to be a good choice

  4. Found this blog after talking to my doctor about trying to medicate what I believe is a life long battle with add/adhd.

    Every thing I have read about ADD/ADHD fits me to a T. Even though I was a bright child and got very high marks in tests my inability to focus and do homework made me a failing student. I’m messy and could never keep a clean home or workspace which is a point of shame for me. My lack of a degree has effected my ability to take care of my family because at the job I currently work I do not make enough to support them to the extent I am capable of. I also feel I have various addiction issues. I have been a marijuana abuser since I was 18 years old in reference I am now 35. I realize now that I probably do self medicate my issues with marijuana. I also have unhealthy addictions to video games and sex. Relationships have never been easy for me. I never had a problem finding love but after time I would start to feel restless and would find reasons to alienate that person until the relationship was over. I used to abuse alchohol but I was thankfully able to keep that under control. I am a diabetic and my lack of focus and impulse control issues makes it hard to control my blood sugar in a consistant manner. Plus my smoking pot contributes to the health issues I am already dealing with. I am a father now with two beautiful daughters and a woman who loves me. It’s because of her that I am seeking treatment for this because she works in the mental health field and she’s seen the symptoms and is raising a daughter from her previous marriage who was diagnosed with ADHD and we are very similer in behavior. I talked to my doctor and am currently trying strattera to hopefully get a hold on this. Having read others issues with this condition makes me very sad because I feel with more education and guidance I could have maybe faced this fully at a younger age. As it stands now I feel like I have lived a life wasted dealing with something I couldn’t understand. I do feel better reading others stories and also want to thank you for having this place for discussion of these issues.

    • Thank you for what you wrote. I have a wonderful 9 yr old son who in the last 2 weeks has tried two different stimulants. Unfortunately the side affects were bad so today I was literally in tears not knowing if I should keep “chancing” it or call it quits and “deal” with it. I am going to keep trying because I do not want him to have to feel what you do. I don’t want him to struggle and self medicate himself as he gets older. Thank you for your honesty. It helped me,if nobody else.

    • I too am an adult wrestling with ADD/ADHD. I was prescribed stimulant medication (adderall and ritalin) from age 12 to age 22 but lost my health insurance under my parents and as such lost my meds. 8 years later and MANY addictions later I have finally been prescribed Strattera for my ADD/ADHD. It is not uncommon for those suffering as adults to self-medicate and it can then become difficult to obtain stimulant medication if you tell your doctor about your addiction history. How long have you been taking your strattera? I’m on my second day and so far I’ve noticed nothing. Let me know how things work out or if you find any other solutions. Take care

    • Just a thought, ADHD with anxiety and/depression is often misdiagnosed bipolar disorder. This is especially true for folks who have not been able to ind the right meds combination.

      • Actually, many people with ADD and ADHD have comorbid (co-existing) anxiety and depression. It does not indicate Bipolar Disorder. Ritalin can worsen symptoms of anxiety in some people whereas, others do fine with it. With clients who have anxiety, medication such as Strattera is a safer bet to try first.

    • “Relationships have never been easy for me. I never had a problem finding love but after time I would start to feel restless and would find reasons to alienate that person until the relationship was over.”

      Sounds just like my life. I’ve also had the troubles with addiction. So that brings me to addrerall — seems too good to be true, right? A drug prescribed by the doctor that treats the ADHD and lets me abuse a substance. Problem is I hate the way amphetamines make me feel, but I can’t seem to stop.

      Thinking about trying strattera, but I’m also thinking about going back to “normal” which was a far more chaotic, but also far happier time

  5. I found this blog and I think it may provide the step in the right direction in terms of advice. I am a 23 year old college student who has been diagnosed with bipolar disorder, chemical dependency, and ADHD. I have been clean (no drugs, including alcohol) for almost 2 years. Both of my manic episodes in life have been drug-related or drug-induced, so I lately have been questioning the bipolar diagnosis. Before I got clean and began a strict medication regimen, I was on Lexapro for depression. I began buying Adderall from others students and of course, with no direction from an MD, used it incorrectly. It led to no sleep and a manic episode.

    Now, I am on Strattera and Lamotrigine for mood regulation. I found Strattera worked in the very beginning. I was so cloudy from just getting clean and finally being free from all the chaos of mania that I noticed an increase in concentration. That was May of 2009. Now, in November 2011, I feel like Strattera’s efficacy has declined, for me. I’ve been on a string of antidepressants, most recently Wellbutrin, and recently my doctor took me off all antidepressants because Strattera has antidepressant benefits and “sometimes, depression just goes away on its own,” as she put it. I would say my mood has been slightly better.

    A few weeks ago my doctor said she was thinking about trying Adderall with me, but worried because of the abuse potential, and because I had abused it in the past. As she said, “It worked for you but you abused it.” As a person with a history of substance abuse issues (otherwise known as addict), I expressed a slight worry about Adderall. A few minutes later I realized she had made a mistake. Yes, I obtained Adderall without a prescription but I never took out-of-this-world doses, never snorted it, never used it for anything but trying to complete my homework. I left that meeting discouraged because I wanted to revisit the idea of trying Adderall but we ran out of time. A meeting a few weeks later, I brought up Adderall. She said she would need to think about it. I should mention that about a month prior to her even suggesting Adderall, she increased my Strattera. I had lost the Rx and so I officially began taking the new dose at this time. I take 60 mg at night because it makes me sleepy, and 18 mg in the morning. I have also begun taking a supplement called L-Tyrosine on my own (my doctor doesn’t comment on amino acids.) I notice no change. If anything, I notice that now, I am more distracted than EVER. I actually cannot do a task for more than 5 min unless it is enjoyable. On my browser, if I come across a word I don’t know, I Google it. Then I open more and more tabs as things pop into my head. These are usually websites that have nothing to do with what I am currently trying to achieve, ie, schoolwork. Currently I have an exam at 9:00 and I have 7 tabs open; only 1 is related to studying for the exam.

    I am desperate for help because as soon as I graduate in December, I have to hold down a real job and/or possibly apply and go to graduate school. I know I have great potential but I think I need something that works better for me than Strattera. I want to try an extremely low XR dose of Adderall. I truly feel good to be off antidepressants for now. Lamotrigine is necessary for mood control. But Adderall, I feel, could be an savior because increased concentration = better outcomes, decision making, goals getting accomplished, etc. This leads to feeling better, ie, better mood.

    It’s hard explaning this all to my doctor especially because our meetings consist of a 5 minute chat, renewal of prescription, and her cutting me off anytime I say anything personal that does not relate specifically to my mood and attention. Not that that’s bad, but it is not a very conducive environment to feeling heard.

    Sorry this is so long but I tried to be as concise as possible. If you could offer anything, even a sentence or resource to look at, I would be immensely grateful. I have 6 weeks left in my final semester at a very tough college and I would like to go out on a note a bit higher than the dismal one I’m currently on. Thank you.

    • Hello Pip…
      My response is probably way too late, but perhaps someone else can benefit from my experience.
      I’ve been taking either Ritalin or Adderall for quite some years and never, but never feel an urge to “augment” my dosage. In fact, I sometimes take less than my doctor prescribes.
      This DESPITE the fact that I “abused” (took black market) amphetamine tablets as well as the then readily available OTC mucous dryer-uppers and also had a pretty fancy cocaine habit for about a year in my twenties. I’m now 63. Now I know that ADDers are often especially attracted to stimulants years before they understand their attention problem. If fact, it’s known to be one of its hallmarks and often asked about on diagnostic questionnaires.
      Of course we’re all different, but I can say from first-hand experience that you and your doctor may be needlessly worried about abuse if your body and mind can get what helps you. Besides, by law these drugs aren’t
      prescribed for more than one month at a time (at least not in California) and your prescribing doctor has a legal obligation to observe you at regular intervals.. a real hassle and an expense, but an understandable safety measure, I guess.
      It’s a crying shame if you have a doctor who can’t be bothered to prescribe you even a few tablets at a time, then work you up slowly to a month’s supply while you both observe if you’re handling it without problems.
      Strattera works for some, for others the choice is a form of methylphenate (
      (Concerta, Ritalin, generic) or amphetamine salts (Adderall or generic).

  6. Oops… I just realized my previous comment is so long!

    Here is a concise version of my dilemma: I used to buy Adderall from classmates two years ago. Now I am on Strattera prescribed by an MD. I don’t feel like Strattera is working AT ALL for me. I am super distracted and find it hard to get motivated to do even the smallest task. Now I am considering trying Adderall but my doctor is reluctant because of my past history. She keeps increasing Strattera though my symptoms don’t approve. I don’t know what to do, and I don’t want to seem like the stereotypical college student begging for Adderall.

    Any advice would be greatly apperciated!

    • Hi, I am currently on Adderall XR 20mg in the morning for ADD, also pristiq 100mg for depression, and 25mg Lamictal for my so-called bipolar. BTW, antidepressants were the only reason i had one or two manic episodes.

      Anyhow, I have been on the Adderall for 2-3 weeks. It definately helps with getting motivated to complete tasks/chores. However, if I’m not moving around and I sit down to read, get on the internet or my cell phone, I get extremely hyperfocused on what I’m reading. It’s very annoying when I should really be exercising, completing chores, paying attention to my son, etc. Hours will pass without accomplishing anything besides reading blogs. Guess I need to let my mind get used to the dose or decrease it. I guess I’m having the same problem as you do with Strattera and hyperfocusing. Sorry, just wanted to let you know that u may want to try Adderall, but it may have the same issue as Strattera. We just need to stay away from our phones and internet!

  7. Dear Dr. Handelman,

    My son was Diagnosed with ADHD, just under 1 year ago, he turn 5 just this summer. The doctor that he is seeing is a pediatric neurologist. He has been reluctant to put him on medication due to the fact that he has had a very difficult time gaining wieght but eats a very large amount through out the day. I have recently been working with a children’s mental health centre, he is now in the centers milleu program which is having good benifits as i am not the only one seeing the behavioural difficulties that he has including opposition, impulsivity, and temper control. I just had a meeting with the whole team that over sees the benifits and such for my son both phycologist on the team are recomending that my son go onto strattera and think that if there are no side effects that hinder it’s usage with him it would be a good match. I was wondering if this would be true considering that all the research that i have been doing is suggesting that it is for children 6+?

    • There is also a history of bi-polar illness and depression in the family as i myself have bi-polar and my mother has clinical depression.

