Commentary & Notes About How Fast Strattera Takes Effect

I thought a comment trail on a recent post was really noteworthy. I am repeating it below because it echoes something I've been thinking about as I have been reporting on my course of treatment with Strattera:

Reader Comment:

"I thought that unlike stimulants, Strattera did not take effect until after a few weeks. Do you have any comment on that from research or what your prescriber has told you?"

Mungo's Reply:

"Yes, that's my understanding that it doesn't [generally] really work for a few weeks. I am noticing something, and I'd likely attribute it to either (or some) of the following:

1. a cognitive bias i.e. I'm looking for something and seeing it and disregarding other contradicting evidence
2. there is a small effect at first which will vanish before the normally therapeutic effect takes place once the neurotransmitter and loop equilibrium effects establish themselves
3. placebo effect which could genuinely be improving my focus and attention in the short term
4. my ADHD was so bad, that it took only a little of the Strattera in my blood to give it a kick - e.g. your car is out of gas, and all you need is a cup of gas to get to the gas station down the street
5. aliens manipulated my brain while I slept

I think item #5 is the most unlikely.

I'm thinking it is probably mostly expectation bias (noticing the good stuff, not the bad), and maybe the sense of agency I have [developed] now that I've made steps to get on the meds... that alone could [ameliorate] my anxiety which in turn could improve my attention etc...

It's a tough one, but I should tell all readers [the point which you] are bringing up:

Don't expect significant improvements [on Strattera] for at least 4 to 6 weeks, and know that not all meds work for all patients. Sometimes you have to try out a few - including at various doses - to find something that works for you."

Another comment was an addition to this conversation:

Reader Comment:

"[Mungo:] I think that you might be on to something with the sense of agency you get from just starting treatment improving your concentration. I think that improvement might be from the decrease in the scatterbrainity that comes with anxiety. I know that is part of what's been helping me and that was without changing my medication. You might be on to something there."

If anyone has something else to add to this conversation, feel free to use the 'comment' feature at the bottom of this post.

Cheers,

Mungo

Thanks for reading! If you enjoyed this, perhaps you'd like to subscribe to the RSS feed.

You can also follow my tweets at Twitter.com/MungosADHD