  8. For anyone who has a child that seems to be suffering with ADD or ADHD symptoms or for anyone who has a child that has been diagnosed, I strongly urge you to read Last Child in the Woods by Richard Louv

    This book is absolutely amazing and definitely an eye opener for parents, teachers, and child care providers of all kinds. I am a parent and a preschool teacher. I am not making money on the book, its just the only book like it of its kind, and I try to tell as many people as I can about it. You can get used sometimes at used book stores, but it is also very inexpensive on amazon or sites alike.

  9. I’ve taken Strattera as well as other ‘selective reuptake inhibitors’, as this class of medications is called. None of them are 100% targeted to only norepinephrine, dopamine or seratonin; i.e. none of them are exactly and ingeniously ‘selective’. What’s more, to detect these three main classes of neurotransmitters*, cells have numerous ‘flavors’ of receptors and these meds still don’t constitute the perfect match as far as usurping the exact combination of subclasses of receptors goes. Scientists still need to learn much more and beyond that, create meds that not only do the job without also targeting other wrong receptors, but molecules that are not overly toxic to totally unrelated parts of our bodies, such as the liver and furthermore easy to metabolize without creating toxic byproducts in the process.

    All of them have caused me periodic itchiness, which varied in intensity from time to time. Often this would affect the back of my hands and I’d find myself scratching them until I noticed I was bleeding. Why the variance? It’s doubtful anybody really knows. And remember these meds are all about nerves and the way they behave. It might be connected to many things, perhaps connected to something one has recently eaten, which in turn changes amount of many other chemicals circulating in our bodies at various times, like trace metals, hormones, hundreds of different enzymes, amino acids, levels of vitamins.

    *there’s another major neurotransmitter only recently discovered, nitric oxide, (Molecule of the Year for 1992), which earned three researchers a Nobel Prize in 1998. Their discovery led directly to the invention of Viagra and its subsequent cousins, all of which, too, are not yet perfectly targeted to just the right subset of receptors nor totally without breakdown byproducts which play some havoc. Hence headaches, backaches, bluish vision, etc. as side-effects. Nitroglycerin had been in use as a source of this neurotransmitter for well over a hundred years, but nobody knew that one of its breakdown products, nitric oxide, was a true neurotransmitter. We’re learning it has many functions, but is most famous as a vasodialator, meaning it relaxes blood vessels allowing increased blood flow.

    I’ve had ADHD since I was a tyke back in the ’50′s well before it had a name. I was simply an odd, boisterous, stubborn child, an enigma to my folks.

    I’ve learned over many years that I’ve always been quite bright. At age 4 I could never accept the inevitable answer to my obsessive questioning “Why?” about everything I was told to do.
    My exasperated and often face-slapping mother insisted that I make do with: “Because I SAID SO!” I already understood at that age that this was tyrannical and totally unacceptable. I took every kind of punishment, but I never shut down and quit asking ‘why.’
    I suggest to any of you parents who respond in this way:
    Consider that just maybe your AHAD child might be exceptionally bright, perhaps brighter than yourself, and like any adult is insulted by intimidation when he/she intuits the parent actually has no answer, is too proud to admit it or believes the child isn’t ready for the honest truth. Increasingly, scientists suspect that ADHD is a portion of a ‘cluster’ or ‘spectrum’ of related abnormalities. Severe autism at one end, going towards Aspberger’s then less ‘abnormal’ to AHAD. With increasing knowledge comes the discovery that often such children posess a spike or more of genius in some areas beyond their parents’ and that far more of the problem is a communication wall than previously thought. iPads are working miracles opening up surprisingly bright brains to a populous which had naively perceived only subnormal IQ. Google the ground-breaking Aspergers woman, Temple Grandin, who sees both sides and has done so much to help enlighten the formerly ignorant about the degree of intelligence and emotional capabilities of many who lack the capacity to be heard and understood.
    One astounding example: It was long thought autistic children didn’t want to be held or touched because they didn’t have the emotional wherewithal to crave it. Turns out that probably ALL autistic children love touch and holding, but at the first encounter with it at birth became phobic because touch was always so spontaneous, often leading to head petting, getting dragged somewhere, picked up, kissed.. just roulette. This suggests that the moment autism is detected, touch needs to be so predicable that the child doesn’t immediately associate it with “all hell will break loose” and henceforth fear it for life.
    Is there anyone still reading? I told you I was a problem child. My folks tried to beat me down, but I still suck up knowledge at 63 like a sponge am obsessive about my interests and am proud of it;-)

    • As a mother of a daughter with ADHD/OCD, I totally agree with you that my child is of above average intelligence. She hasn’t proven it on an IQ test but I believe that is only because she can not pay attention to the instructions. I have always been told by everyone who meets her that she is very smart and they can not believe the stuff she comes up with. She is highly imaginative and creative, and I wonder sometimes if that is why her brain gets locked with intrusive thoughts. I am on a forum with other parents of kids with OCD and 90% of them talk about how highly intelligent their children are, but because of their conditions they don’t perform to the standards of mainstream society. I absolutely without a doubt know that my daughter is brilliant. I have tried my best to not “beat that out of her” as you called it. I am not going to lie…sometimes I lose my patience and I am not as supportive as I should be. When she was a really little kid and she gave me those non-stop questions about things I couldn’t answer, sometimes I would make things up just to give her an answer. Lately though, I will say “I don’t know” or sometimes I just say, “google it’. I know your mom couldn’t do that 50 years ago. :)

      • Hey, just wanted to say that I was exactly like your kid as a child! :D Haha. I was diagnosed and treated for anxiety, depression, and OCD during adolescence. I’m now 20 and JUST got diagnosed with ADHD. I’m also still a curious, brainy, creative artist and I’m learning to embrace my strengths and my parents are learning to not blame me for my inattention- a better situation all around.

    • ADD/ADHD is distinct from the autism spectrum. A kid with ADD has trouble focusing, but ASD(autism spectrum disorder) is about not understanding social cues. ADD is treatable with meds and also helped with CBT. Autism is only proven to be treatable with ABA and CBT. We did much better coming off meds with our ASD kid. I have personally dealt with both in my immediate family and have tried everything from diets to meds to neurofeedback to OT and countless others.

  10. Hi, I just started taking strattera today but in the genetic form of atmoxetine. I have ADHD but as well as many effects of depression and anxiety, which one of the main reasons why i choose this medication to help all three, but to my surprise i read the box and it said it can INCREASE my symptoms of depression anxiety and my mood. I know it says in young children and teenagers, but im only 20, and im wondering what are the chances of suicidal thoughts and a increase? I dont want to take a ton of meds to help with each of my problems. but i can not take the pressure anymore

    • Hello Christa,

      Like yourself, I had those same concerns. It is not easy taking any kind of medication. Especially once you read the “pro’s and Con’s” of the drug. When we embark on such a mission to rescue ourselves from our issues, we have such high hopes to get better. The chances of suicidal thoughts and anxiety very from person to person. Remember, your treatment provider knows your history and would not knowingly prescribe a medication to you if you demonstrated suicidal tendencies. When I started taking it, like you, I had those same concerns. The fact that you are addressing them shows you are mature and are arming yourself with knowledge. Good for you! That’s important. Another suggestion I would give you is to have someone you trust check on you from time to time and make notes of any changes in moods, speech or general activity. After about 6 or 7 months, ask that person to share with you what they observed and be sure to give them a free pass to be open and honest. You will find this a BIG benefit to you. If you have any questions or need any support, drop me an email. Take Care Christa.

    • Hi there.

      We sound pretty similar and I want you to know I had similar concerns. I have been on straterra for almost 2 weeks. I have not had any depressed/suicidal thoughts AND a very positive note, my anxiety has actually decreased!!! :) yay now I just hope it works for my add symptoms. Good luck!

      • Hi Andre, Rob, and Christina. I realize this thread is old but I wanted to say thankyou for sharing your experiences. I’ve been treating anxiety, OCD, and depression for 6+ years but I am JUST NOW, at the age of 20, getting diagnosed and treated for ADHD. I just started Straterra today. Reading that people on Straterra usually don’t become suicidal AND that their symptoms improve noticeably is so encouraging.

  11. My daughter is 9 years old. She had ADHD and MERLD (miced expressive receptive language disorder) She is constantly asking questions about the human body. She will obsess on the brain for days at a time. What does it do? When color is it. What does it feel like etc etc etc. Then she will move on to another part of the body. I check her interrnet websites and she look at dozens of sites for answers. I try to give her answers but I’ve finally resorted to “Google it?” She is a bright child. Has an unbelievable memory and as a child always assigned people she meets a color. I’ve always been “Black” and Mom has always been “Red.”
    Her fine motor skills like drawing, writing clearly and coloring are still very unrefined and she has a hard time making “small talk” with other kids her age. I guess I am wondering if you ever had a connection between lack fine motor skills and obsessive questioning? Any insights would be appreciated. Thanks!

    • More and more studies are discovering a very blurry line between a “cluster” of disorders, perhaps starting from the hardest to communicate with or relate to cases of autism to milder cases, to Aspberger’s syndrome, where individuals are more able to ‘fit in’, to more severe cases of AHAD or ADD and / ODD to milder cases of hard-to-control attention, to any degree of ‘quirky’ tendency to preoccupation with subjects that the majority considers outside the norm, to people who blend in quite adequately, but are in some way an eccentric, in other words “outside the circle” or “off center”. It’s frankly quite a mess right now as more and more variations on a general theme are able to be spotted, are reported much more than before and clinically identified, while at the same time this growing stack of somehow related degrees of “misplaced” attention or ‘atypical behaviors’ has not given away its secrets and avenues of connection with one another.
      And it somehow leads a thinker to the conclusion that each and every one of us balances on this tightrope somewhere or another and none of is unaffected by some kind of quirkiness, some ‘oddball’ quality we’d be too ashamed to tell even our closest friend. We can’t stop buying lotto tickets, we overeat, we’re sexaholics or else phobic about sex -or germs, stuffy air, have a silly predilection to collect some odd thing we don’t talk about, or simply can’t resist watching yet another game on TV.

      What can one do? I’m 63 and now know I’ve had a form of this syndrome all of my life. I’ve had quirky, unusual interests all of my life. I drove my folks nuts because I wanted a chimney for Christmas, (actually, one of those metal vents on roofs for furnaces, drains, etc, and that are to be seen in all shapes and kinds). Another year I desperately wanted a stop light, you know, a regular red-yellow-green automatic traffic signal. I never got any of these things (yes, there were others). I look back now and feel my folks mishandled so many things. Often it would have been only a matter of acceptance and less embarrassment, sense of failure or angst about what I’d become as an adult if they’d given in. Of course my folks’ motives were good; they loved me, wanted me to be well-liked, not laughed at in school, to be have a successful life as an adult with a family and three kids. In the ’50′s as a child, parents had nowhere to turned and dealt with ‘problem’ or ‘odd’ children such as myself the best way they could and unfortunately often corporal punishment such as slapping, ridicule, to throwing one’s arms in the air to indicate to the child how really ‘weird’ or what an ‘oddball’ he or she was. I recall overhearing my grand folks in the next room telling my parents in a somewhat low voice how the child of some acquaintances of theirs had been such a problem, “Well, It was a miracle, they took him to a clinic and this surgeon operated on his brain, just a tiny snip. You wouldn’t believe the miracle, he’s now the nicest kid and so sweet.”
      I was seven when I heard this. I was also very, very smart. Actually, the problem was, I was too smart for my parents’ egos. I say that with love. But it was true. They’d rather I shut up than put them to the task of dealing with boundless curiosity. That was surely the root of many a slap across the face by my mom for refusing to not be told ‘why?’ Unfortunately, this is a very human foible and perhaps I’d be tempted to resort to the same if it were relentless. For instance, I doubt very much that my mother understood that that boy had been lobotomized, but it wasn’t lost on me!
      To the point:
      ADHD is a curse, but also a blessing. Don’t ridicule your child into submission or ‘normalcy’ Don’t make him/her fear and loathe himself for being ‘different’. It can take years and years to undo such damage. Teach your child that each of us is unique and a wonder. Give him tools to live with himself lifelong with self-love. Show him how to set one, two even three alarms on a calendar to give himself time to shift from one subject he’s hyper-attentive about to the next. ADDers have a hard time ‘shifting gears’ from one subject to another when deeply involved. My mother would bark at me from my bedroom door to go do something else. Man, I’d be so far away, she’d frighten the daylights out of me. I spent years feeling like I was walking on eggshells with nowhere to hide.
      ADDers are stubborn as mules. This gets tempered with age, but remains a trait and can lead to excellence by stick-to-itiveness with learning foreign languages, calculus, getting a sculpture just right without giving up.
      I’ve learned so much about so many topics, traveled everywhere, managed to work on my own without dealing with a boss everyday. There’s a life for your child out there. With all you see as drawbacks, there is equal brilliance, excellence. Don’t over-worry it. Teach tolerance for others instead. Come up with inventive tools, clocks and timers, allow extra time to change subject matter. Where your child lingers ‘too long’ on something, he’s learning right in that moment more profoundly than you perhaps ever dreamed of doing. Whether you deem it of value or not is not for you to know. LOVE AND ACCEPT. PRACTICE TOLERANCE. Towards yourself and all souls.

      • Mike,
        Your post was so inspiring for me! I have a six year old son who has a diagnosis of PDD and is going to be evaluated for Aspergers. He also has ADHD. Like you as a child, he rarely asks for toys for Christmas. He wants water-towers, cell phone towers, furnace fans. All i want is for him to be liked and fit in. I’m always worried about him and his future. Will he have one? Will he be happy? Reading your story reminded me that I need to be patient and support his quirkiness…embrace it and love him for who he is. I’m happy to hear you have grown and had a successful life and relationships.
        God Bless you.

        • Thank you Jen. It means a LOT to me to hear that even one person read and, better yet, got some good out of what I wrote.
          Yes, yes, your son sounds so much like me at that age! I would draw how I imagined the insides of a refrigerated drinking fountain or air conditioner must work, etc. I wanted a “real” ream of paper!! Very odd wish before everyone had a home printer. I got laughed at, but after much pleading, it was one of the most memorable gifts once I got it. I was a jumper. I’d jump for .. hard to guess.. maybe fifteen minutes standing in one spot. I became ashamed of jumping as I got older, but it felt so good and helped my mind re-design and invent all kinds of cool things. Or perhaps I’d fantasize about some exotic land I wanted to go to and what it would be like. It was really just the same as many who get a strong urge to pace or take a walk when absorbed in thought. My folks finally got me a Pogo Stick.. one of their smarter solutions; I’ve always had these huge legs of a quarterback. I became good with my hands and learned to make art with all kinds of mixed media. I’ve made tons of art I’m really proud of and sold some beautiful things that display nicely in palatial homes far richer than my blood.
          Just one more thing and PLEASE don’t anybody fret, as I have absolutely no reason to know or if this is related:

          Already at the age of 4, 5 or 6 I began to suspect there was something “different” about me sexually, too. Of course I was still far too young to understand what that meant, but it was enough to make me fearful and worry as I was figuring out more each year what I’d best not ever talk about. I wasn’t ever very effeminate, but I was near the last pick for sports, dreaded that shame, but I did care about re-designing my folk’s home and dragging them around to show them some house our’s should be. That was suspicious enough. And I learned quickly how I must behave to cope with living in a household, brother, sister and society very backward and negative towards homosexuality (imagine the 50′s and 60′s and my dad a big narcotics officer who went off to work with his .33 Special and chromed handcuffs every morning). I’ve often wondered if a few of the things I was interested in as a child were sexual sublimation, as I was certainly trying to figure out many, many mysteries.

          So you can see, I was this child who was wonderfully creative and bright on the one hand and on the other a worry, frustration and I’m sure at times an embarrassment for my folks and older siblings. And all of this through an era that was the epitome of Conformity with the Joneses.
          Keep in mind that in those Dark Ages, “gayness” (nobody knew that word) was scorned with complete self-righteousness. It was classified as a horrid disease by the same industry and perhaps the very university Dr. Handelman attended.
          Even today more than a few alcoholic husbands, for instance my decades later re-found playmate from second grade and I suspect even my own grandfather– ended up on the bottle because of taking the only known, or at least acceptable, path to a premature marriage with kids that should never ended up in such a mess. Yes. We are all too judgmental of others. The biggest part of the problem is stupidity, not whether your children are “different” or not. Don’t ever let them be the brunt of any small thinking you may still harbor. Just teach them to have courage to be who they innately are.
          The huge cultural tsunami of the later 60′s and 70′s happened just in the nick of time for me. I was just old enough to flee to a much more liberal and enlightened Europe in that era and really begin my own life. I’ve been happily espoused for twenty years now. Although the U.S. still denies us a legal document, we have a good life and are as happily married as any reader here.
          In closing let me say that I don’t believe ADHD has anything to do with which gender one ends up being attracted to, but in my case, I believe it was a blessing in that it gave me the stubbornness and will to push through and not be beat down by others’ stupidity.
          Anyone who believes this much harder path is a “choice” and the chooser is a “sinner” has his/her head up… yeah, up there.
          Teach your kids self-pride for their own individuality and acceptance of others.

          • Wow! Almosts speechless….my daughter who has ADHD/OCD is an artist. She can draw with amazing ability.

            But something you said triggered something with me. The part about being sexually aware at an early age. My daughters OCD started in 3rd grade and as intrusive thoughts. Her biggest fear was “people having babies”. That’s exactly how she would say it and I could never get her to explain what she meant. She is 12 now and we are still working through her anxiety. The other day she told me she was having “bad thoughts’ which is what she calls her intrusive thoughts. Sometimes she will tell me what they are though often she will not be detailed about it if she does tell me. She told me that day that she had the thought that she was gay but she knew she wasn’t. But she thinks she thought that because my nephew is gay and we always compare her to him. I just told her that no matter what…whether she was straight/gay I would love her. And that everyone has probably thought about it at least once. I also agree that it is not a “choice”. I could recognize it in my nephew when he was 7 or 8 years old. I just don’t think he would choose it. After you telling me about your grandfather though, I am wondering about my own dad who is now 73. He is an alcoholic. He always had a lot of homosexual friends. One of his best friends growing up lived in his family’s home and was gay. Hmmm…I wonder.

      • All I can say is…WOW! Thank you so much for being very open with your experience’s. I can’t believe how much I see myself And my daughter in these writings. I feel like laughing and crying at the same time. I agree, love yourself and others regardless of their differences. Much love and peace to all of you and tour journey ?

        • Oops.. And your journey. P.S. My daughter is 12, started Strattera about 6 months ago and seems to have helped, so much so, I am starting g this week at the age of 47! Never give up!!

  12. My son is 6 and has text book features of ADHD/ODD. He was always a very bright, active boy who never sat still, but it wasn’t until he was 4 in pre-K that he started having significant problems both at home and at school. We tried a year of behavior therapy and I cut back on my work to give him more attention/structure (my husband and I are both physicians). Despite our efforts, he continued to get worse. I was very hesitant to start him on medications, but after a year of trying other techniques, we opted for the medication route. It was trial and error, but we finally found the perfect combination of Intuniv 2mg and Concerta 18 mg. It was a dramatic change and he got great reports every day in kindergarten and I was finally seeing the light at the end of the tunnel. The real treat for me is that his ODD symptoms seemed to go away almost completely. Then, the tics started (strange eye movements with head turns). We had him evaluated by a neurologist and neuro-ophthalmologist who both agree they are tics most likely brought on by the Concerta. So we stopped this 3 weeks ago and his behavior in school has deteriorated to the point that we may have to change schools (and his teacher at the current one is excellent with years of experience so this did not come up lightly). Unfortunately, the tics haven’t gone away completely (which is a bit unexpected after stopping the Concerta), but I still think the association between the Concerta and the tics is there as they did get dramatically better after stopping it and the tics developed less than 2 months after starting the medicine. Now, I’m not quite sure what to do as I’m worried about starting him on another stimulant. I’m particularly worried about him developing Tourette’s syndrome. I’ve come across Strattera, but his psychiatrist isn’t a big fan (she participated in the study that showed it wasn’t so helpful in 5 & 6 year olds). Any thoughts?

    • Olga, I’m sorry that nobody has answered your plea for help. Perhaps you’ve given up on reading here, but just in case, and also for others… I’m sure many have read what you wrote but the truth is, there is no answer for you. I believe meditation can really us, but it takes much discipline, tenacity and practice, the exact qualities ADDers have trouble with. Moreover, your son –especially at such a young age– wouldn’t likely cooperate with such practice in stillness, which offers absolutely no immediate reward and seems only like the worst torture to even many ‘normal’ beginners. But perhaps there’s a specialist somewhere who teach kids to meditate.
      That his tics have ameliorated is a very positive indicator that with time they’ll disappear completely.. as long as he doesn’t discover some kind of purely psychological attachment to these tics.
      Children –and adults alike– are really not much different from my parrot, Mango, or any other highly social animal in their need for attention and succor, so without conscious effort can easily assume habits that appear to work to this end –even if the habit is “maladaptive” in the bigger picture, i.e. has more drawbacks than advantages for the individual from a LOGICAL point of view. For instance, if Mango needs nurturing badly enough when I’m preoccupied and unwilling to stop and give it to him, he’s very patient for a long time, but eventually if still ignored, he’ll do something “bad” he knows I must address, something he’d never try when he’s feeling content. We are all like this in ways we often don’t even realize. So don’t make a big deal about any tics that still happen so he won’t imbue them with some kind of round-about benefit –or nonproductive worry, either.

    • Olga, I’m sorry that nobody has answered your plea for help. Perhaps you no longer read here, but in case, and also for others… I’m sure many have read what you wrote but the truth is, there is no answer for you. I believe meditation can really us, but it takes much discipline, tenacity and practice, the exact qualities ADDers have trouble with. Moreover, your son –especially at such a young age– wouldn’t likely cooperate with such practice in stillness, which offers absolutely no immediate reward and seems only like the worst torture to even many ‘normal’ beginners. But perhaps there’s a specialist somewhere who teach kids to meditate.
      That his tics have ameliorated is a very positive indicator that with time they’ll disappear completely.. as long as he doesn’t discover some kind of purely psychological attachment to these tics.
      Children –and adults alike– are really not much different from my parrot, Mango, or any other highly social animal in their need for attention and succor, so without conscious effort can easily assume habits that appear to work to this end –even if the habit is “maladaptive” in the bigger picture, i.e. has more drawbacks than advantages for the individual from a LOGICAL point of view. For instance, if Mango needs nurturing badly enough when I’m preoccupied and unwilling to stop and give it to him, he’s very patient for a long time, but eventually if still ignored, he’ll do something “bad” he knows I must address, something he’d never try when he’s feeling content. We are all like this in ways we often don’t even realize. So don’t make a big deal about any tics that still happen so he won’t imbue them with some kind of round-about benefit –or nonproductive worry, either.

  13. I’m 21 years old and have gone thru many stimulants and also had neuro feedback brain training. None of these have worked. I am willing to try strattera, but here’s the catch. I’m about to have my baby boy here in a week or so and want to be myself. Should inbe concerned about irritability or anything such as that, that could conflict with me being as happy as I should? Is right now the best time to get on strattera?

  14. I have been a nurse for 13 years and personally also have struggled horribly with ADHD since atleast the second grade in school. I have taken Strattera since 2007 and it has 100% changed the quality of my life. I personally don’t feel that any pill is a “miracle” drug that will take care of each and every problem or symptom we experience in life, as I still personally struggle with anxiety at times, But overall the ADHD symptoms and depression that can be present with ADHD are pretty much non existent while I am taking Strattera. I personally notice a difference the first and every time I take this medication and that is no lie. One of the immediate affects of this drug for me is I notice much more attentiveness while I am driving that I had no idea was even missing (Scary).I cannot imagine not being on this medication and plan to remain on it the rest of my adult life unless there is any indication that it would be known as harmful to the body. My son who is almost 8 years old is also being looked into as being ADHD and I am planning to ask about him being put on Strattera. I feel that people with ADD or ADHD need to do what is best for them and what they decide, not necessarily either medicate or not medicate. However I am telling you all that I personally am now medicated and only wish that I had been sooner in my life.

  15. I was not diagnosed with ADHD until after I had finished my Bachelors. I still managed to graduate Cum Laude. I often wonder, how well could I have done? I have been taking medication for going on 2 years now, and I am having my second promotion along with significant pay increase in those two years.

    To those of you who say you can live without it, you can, and you can do well and get a good job. However, if you were medicated, you would do much better at that job. I am a case in point.

    Anyway, I took Strattera alone for over a month. All I can say for it was it made me nauseous and tired and sex wasn’t an option. I was calm, but not focused. Perhaps, if it is used with a typical stimulant it would work better, but I cannot say anything good about it alone. There is no replacement for stimulant therapy in my book, but I actually like being able to focus on my work and not just knowing that I have work, but I’ll get to it… sometime.. it sure is a lot. Even making a list doesn’t make it seem any better.

    • Dan, you mentioned something very fleetingly that I find too important to gloss over, but that many readers might have not fully grasped, especially mothers, who are often the one parent who ends up taking the bull by the horns to get practical help for an ADHD child and follow through.

      You wrote: “… and [while on Strattera] sex wasn’t even an option.”

      Strattera’s generic name, atmoxetine, gives a reader a clue as to what family of meds it belongs to. It’s a molecular relative of other meds ending in -oxetine. These are all a class called Selective Serotonin and/or Noreprinephrine Reuptake Inhibitor. SSRI or SNRI for short. Several molecular siblings are Fluoxetine, (Prozac), Duloxetine , (Cymbalta) and more.
      Although still being studied, these meds serve to keep more serotonin and/or norepinephrine (two of the “neurotransmitters” our bodies use to transfer signals from one nerve cell on to the next) available and for a slightly longer time period before being reabsorbed from within a gap between them called a synapse, a sort of on/off “gate” between them. Altering the signaling and its timing at these synapses between brain nerve cells affects how they function and thus how we feel, remember, concentrate, think, and everything else.
      It seems to be that whereas depression can be alleviated in many people with a serotonin boost alone, others need help with norepinephrine. None of this class of meds is without some crossover in affecting both to one degree or another. This is why Strattera can help lift some people’s depression and sometimes those related antidepressants can lessen ADHD symptoms.
      Although manufacturers know it well, it’s rather downplayed that SSRI antidepressants cause many, and particularly men, to experience anorgasmia. Meaning that although a guy may still desire and attempt vigorously, even ferociously, to reach orgasm, he may just get “warmer and warmer” but can’t quite “arrive” and finally gives up, or at least not without a lot of frustration and then success, but with attenuated sensation, and certainly with less frequency than he might be accustomed to.
      Women, for some reason not yet understood, are less likely to experience this peculiarity, which is frankly wrecks real havoc for many and is itself a good reason to get depressed if you weren’t already.
      Finally all these years after the ‘sexual revolution’ of the 70′s, a decade into the 21st century, people are beginning to admit to themselves and to others that masturbation isn’t a dirty word, but something important to all of us at ANY age and wow, certainly when we were 13, 14 or and after much trying.. admit it, you did try before you were able (all your neighbors, too), when you finally succeeded.. well, suffice it to say, you still remember vividly when and where it happened. It was suddenly the greatest thing since sliced bread. WOW. Strattera can and does cause anorgasmia (my prudish spellchecker still red underlines that word).. I ask you, particularly you moms, what teenage son would ever even as much as hint to you that he’s suddenly lost one of his favorite and very private joys? He may or may not even connect this issue with meds.
      What’s likely to happen? Non-compliance with taking this med. If you ever found out and asked why, do you think he’ll tell you the truth? No kid would tell his mother. Sadly, not even his dad or his doctor.
      You may be at your wits end believing Strattera just doesn’t work, or suddenly stopped working, with no clue that he’s been flushing each capsule down the toilet for months.

      Unfortunately, although this fact is slowly leaking out, Eli Lily has not been helpful about this issue, instead burying it. Read the FDA mandated box labeled Drug Information on Strattera’s insert. This always lists things consumers should know. Sadly, in the U.S. at least, Strattera gives two (2) separate listings for “side effects that may occur”, One for adults and one for younger people. Way down on the adult list, you’ll find “sexual: sexual side effects” Period.
      Worse yet, the list for young people just skips the category ‘sexual:’ as if it were not applicable. Yet, statistically speaking, by far the the most prescriptions for this med are written for boys before, at onset of and after pubescence. Mothers, please be wise and loving… and do not act impulsively or in any way insensitively without much forethought and if at all possible via your son’s dad, an understanding male doctor, counselor or any ‘guy’ he might be more inclined to open up to about this than the most embarrassing and taboo person in the world to tell: his mom. This subject is absolutely mortifying for all teens just as it was for you, your siblings, all of your neighbors and their relatives at 15.
      I’ve often wondered if this isn’t actually the crux of elevated teen suicide and administration of this class of meds, for a good case of anorgasmia truly makes for the Perfect Storm for a depressed teenager already caught up in a hurricane of other problems and fears at home, school, etc. from which he sees no escape at all, even if temporarily.

  16. I was prescribed straterra, up till this point i haven’t taken it yet. i was just prescribed last week. The problem i have is, i am 36 years old, i haven’t had regular doctors checkup or appointment probably in 20 years. I am overweight.. meaning 5’7 230 pounds, but i am unsure if i have any heart conditions, as far as i know i do not. What if i were to take it and have sudden death? Is there really any risk? My regular doctors appointment is march 19th, he sure isn’t going to give me an ekg etc.. etc.. so it’s not like i’ll ever know for sure until something bad happens! Am i paranoid or?

  17. Thank you so much for this article. My daughters psych recommended that her peds change her from Vyvanse to Straterra for her ADHD/OCD. I was worried about changing. We are going for the visit to change tomorrow. Your article was very informative and I am truly hopeful that my daughter will find it helpful.

  18. I have an 11 year son which is so frightened of life,I was told he has ADD.He plays soccer and I just feel he give 50% of himself. Will this help him as there is so much side effects.The doctor has recommened Straterra.

  19. My 6yr old son was recently diagnosed w/ ADHD. We chose Stratera because it was a non stimulant drug. He started taking 10 mg at night and took that for 2 wks w/ no affect or side effects. We increased to 25 mg ( he is 42 lbs) and now has been 4 wks with this dosage. Because of his age … It is hard to get feed back from him. He did jump from a reading level 1 to a level 6!
    We are not seeing a decrease in impulsivity or hyperactivity. We have decided to continue the 25 mg dosage for another 4 weeks before changing anything.
    Can we safely increase.. Due to his weight? I think I read it was 1.2 mg/kilo?
    I would LOVE some feedback.

  20. Hello Teresa..
    So you have a sixth-grader? Although eons ago, I vividly remember my classmates and teachers in those years. I don’t know how the system works where you are, but we kids moved to middle school –junior high– the next year for 7th grade. What a tumultuous change! Those are really rough years for all kids. Hitting puberty, growing an inch a month. Personalities start to become more defined, everyone’s clamoring to fit into one clique or another and fears abound about being left out or not being considered “cool”. Boys start locking horns and girls start competing for attention and comparing their looks. If you think back, we bordered on being savage, hormonal animals. I guess that’s why they put those 2 or 3 years in a separate school almost like a separate cage.. I say this half jokingly. But only half..

    In light of the above, I wonder if you have all the information about what’s going on in your son’s world and in his head.
    On what do you base your statement, “he’s so afraid of life”?
    Being a fearful person, child or adult, certainly doesn’t come to my mind as a major hallmark of ADHD.
    However, I can see how repeatedly suffering surprise attacks, frequent physical accidents, forgetting what one is supposed to be doing, then becoming startled out of one’s wits by sudden yelling.. all because of poor attentiveness to one’s surroundings –or more aptly put, hyper-attention on something fascinating far off elsewhere– could condition anybody to be a constant state of anxiety and fearful of taking any action at all.
    Similarly, who told you he has ADD? Your family doctor? If so, based on what, exactly? I hope more than just your observation about fearfulness or his telling him that.
    I think for the time being, Straterra or not and whether Straterra works or not is not even the issue. If I were your physician and heard what you told everyone here, I’d be more interested in gathering more knowledge about your son’s exact fears and finding out if there’s a reason for it, if something or someone has traumatized him –just finding out exactly what’s going on there. maybe even enlisting the help of a therapist to get him to open up.
    Has he always given “only 50%”? From where do you have this notion? Maybe he’s trying 110% but it’s still not good enough for you? I’m not saying this is the case, but you know there are parents who are like this. Their children can never do or be good enough for them. Such a child, dependent on parents for survival, has no choice but to become resigned to never being quite up to snuff, becomes withdrawn and gives up to a certain degree before he even gets started. Does he have a dad around? If so, is his dad rarely or never satisfied with things your son does? For if so, that could certainly make him feel worthless and apathetic about trying.
    I was in 2nd through 9th grade with a neighborhood pal who did poorly all through school while I did very well. At age 60, we found each other after all these years and began corresponding. Boy, the things I’ve learned by patiently asking and listening! He’s every bit as bright as I am and loves to learn. But he one of those kids who just fell through the cracks. Come to find out, his dad was a full-blown alcoholic and his mom perhaps, too. He told me our fourth grade teacher was the only one who encouraged him. She told his parent he needed help at home with reading. Chris just told me this recently, “But my folks never lifted a finger to help me.” They had other interests. They even joked that he wasn’t a real bright bulb. Once I reminisced with him about making papier mâché dinosaurs in 5th grade. He confessed to me that he never made his because he didn’t understand what we were supposed to do, but was too afraid to ask any more questions! With these two pieces of information, the needless tragedy of it all dawned on me: My friend’s only fault was being in the wrong grade. He should have been held back a year to give his little neurons the time they needed to catch up. This was such a stigma for parents, the thought of having a “slow” child, so naturally we kids believed this ignorance, too. So it never happened.
    Had he been given the time his natural genetic makeup required to mature, I suspect he would have gotten much better marks, a bit of praise, and his self-esteem wouldn’t have been half as battered all through school and later in life.

    • Mike was just surfing the net and came across ur posts. I can relate to many many of your posts. I to was ADD as a child. I am 44 and back then there was no diagnosis for ADD….in the 3rd grade I was put into Special Ed. They did not even tell my parents…I was not paying attention, was all over the place and then without notice was in withe the special students….My Mom find out about me talking about coloring most of the day.

      Then in the 7th grade i was taking an algebra class at the University of Pittsburgh. By the grace of God I excelled at sports and the principle was the football coach. He took a special interst in me and the rest is history. I ended up going to College on a footbalscholarshipip bucouldld have went on a academischolarshipip. The principle structured my classes around me….if I was not a top athlete this would never have happened! Again, the luck of the draw.

      My personality is ENFP so I have always been big picture and easily bored. I found this getting worse as I became a manager. Keirsey explains we practice what we are good at and we become really good at it…lol. Trying to say that my tactical skills have slipped…and just ion the course of life I had to deal with very detailed facts and figures. I was never not able to do this work butneverwver interested me. I actually majored in engineering while playing football at a DI school. Calculus, chemistry, physics fascinated me for that class…so I paid attention and it came quite easy.

      As I got older I knew I had ADD. I put things off…multitask to much and and boisteroustand bluntdblunt. I got away with this for years as people knowe me know I am the kindest most compassionate person one can know…..but as I moved up to executive levels of management…being 6’4″ 350#’s (I am not fpower lifterlift and am at the top of the sport), loud, boisterous, black and very very expressive. It did not fexecutivecutive model. In fact I work for a super major oil and gas company (very liberal actually) that helped me with modifying behaviors….not changing my personality. In fact out of 10,000 engineers their may be 1 ENFP. I care much much more for people than I do facts, figures, products, or results.

      Anyway several years back i was put on Adderall….Wow did it work. I found myself lest likely to blurt out, take control of a meeting, reflect more on things in general. I toboutsy boudts with speed…but this is medicine for me not recreational…if that makes sense???? Adult ADD is exactly as u said Mike it can be a bitch, but if you use it to ur advantage it can realstrength stregth.

      I am lucky enough to work for the best company that I know….they identify this in people and develop them around there streghts…WHAT A CONCEPT! They are so people focused! 50% of our review is on behaviors…getting results the RIGHT WAY! If your and asshole and trample the rest of the team…that does not fit into the values of the Company.

      Keep posting Mike…ur a caring compassionate person! You made me think about those awkward middle school days! My daughter is 13 and it made me really think what she is going through! She is an angel… characteristics of Dad all Mom…very quiet, thoughtful, still, loving and compassionate….

      Again Mike enjoy ur thoughts!


  21. Quick question. I’ve been taking Strattera for 5 days. I’ve felt the difference right away not the couple of weeks down the road like you mentioned in your article. I even pushed myself by letting my wife take to two stores packed with people then drive home in the middle of rush hour with no problems what so ever. This medication is good. So what’s the deal? Am I more sensitive to the drug or is it something I should be worried about? And my last question is would this help a regular person concentrate better also

  22. Mike,
    Thank you for the words.
    a 40 year old here with ADHD and AS; we need more people like you telling the word.

    Parents take their kids to the Dentist or Optician often enough; just look at the horror on their faces when you point out that a character trait you have just had to listen about concerning that kid is an ADHD trait.

  23. Chris,
    In my experience, NO. Why worry about feeling better at this point? Life is fraught with enough genuine dangers. Another -or further- economic crash, auto accidents, tornadoes, earthquakes or an influenza pandemic worse than the one in 1919.
    Strattera is a class SNRI med and works like I explained in an earlier posting by, in this one’s case, allowing the neurotransmitter called norepinephrine (a signaling chemical produced by our bodies) to tarry just slightly longer in a special gap at a communication juncture between nerves cells. This communication gate is called a synapse. We each have billions of them. After a certain short period of time, a matter of milliseconds, the neurotransmitter is “reabsorbed” , i.e. removed again from the gap and saved until the nerve cell calls on it once again to enter the synapse and perform its job.
    Much still remains unclear about how this entire and very complicated nerve to nerve communication system functions and exactly why taking a med that ever so slightly lengthens the time a neurotransmitter remains “available” in the gap (synapse) before it’s once again re-uptaken, i.e. re-absorbed and stored away, affects our actions, thinking, self-discipline, attention, memories, our very feelings, etc.. Understanding how all this works is at the very cutting edge of research, but we’re still far from there. Heck, we still don’t know what makes me convinced I’m an individual, conscious, sentient being, whom I identify as “me” instead of “you”. We don’t know how all the thoughts, ideas, inventions, opinions, likes and dislikes that go on within us constantly are strung together like pearls on a single string that all together comprise what we think of holistically as “me” or “you”.

    It’s simply a matter of experience that tells doctors and researchers that it takes “some weeks” for the effects of the current generation of “reuptake inhibitors” (actually, they don’t inhibit, they just retard absorption) to be noticed. It’s often stated that it’s because it takes about this long for these medications to “build up” wherever they need to be and their effects become noticeable. Actually, I don’t know if it’s even been proven that this is the reason for the delay in onset of results. Perhaps these drugs arrive right away, but require time to slowly rebuild the way the nerve cell functions because of its presence. I’ll bet anyone a G note, the exact reason remains a mystery.

    But perhaps most importantly, don’t underestimate the power of the famous “placebo effect”. In the field of medicine, this is not necessarily seen as a negative or somehow foolishly naive thing. It’s not at all uncommon for someone suffering from depression, for instance, to start feeling better the moment they call to make their first appointment with a specialist and write it on their calendar, then start feeling better still the moment they swallow their first antidepressant capsule from a free sample bottle right there in the doc’s office. The power of suggestion plus the sense of self-pride, not to mention just that horrible weight of indecision which suddenly lifts when one takes the bull by the horns to do anything in life, like asking for help after much anguish and doubt about doing so.. Well, that can certainly lead to faster recovery.
    Now, just don’t go and spoil your good fortune to experience an exceptionally speedy response with, of all things, nonproductive worries!

  24. Mike,
    I have so many questions…you’re the first person that has expressed my childhood (and adult) issues so accurately. I just want to say that unconditional love was, and still is, my strength as a parent. But I mainly want the benefit of your wisdom about what next…I’m at a transition point in life, and want to reclaim my creativity, as well as contribute to others. Btw, you’re a gifted writer in addition to your other accomplishments!

  25. Thank you, Renee.
    IMO it’s an innate need for all social beings, animals and humans, to feel that each individual is a valuable and needed contributor in its herd, flock or society. I view humans all as one family, the old term kin. All of us are brothers and sisters and our progeny are children of us all and under all of our care.
    In today’s hectic world it’s far too easy to avoid seeing that we truly are exactly this connected. We share everything, if you think about it. The actions of each affects all. Obviously, how you vote affects me and everybody else. More subtly, how that mother in line behind you is yelling at her toddler affects not only its future, but yours, your children’s and mine, too.
    Except for those in some very isolated, rural community, we’ve reached a degree of insularity and disconnectedness where we rarely dare to even look one another in the eye or, god forbid, turn to that mother’s child to give a disapproving scowl with the clear meaning: “Your screaming is awful behavior and giving us all an earache.” Or turn to her and say, “What are you thinking, lady? You’re torturing your little girl! I’m disgusted. She’s what? Three years old? You have her out here at Downtown Disneyworld at 11:30 pm waiting for a bus back to your hotel?” (I was so exhausted I could hardly manage that wait.)
    Many fear social suspicion of being some kind of pedophile to such a degree in this climate, they wouldn’t dare to even shoot a smile or a playful wink at a child staring at them in big blue wonder.
    Your neighbor next door, the loan officer at your bank, your health plan’s customer service call taker (after a maze of menu options), everyone you interact with is your kinfolk. Like it or not, we are all completely interconnected in that each shares the consequences of others’ actions. If my neighbor abuses his kids with foul language, whacks them silly and ridicules them as worthless dogs and fails to instill them with a strong set of ethical values and sense of self-worth, sure as the sun will rise tomorrow, you, your kids, that lady at the bank and I must all share this tiny planet by not only first paying for their education, the city vandalism they do as teens, possibly their incarceration as adults as well as their foul behavior in the seats next to ours on some flight to New York.
    So, like it or not, we each have the unavoidable responsibility of involvement, to intercede, get in each others’ face, both with generous love and copious praise for good deeds done with excellence, but also to have the guts to let others have a piece of your mind by reminding about mutual responsibility and adherence to ethical behavior (perhaps never learned from ignorant –or absent– parents) or remind them gently to remain ethical, keep promises, not lie. Point out to that bank girl who assured you she’d get back to you tomorrow before noon with the financial details you needed when she had no such intention and couldn’t be bothered to mark it on her calendar.

    To my mind, if you don’t pluck up the courage to speak out and be a teacher, rabbi or what have you, to your sisters, brothers and children in situation like these, who do you think in all of humanity will do it?
    Where will our culture go next if everyone uses “political correctness” as a so convenient cop out to disengage themselves from mutual help?
    IMO the entire concept of “P.C.” is a phony excuse and a cultural killer.
    To my mind, this is the kind of involvement with each other a society, a culture, a family really, must have to survive and thrive… part admonishment but also generious dollops of admiration and praise to strangers for any deed done with excellence. This costs not a cent to spend and does so much good.
    Now it’s easier than ever for people to be completely self-centered, cheat, rip off impersonal and uninvolved bosses, coworkers, government bureaus and customers, ignore all responsibility for the welfare of us all as a single entity, a culture, and only look out for ourselves like feral animals that nobody cares about nor calls to account for anything. The result of this is that it’s easier and easier to get away with shady doings you don’t feedback about by using these intimidation tricks –that IS what they are– to quickly gag others:
    Who the **** asked for your opinion? Mind your own business! Butt out! Who do you think you are?
    These are tacitly accepted intimidation techniques to shut down others might cause you guilt about irresponsibility. –Simply shame others into silence.–
    As a result, people learn to say quietly to themselves: Who am I to to judge? It wouldn’t be P.C. for me to say anything. It’s not my issue. Live and let live. (Yes, of course I do firmly believe in this concept when it’s not about harming others in some way.)

    We each make judgment calls on all things every waking hour. We’d be lost as a species if we had no ability to, or abstained from discerning right from wrong, constructive from destructive behavior, selfishness from generosity, close-mindedness from curiosity and openness, fact from fiction, truth from propaganda in advertising and all communication, actually.
    The sad truth is, due to our current attitude of “it’s not my problem / none of my business” we’re quickly tossing away one freedom after another wholesale. Our ability to choose for ourselves, be discerning, to make demands for fairness or even recognize it, ethical transparency and dealing in business, not get steamrollered by selfish interests of bigger fish, etc. The devastating part is that as we forget more and more of what we fought for and demanded in the past, the less and less we know to stand up for and demand as time goes on.

    How have we gotten to this Orwellian world? (For we have arrived.)
    We’ve been ever so gently lulled to sleep and softly dropped off in a poppy field without our even noticing. Unless you work to stay constantly vigilant, you’ll fall for it. Actually, we all do repeatedly, missing the insidious subtlety of it all.

    Here’s a great example.
    Pepsi Cola’s current slogan on billboards all over the US (at the very least) sounds perky, fun and pretty innocuous:

    “Live for Today!”
    (Visual: fun-loving, active young people enjoying Pepsi).
    But peek just behind that message. What is it whispering in the reader’s ear to do?
    “Play! Life is too short. Be happy now! Don’t get left out of the party. Be a smart consumer, buy plenty of this season’s fun toys and forget all about yesterday. Do this everyday! Forget that student loan for today! You deserve today off! Don’t worry your head about economics and politics. Instead, read Brad Pitt’s latest antics! Grab a new summer dress and pumps like JLO’s for a fifth the price! A scandal! Don’t let her have all the fun! Have (never “Buy”) a Pepsi and be really happy today!”

    What does all this have to do with AHAD? My kid? The effectiveness of Strattera?
    Nature, god, evolution, whatever you choose to call what got us here, never intended for us all to be Pringles or even regular irregular machine-made potato chips, but rather something like home-made, everything thrown it Chex mix. And with good sense. A healthy culture appreciates and values the virtues and attributes of all of its citizens for its huge breadth of contribution. The US (I don’t know about Canada) is the last first world country to put ALL school kids on a college oriented track. I guess we all bought some kind of line that it’s American to give everyone a shot at being a doctor, professor or an Einstein. Unfortunately, this is detrimental because it discards, simply throws away all youths who have an avid passion for tinkering with tools, clocks or welding, those with a passion for farm animals, working with their hands on wood or making fine leather footwear –well, all sorts of things that don’t fit the university picture, i.e. algebra, calculus, foreign languages, etc. So colleges get less and less of our kids. They’re considered second class and simply cast aside to fend for themselves or become dispensable fodder for our economy via some war half way round the world.

    In short, perhaps what you might want to put your mind on is not whether you or your child has AHAD or whether Strattera is best way to fix it, but rather why it’s now suddenly so prevalent and why you fear there might be no place in our culture for an individual who stands outside the norm.

    Think for a while what big industry wants from you. I think we can all agree big business pretty much run the show these days. What does it want from you and your children?

    Predictability. Complete reliability as a consumer of whatever product or service they peddle. Stockholders need predictability, reliability. Industry strives to pigeonhole each of us and then does its darnedest to keep us there so we’re not moving targets, but easily “accessed” like docile milkers.

    You take it from there. Be a free thinker. Look behind the curtain of every TV commercial you’re spoon fed. What is fed to you on news channels? Do you demand more than sensationalism and gossip stories? Personally, I find I have to read the British magazine, The Economist, to learn anything the slightest bit neutral about what’s happening here. It ain’t all good news, but it beats averting one’s eyes from reality in Face Book.

    Michael Storer
    Los Angeles

    • Mike,I am pleased with all your insight and information. I’ve fought labeling and medicating my grand daughter although it is a clear case of ADHD. She was the perfect, easy child. No terrible 2′s, bright, caring and social. But the problems have crept in and now with starting pre school, it’s clear that no matter how smart she is, learning is difficult in a school setting. I’m thinking of trying her on the Strattera. Her father also was affected by it and medication helped him drastically. I know see that all the problems he has now are because he still suffers from it. He is very impulsive and had a hard time keeping his business afloat. Owns 4 vehicles that constantly need repair, instead of getting one reliable one. I want my grand daughter to have access to the tools in life that will help her succeed in taking care of herself and being independent. Your columns have shed light on the fact that it needs addressing as early as possible and sometimes may have to be addressed long after adulthood. Thank you.

  26. My friend’s 8 year old daughter has ADHD – primarily hyperactive subtype, as well as a regulatory disorder and anxiety. She has been on Concerta and Biphentine, and both really ramped up her regulatory disorder. WouLd a non-stimulant such as Strattera have less impact of self regulation – lots of hitting, kicking, crying, tantrums over small things?

  27. My 7 year old daughter has been diagnosed w ADHD & we also find that she can be very anxious & fearful of various normal events i.e., sound of a school bus.

    Her anxiety can make it very difficult to try school work because of what seems to be a fear of failure. However, when we can finally get her to do her work, she usually does relatively well.

    We did see a D.O. Family Physician who ordered lab work which showed that several neurotransmitters are higher than the normal lab values. One of the transmitters in excess is norepinephrine.

    If we start Strattera, will this increase the level of norepinephrine and make her condition worse? If so, is there a better choice (choices) for this situation?


  28. My son is 19 years old, diagnosed with ADD, we live in Chile and he has taken Concerta (methylphenidate) for 3 months, and just there the side effects were present (nausea and headache). He quit taking the drug but he feels that he can´t concentrate very well . The doctor told him to try with strattera but I’m afraid he will have the same side effects. Is there any drug that he can use without having those side effects?
    Thank you for your answer

  29. I was diagnosed with ADD when I was 13 I started on ryttlin That is some nasty stuff and was on it for three years after pleading with my parents to not make me take it anymore. I went through high school with no meds. Then when it cam time to go to collage I got a persctiption for strattera. It was great for the first three years I didn’t sleep becouse of the drug and I had great attn and focus. But the the real side effects started kicking in. I wsa cranky and not happy. My attn started to wonder again and they increased my dosage. After collage I tried to come off but I couldn’t I would suffer withdrawl symptoms bad. I was on it for 8 years total and finally I was thinking susidal thoughts and it was killing my liver so I had to ween myself off. This was not fun. I have learned the real cause of add. It is often from going past words that were not fully understood. This may sonud stupid but this is a trick that I learned from a old engineer. Looking up and defining words that I come acrost that are unknown has drastly improved my life. I now can learn anything with ease. I do not write this to prevent anyone from taking this drug. But I want to let people know that these drugs do have sideffects and the will come up and when they do you cannot come off the drug easy. If you are looking to put your kid on drugs for ADD there are alternatives. Make shure they eat healthy and alot of portein in the morning. This helps focus. The other thing is tell them to look up any words that they don’t understand and get them defined using a dictionary.

  30. My son is 22 yrs old and wanted to be tested for ADHD. Our family doctor believes that his symptoms are more consistent with depression and prescribed Paxil which made him tired and unmotivated.( he works in a gym). Today they switched his medication to strattera after talking about his reaction to the Paxil. He has had alcohol dependency issues and has admitted to using marijuana and other things so I know they are cautious to give him adderall. He told me he took adderall in college to help him study and it helped, but I am nervous about the dependancy issue as well…any thoughts?

  31. dear dr. kenny,

    my son has been on lowest dose of intuniv for 2 years and it has taken the edge off. Helped lessen aggression, impulsivity, and tantrums. Also helped him to stop overeating (anxiety and sensory issues did not allow son to regulate how much food he ate so he always wanted more food). Anxiety, irritability and sluggishness/depression will soon be treated with stratera. Is 25 mg right to start him off? My script is a capsule so I cannot work him up to that does by cutting pill in half. Is this too high a does to start him off on. He’s 54 lbs. Can strattera possibly improve sluggishness if it’s rooted in depression? which triggers sluggishness more, intunive or strattera? thank you!

    • About Sluggishness, Depression, and ADHD. A Different Perspective

      I am 40 years old, and for most of my adult life I thought I had clinical depression. Maybe I still do, maybe I don’t. I’m not sure whether its a chicken or egg.

      Is the depression caused by feelings of inadequacy? For example, by the time I was 14 or 15 it was clear I was bright, did well in school, and
      “presented well”, but inside I always thougbt why can’t I complete anything or organize myself the way I want? Why do I make simple mistakes no matter how hard I try to pay attention? Why do I never seem to know what’s going on when everyone else does? Why am I so sleepy all the time?

      I’ve been medicated for clinical depression since I was 20, and spent much of my life struggling and anxious and sleepy half the time, and the other half I was fine – irritable sometimes, but otherwise feeling ok moodwise.

      I passed for normal because I found school easy. I wasn’t hyperactive in my body.

      I learned workarounds for losing things and forgetting things, and I was lucky enough to have parents that treated me like a competent capable person.

      Possibly lucky was that they also avoided conflict so they left me to work out the glaringly obvious problems for myself. They figured if my grades were good, I had friends, and I could more or less keep a part time job at the same time then it didn’t matter that I was always irritable at home and that I spent a lot of time sleeping if I wasn’t out with friends.

      I’m not sure if I would have been better or worse off if they had addressed the issue and sent me to doctors or counselling, because let’s face it, 25 years ago, I would never have been diagnosed with ADHD anyway.

      Back to sluggishness. When I was 18 or so I read an article describing depression symptoms and irritability and too much sleep were my main “symptoms”.

      I always thought the rest was “personality”. Flakiness, flightiness, forgetfulness, multiple personal projects that never got finished, losing things, impulsivity, quick and almost obsessive enjoyment or enthusiasm for a person or activity , then losing interest in things quickly, having 2 week boyfriend after 2 week boyfriend, not being able to keep track of time, piles and mess following me everywhere like a trail of breadcrumbs…

      I just thought these all were “the magic that is me”.

      So long story short. The anti-depressant I was put on was zoloft. After the weeks passed and the anxiety side effects stopped, what I found was the biggest benefit to me was the extra alertness it gave me. It may be that I needed and still need an antidepressant too, but then again, maybe not.

      I wasn’t sleepy all the time, and therefore was less irritable. My mood was a lot better and my emotions dulled. Which was better for me and more comfortable for me than the way I was before.

      I still experienced sleepiness and needed naps, but the easier morning wakefulness really helped me overcome the depressed feeling.

      I am now on Vyvanse (a long acting adderal type drug) , that is a stimulant, and it seems to keep me more awake too. I think the sleepiness is an overwhelm response. After hyperfocusing or getting distracted and the struggle that comes with each of those my brain seemed to shutdown by making me overwhelmingly sleepy.

      I saw studies of normal brains and ADHD brains doing boring tasks and mentally exhausting tasks, and in both cases normal people showed brain activity in certain parts you would expect, but the brains of people with ADHD… Their brains showed the activity slowing down to almost nothing in the same areas, and indicated a “shutdown” of that brain area.

      I think this may be what my brain is doing. It has a shutdown response and that’s why I feel so exhausted after trying my darndest to do something boring, or overwhelming, or really hard, or really not-fun.

      My thought is this – maybe your son is sluggish because he has a shutdown response like me?

      If so, maybe he needs a stimulant based drug instead? To keep the fires burning so to speak.

      Just an extremely long winded thought.

      • One more thing – the antidpressants do nothing for my ADHD traits.

        But, the Vyvanse makes it much easier to filter out excess thoughts, and stay on task without feeling sleepy.

        It also cuts down considerably on the amount of ideas that bombard my brain, and I am much more likely to choose activities that are productive ones, not lose track of time doing unproductive ones, and being able to refocus myself after I get distracted or procrastinate.

        • Thank you for your response! The reason our family doctor wanted to try something else was because of his alcohol dependence issue- didn’t want to compound the problem with a methamphetamine based drug like adderall. He has taken the strattera for 2 months though and says he still feels sluggish. He will go back and reevaluate at the end of this month. Thanks again!

      • Hi! I totally relate to you about the brain exhaustion. Sure, I can get stuff done eventually but I’m going to be exhausted, cranky, and frazzled afterwards. Often I’ll be functioning fine and then I feel my the ‘executive’ part of my brain (frontal lobe) gradually shutting down as it gets fatigued (especially after 4 or 5 pm). This gradual depletion causes all kinds of issue, things like: rapid loss of energy/motivation to complete a boring task, decreased ability to block out/regulate the volume of sensory ‘noise’ in my environment and thought/feeling ‘noise’ in my brain, selective hearing and increased anxiety when I’m in an emotionally distressing conversation, situation, or environement.

        I’m 20 years old and have been on Zoloft for the past 6 years to treat anxiety, OCD, and depression and it has helped me a lot, especially when I started taking it. However, I’ve had inattention/disorganizaton/motivation/hyperactivity/hyperfocus issues all my life. I just got diagnosed with ADHD this month and I just started taking Straterra. My psychiatrist prescribed an SNRI (Straterra) first- instead of a stimulant (Vyvanse)- because a stimulant will likely aggravate my OCD and Tourette’s symptoms. However, if Straterra doesn’t doesn’t do it (“keep the fires burning” as you said), then I’ll consider trying Vyvanse, a 24-hour release stimulant. Adderall is a last resort because it is an instant-release stimulant that will very likely aggravate my sleep issues (too aroused to get deep, restful sleep), OCD, anxiety, and mood/energy instability.

  32. my 9 year old son is on 36mg concerta xl is it normal for him not to be growing tall. He and his 5 year old sister are just 10cm height difference. He is just on the centile but his growth has slowed down.

  33. I have recently started taking Strattera and have been on it for 3 weeks now. It is hard to say if it works or not. I feel I retain more information while reading and writing, but not at work. I am 21 years old and suffer from adhd; I have probably suffered from adhd my whole life, but was recently diagnosed. I also was diagnosed with mild, chronic depression, which I take 20mgs of prozac for.
    I guess it is easy to pay attention to the task at hand, but to get that task at hand, is the problem. For years, I struggled in school, due to the fact I was restless. Most teachers (mostly math) thought I was very bright. I was placed in College prep and Honors classes for some subjects and others, I would be placed in General classes- general classes mostly have slower children in them.
    Is there something I can do that will help me become more motivated? It just seems that saying it, is infinitely easier than doing it. Why is it I can only be productive select days out of the week? Any advice would be appreciated. Thank you. -Justin

  34. Hi.
    I was on eighty mg of straterra just prior to starting a grad school program. I was able to concentrate ok for the first two weeks but then I started spacing out really bad, then I started getting hot and sweaty, Became rude and full of anxiety, began missing appointments and deadlines. I asked the doctor to take me off, she wouldn’t … people around me started getting nervous and I was released from my program that I worked five years to get into — I am now off of this stuff and all my adhd has come back but at least i can be me….I get it, that you tx children , but , the side effects i experienced pretty much train wrecked my life. I’m now back up to me usual good grades but I can’;t figure out how to explain to other programs I’m applying to what happened to me. I was dismissed from an Occupational Therapy program at a major university and this has been a devastating turn of events for me. I just want people to understand this drug as good as it may be is definitely not for everybody and you should monitor your behavior VERY CLOSELY with the help of a loved one while taking it.

  35. Being in my 40′s my doctor started me off on 40 mg for 2 weeks, 60 mg for 2 weeks and then 80 mg for a month.

    The side effects for the first week were very challenging. My stomach felt nausious, I woke up every morning at 3 am, suffered from “jimmy” leg, feel restless and could not fall back asleep until 5am. I was very tired throught the day and my stomach felt queasy and would have a dull headache. I wanted to quit after the first 3 days but after a week it got better and after the second week the symptoms almost dissappeart. When I went up to 60 mg, the waking up at 3 am returned for less than a week. In my opinion the medication really started to take effect and my obsessive racing thought decreased noticably. When I went to 80 mg, the waking up at 3 am returned but only for a few days. Over all I can concentrate and really enjoy the moment. I spent the day at the park and really enjoyed the time wih the family. I could sit and watch my kids play and had no racing, steady thoughts.

    The relationship with my wife has improved she said I no longer go into “Deer in headlight” when we have conversations. At work/home I no longer feel the need surf the internet non stop.

    As for being more productive the medication only goes so far, there is no magic bullet for setting goals and time management. If I set goals and organize my day I can get more done with less distractions.

    The benefit I enjoy most of all is my new relationship with my wife and kids. Have you ever been to a school play and during the entire show your mind hyper focuses on things that mean nothing? Straerra helped fix this. Yes, after 10 minutes my mind may wander but once I realize what I am doing I can go right back to being “in the moment”.

  36. My experience with ADHD & Medication:

    I’m 47 and was only diagnosed with ADHD about 18 months ago when work stress nearly put me in hospital. The diagnosis was a bit of a revelation and explained my rather turbulent life thus far. I always knew that I was different from others, I just didn’t know why.

    Initially I was medicated with Concerta XL and Sertraline(anti-depressant), but had a notable incident occurred when I increased the dose to 54mg. When doing the school pick-up the left hand side of my face felt like it drooped. At the time I thought I had a stroke, but on further investigation it appears the Concerta damaged my central nervous system and stunned the ganglia nerve on the left handside of my face. Fortunately my face isn’t actually drooped or dis-figured, but after 18 months I have no feeling in the left hand side of my face. Not a big deal in the scheme of things but an irritation and a constant reminder of quite a dark period for me. In hindsight I had notice a raised heart rate at a 34mg dose but chose to ignore it as I was rather desperate for the meds to work.

    My next attempt was a combination of Wellbutrin and Dexamphetamine, but even on very modest doses my heart rate seems elevated and thus I stopped. Which was depressing as this seemed to rule out the most effective dopamine enhancers ( Amphetamine & Methylphenidate Stimulants)

    Next was the only approved non-stimulant medication – Strattera. I’m on the maximum 120mg a day dose and am glad to say have had modest benefits, with no side effects (other than slight urinary restriction). The drug appears to slow me down a little, enough for colleague to notice a difference, and it seems to calm me and allows me to manage stressful situations a little better.

    I would like to know what exactly the drug is doing, but guess that there is a partial improvement in the Norepinephrine neur-transmitter.

    What it doesn’t do is address the other problems that have plagued my life in general, but most notably work. i.e. impulsiveness, huge appetite for risk, lack of attention to detail, terrible short term memory, and overall poor regulation of executive function. I would love to address these but my problems with stimulant medications appears to be a blocker.

    The paradox I have found with ADHD is that I did fairly well in education and got a lower Second Honors degree in Physics, though I never really managed to study properly due to my severe attention problems. I can only get to page 3 of a novel before putting it down due to profound boredom.

    After a fairly turbulent early career I got into computing, and was fairly successful, although having awful attention to detail and low attention span, it must have made me about the worst programmer on the planet. Strangely my career has progressed far more than many of my more capable peers, and I look after multi-million pound budgets as a project manager. How the hell, I thought when I discovered my ADHD diagnosis. A project manager with seriously impaired executive function ….. crikey … I think someones having a laugh at my expense.

    I think what has got me through is my speed of thought, aggressive appetite for risk, hyper-focused energy and drive. Bizarrely I often feel like the smartest person in the room., but am prone to stupid mistakes So success? but at quite a cost, as I continually fail due to the underlying impairments that I have to struggle with.

    All in all work seems to be my nemesis, and I seek my next contract with an element of dread, in the knowledge that history is likely to complete. The stress that comes from work has also had a huge impact on my marriage.

    Cherry on the top has been the discovery that 2 of my 3 children have inherited their dad’s ADHD, and unfortunately (unlike their dad) this has led to them failing at school.

    We have started my oldest on Amphetamines and fortunately he doesn’t seem to share my intolerance to stimulants, and his attention levels have improved.

    Frankly I’m a little tired of this life thing, but I have responsibilities and 3 beautiful children to look after and support. Two of which I feel I have scarred for life with ADHD.

    BTW. Please don’t suggest using lists.. I have ADHD, and I have not yet been diagnosed with stupid.

    Note that I really wrote today to mention highlight the nervous system damage that came from the use of stimulant medication. It seems a rare reaction, but I want fellow ADHD sufferers to be aware of this possible side effect.

    Sorry about the rant.

    • Dear John,

      Use lists – while not stupid, your diagnosis does oblige you to look at the fact that there are simple solutions which are only withheld from you by the quirks of the ailment itself. And if no bell is rung here, may I respectfully suggest reading up – there are excellent books out there which will benefit you and perhaps even more important: your children.

  37. My 12 year old son has ADHD and anxiety. He has been on stimulants since he was 6 years old. He started middle school this year and the anxiety has increased significantly. We are wanting to lessen his stimulant med (currently Focalin XR). We are on a school break for the next 10 days and started Straterra yesterday. His MD wanted us to try the Straterra with a lower dose of the Focalin. I’ve been scared to use both, so haven’t yet. Is there any research (either personal or medical) that addresses this approach?

  38. I am 63 yr old female just now diagnosed with ADD/ADHD. Was prescribed Straterra due to no tolerance to stimulating type meds, drinks etc. It gives me terrible dry mouth and a headache. Most concerning to me is that it feels like a stimulant to me. I do not like the ‘speedy’ feeling it gives me. Dr. Told me Strattera is not generally used for adults because is ineffective but allowed me to try it. They Saud ill most likely need Adderall but it’s hard for me to imagine how that will affect me as a stimulant. Has anyone else had same effects of Straterra? So glad to have found this site. Thanks!

  39. How effective is Atomoxetine (Strattera) for ADHD?

    As I remember it, there was a lot of hope (and perhaps some hype) around Strattera when it first came out. Both doctors and parents hoped that Pharma would find a safe effective alternative to the Schedule 2 stimulants like Dexadrine and Rit because pr…

  40. Thank you for the article. My daughter is 8 and currently trying strattera out. She cannot swallow and we have reverted to a spoon of peanut butter with the powder mixed in. My concern: how long does strattera stay in the body when opened and bound in peanut butter? She takes it at 6.20am in the morning. An hour before school starts, and she is at school until 1pm. I want to work out if it is effective for that duration or longer would be best.

  41. I just discovered this blog and am deeply moved by Mike’s generous, caring posts. There is so much good information here, and Mike serves it up with a wisdom and compassion that could only emerge out of suffering, love, and empathy. The posts contributed by the mothers and the young people, the middle-aged and those in their 60s – all move me deeply. As a 60-something woman with ADHD, I strive to keep these thoughts in the front of my mind: I am a misfit, but not defective. ADD and/or ADHD cannot really be DIS-orders. Those terms are unfortunate labels for characteristic groups of neural features that correlate with certain behavioral and cognitive patterns that have been with us always. I believe humanity needs to perpetuate these features in our gene pool. But damn! The people who carry these features are terribly devalued in the urban centers of 21st century Europe and North American. The world was vastly more hospitable to ADHD folks in the past. I grew up in Texas, where the bravest, most spirited and energetic people were among the most admired and best rewarded. It was perfectly clear that my very most recent ancestors had needed every scrap of their intensity just to survive. But the world has become less appreciative of the gifts brought by folks with ADD/ADHD brains. By the time I came along conditions were already starting to tighten up for minds like mine. But in 1955, NOBODY would even think it possible for children to sit still and shut up all day as they are required to do now. I believe great dangers await any population that submits to the sedentary conditions we’re calling normal these days. They are bad for everyone, but a narrowly restricted life with high expectations for academic achievement, compliance with increasingly diverse and exacting rules, and constant measurement and ranking of individual performance in the most mundane activities — all this stuff tends to fall more heavily on young people with ADHD. There is less joy afoot these days, and I’m sure that the suppression of ADHD/ADD characteristics has a lot to do with this. I’ll climb off the soapbox but I want to say something: Moms and dads, your children do need appropriate medications, also the best educational settings you can find for them. But there is more you can do: Be really, really compassionate and encouraging. Teach them mindfulness meditation. Be sure they eat nourishing food; exclude junk food; radically restrict time spent in front of screens. Ensure that they get abundant exercise. Folks with ADHD/ADD truly need to experience happiness in the outdoors. (Read Richard Louw’s book, Nature Deficit Disorder!) Create opportunities for your kids to take part in sports, travel, music, drama, arts. If the child has trouble at school, be a resourceful, optimistic problem-solving advocate with teachers. Help your kids develop self-respect through personal achievement and hard work. And, hey, moms and dads, do get yourself evaluated for ADD/ADHD. The apple doesn’t fall far from the tree!

    Oh, about Strattera. Strattera will prove to be a highly effective medication for SOME people. It was for me. My psychiatrist ordered a genetic test that returned ratings of all the major ADHD medication in terms of their suitability for my genetic type. I had already found Stratterra to be super-helpful, and the test confirmed that it should be. It also endorsed Welbutrin and Adderall for me – again, confirming what I had been able to observe. But some other meds were termed, “use with caution”. The value in having the test results was that it persuaded me to be compliant with the Strattera. My MD, therapist and husband could each tell when I skipped it for a few days, because my “adhd” behaviors came on so strong and my anxiety spiked. I could hardly bear to take it because it is devastatingly expensive, though I did appreciate the improvements in my quality of life.

    I find myself in a really regrettable situation now because I can no longer work in my profession and can’t generate enough income to pay for Strattera. My ability to carry on earning a high income dwindled as my marriage began to fail. I am about to be divorced, and this is a testament to the stress a partner’s ADHD can impose on a marriage. I’m about to qualify for Medicare, and I haven’t found a plan that brings Stratterra into reach. If Strattera works for you, enjoy the benefits and do not take them for granted!

  42. Can someone speak to Strattera and hair loss? I’ve taken this medication with remarkable results. However, I noticed my hair started falling out in gobs when I started the medication. Looking at the official Strattera website, there is no mention of hair loss as a side effect. Confused I’m not sure if I should continue to take the medication in hopes the hair loss will eventually subside. Or if I should stop it altogether and try a different medication. Please let me know what you think.

  43. I had my 12 year old son on Straterra for 5 months. Within the first two months he had lost over 12 pounds and was already very thin to begin with so he went from 92 lbs to a low of 78 lbs. then stabilized at 80. He grew over 3 inches in a growth spurt and could not gain weight. His appetite was not suppressed and he was eating a lot of food. His psychiatrist and md both said it was not because of the Straterra but my mothers instinct said differently. His joints were hurting and he was very gaunt. I stopped the Straterra and within 6 weeks now he is back up to 89 lbs. He had no other noticeable side effects but the minimal increase in attention and impulse control were not worth the physical effects.

  44. I was diagnosed with ADHD in second grade. When I was young I started on Ritalin but in high school I soon switched over to Adderall. For me Adderall works for the most part but the side effects have begun to outweigh the benefits. I am now looking for an alternative medication to treat my ADHD. I’ve been doing some research on Strattera. My biggest problem one taking Adderall is I don’t feel like myself. My personality is completely repressed and I always have to be fiddling with something or doing work. My friends a very obviously tell when I take my medication or when I skip it. My biggest problem Is adderall doesn’t last through the night if I take it in the morning for my classes. So I take adderall in the morning and after classic I am planning to study. If I take it too late it is impossible to sleep. When I take it after three o’clock I am certain to be up all night. Not sleeping makes studying almost fruitless because I don’t retain the information like I would if I got a good nights sleep. I also feel very antisocial and often times depressed when taking adderall. Because I’ve been taking adderall twice a day for five years I feel the affects are not as strong or prevalent. I still feel a sense of motivation but I often find myself procrastinating two to three hours doing other tasks and avoiding my actual school work. My question is about Straterras side effects and if they’re similar to the side affects of adderall and what I described?

  45. when you say Strattera has a ‘downstream effect on the dopamine in the brain, specifically in the frontal lobe.’ does that mean it’s getting LESS dopamine in the brain (not what I want) or MORE, as in downstream means it gradually gives MORE dopamine in the brain (what I want).

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