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

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

Daily Twitter Posting Roundup from @MungosADHD

Here is a roundup of my most recent Twitter posts from @MungosADHD.com:

• Dr. Atila Turgay Dr. Kenny Handelman ow.ly/1WE3I
• 3 Tips to Better ADHD Shopping | ADDaboy! - HealthyPlace ow.ly/1WN6f
• ADD'ing it all up: Murphy schmurphy ow.ly/1WN6v
• What Is It Like to Have ADHD? - HealthyPlace ow.ly/1WNvH
• So I Married an ADDer: For Partners of People with AD/HD: Where Have All the Flowers Gone? ow.ly/1WRuM
• Pinball Cognition: Help, I need an adult! Or rather, I did.... ow.ly/1WRvv
• #ADHD New Blog Post: Day 7 on Strattera - Focused in Meetings and No Side Effects ow.ly/17GYX3
• Stephanie Sarkis, Ph.D.is the author of 10 Simple Solutions to Adult ADD ow.ly/1X1MK - I highly recommend this book for all ADHDers!

Cheers,

Mungo

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Focused in Meetings and No Side Effects from Strattera

Well, nothing especially dramatic today happened.

I had 18 separate meetings today, most of them being brief annual employee evaluation one-on-ones where I asked questions about and discussed my staff's roles and all that sort of stuff. They're pretty tiring, especially when I booked most of them back to back. But I was able to focus on them completely. I'm normally good in one-on-one meetings because I find interacting with individuals really interesting.

But I also had group meetings. While I'm focusing really significantly better than I was a couple of weeks ago, I am more and more noticing my impulsivity trying to burst out with 'funny' comments. I don't think I'm more impulsive than before, but simply much more aware of my tendency. Now, some of my comments are funny.

At one point yesterday I explained to an ebullient and generally inappropriate sexist male director (who was hitting on one of my staff and asking if she likes to drink vodka because she is Russian) that "I have a feeling that the more vodka that you consume, the more attractive I would likely appear to you..." (Now, for full disclosure, in university one year my buddy and I dressed as hookers for the Halloween party and we were very unattractive as women. So basically, it would take a LOT of vodka for anyone to find me attractive, at least one looking for a woman...). Everyone chuckled. He back-pedaled, and I was able to regain control of the meeting. But there is a time and a place for everything. Perhaps that was okay, because it pushed him back, but in some meetings at my company, there are brutal undercurrents of rivalry and pettiness, and I need to stop being sensitive to that and trying to act as stand-up comedian referee, attempting to defuse the tension.

I don't think I can notice any side-effects today related to the Strattera. I think my anxiety has increased slightly because I find myself bruxing my jaw and teeth during the evening. But that too could be due to the change in the benzodiazapene from lorazepam to clonazepam, with its more gentle effect and softer time course of drug action. But I'm not shaking or quivering or trembling or wobbling or having a paroxysm (I'm running out of words here), so I guess the anxiety isn't all that bad.

I got a whole bunch of yard work done this evening. A bunch. A big ol' bunch. As my wife remarked after the fact with a look of awe and confusion in her face, it seemed due to an uncharacteristic 'burst of energy'. I also spent about 2 hours last night (until nearly midnight before I collapsed of exhaustion) cleaning the basement. The dog watched me from his supine position. He was trying to will me to go the hell to bed and shut the hell up. He's a good dog.

Maybe Strattera will make me clean stuff. Not obsessively, but from the already crazily messy state that I leave things in. Now THAT would be cool. Soon they'd be selling Strattera along with Mr. Clean Magic Erasers and those Swiffer floor cleaners:

"Take a tablet one hour before using our cleaning products and you'll be cleaning like you have never cleaned before."

I worked in advertising for a few months. You'll now understand why it was only a few months.

Anyway, enough of this. I have some Tweeting to do with my @mungosadhd account.

Plus I have some updates needed for my Mungo's Military blog which I opened recently (hyperactive enough for yah?!)...

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

Daily Twitter Posting Roundup from @MungosADHD

Here is a roundup of my most recent Twitter posts from @MungosADHD.com:

• #ADHD New Blog Post: Daily Twitter Posting Roundup from @MungosADHD ow.ly/17FNuq
• RT @drkenny: New blog post #ADHD: Generic Concerta in the US www.addadhdblog.com/generic-concerta-in-the-us/
• RT @SplinteredMind: ADHD Meltdown: Ever get so busy that you forget a deadline or errand? How do you f... bit.ly/a1NKJN
• RT @frankcoppola514: #adhd New Book About Adult ADHD: So a lot of you know that my husband has ADHD bit.ly/aMMeRF
• New Book About Adult ADHD « My Crazy Story…In A [Perfect] Nutshell ow.ly/1W6ur
• Positive effects of repetitive transcranial magnet... [World J Biol Psychiatry. 2010] - PubMed result ow.ly/1W6Uo
• Attention deficit hyperactivity disorder in adult s. [World J Biol Psychiatry. 2010] - PubMed result ow.ly/1W6UH
• ADD'ing it all up: It suits me. ow.ly/1W6Vx
• Experiencing ADDvantages: What To Do When Hyperfocus Works Against You ow.ly/1W6VT
• What you may be doing that keeps you from making friends ow.ly/1W6WF
• 18 Channels - my ADHD colored life...: This was supposed to be an improvement... ow.ly/1W6WX
• My ADHD Meltdown | ADDaboy! - HealthyPlace ow.ly/1W6YA
• Generic Concerta in the US Dr. Kenny Handelman ow.ly/1W6YW
• ADD'ing it all up: Seeing through the pain ow.ly/1WdVh
• 18 Channels - my ADHD colored life...: Assault on my senses.... ow.ly/1Wwf5
• #ADHD New Bl og Post: Day 6 on Strattera - Focus in Group Meetings, Noticing Those Who are Not the Sharpest Pencil in... ow.ly/17Gthp

Cheers,

Mungo

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

Focus in Group Meetings, Noticing Those Who are Not the Sharpest Pencil in the Box and Road Non-Rage

Day 6 zoomed by today. I had lots of meetings and lots to do. I noticed I had nearly continuous focus during group meetings, and during one-on-one meetings. I just hope that isn't a blip or caused by something else, like cosmic rays, the position of the stars, my astrology sign, homeopathy, or other such scientifically-validated theories.

My desk remains cluttered at work, but differently cluttered than yesterday as I pulled out all sorts of stacks of paper from storage cabinets to go through them thusly:

• recycle bin (60% of sheets)
• garbage bin (20 % of sheets)
• filed away to be recycled or disposed of later when I'm feeling braver (10%)
• filed away to be referred to later (9%)
• folded and placed in my pocket for later perusal (1%)

I was feeling irritated today. I felt like about 50% of the people with whom I work would benefit from a brain enlargement or at least a reverse-lobotomy, if there is such a thing...

I found myself shaking my head over and over again when I saw the responses people made to me and others. One way I coped with a particularly irritatingly blunt object that I met with for a while was to draw a small mark on my notepad everytime I noticed them being utterly unimaginative, intellectually dull and incurious. That is, denser than lead. At the end of my meeting, my page had 12 thin marks blended in with my notes. I think that is a healthy way to cope with stupidity, rather than zoning out and wishing I were among people who weren't big believers in folk psychology, and who weren't incredibly internally inconsistent in their attitudes, beliefs, opinions and responses to questions. Or zoning out and thinking about camping instead, while nodding enthusiastically at their expressions.

But I got through that. John Le Carre once wrote about a protagonist who used a mental trick to insulate him from an interrogator's intimidating questions - he simply imagined the interrogator wearing diapers and with a soother in his mouth. This gave the protagonist some mental distance to allow him to avoid becoming overwhelmed or confused during the interrogation. For me, I instead noted - or 'flagged' - instances of the person being stupid (I have high expectations for folks I work with - we do some very high level stuff sometimes) and recorded these occasions dispassionately.

I also noticed that driving to work this morning, while I was tempted to honk at road-idiots, I declined calmly and got back to my task at hand - guiding the vehicle in the general direction of work. This is interesting - as though I am getting control over some of my impulsive behaviours.

Anyway, it is almost midnight and the little boy wakes up at 5ish. So I must sleep and/or pull an all night write-a-thon. I'd prefer the former option.

Sleep well, my readers.

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

Daily Twitter Posting Roundup from @MungosADHD

Here is a roundup of my most recent Twitter posts from @MungosADHD.com:

• #ADHD New Blog Post: Daily Twitter Posting Roundup from @MungosADHD ow.ly/17EVBP
• 5 Gifts of Being Highly Sensitive | World of Psychology ow.ly/1VAic
• Your Brain on Computers - Attached to Technology and Paying a Price - NYTimes.com ow.ly/1VXIp
• #ADHD New Blog Post: Day 5 on Strattera - Focus and Continuity in Group Meetings ow.ly/17FBJ2

Cheers,

Mungo

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

Focus and Continuity in Group Meetings

This post will be brief - it has been a long day and I am good 'n tired.

No negative side-effects noticed. I had 3 one-hour-long group meetings scheduled today where I needed to pay careful attention to each and every participants' discussions and presentations. And in each of them, I was able to maintain my concentration for the whole hour. I caught myself looking out the window at one point, but noticing it sort of happened at the same time that I did it.

I find this to be promising. I found myself working the whole day at work - not spending too much time fiddling about or wandering about.

I think the Strattera is beginning to take effect. We'll see though - it is very early still, and I would like to see consistency around any possible positive effects, and certainly a much more powerful or shall we say deeper effect. I'm still skating on the surface of what I think I can do with this medication.

My desk started getting messy at work, but I realized it wasn't because I'm slipping back into crazy multi-tasking and disorganization - but that all the papers and folders on my desk were there because I was actively tackling my work. My to do list is still long, but I'm getting there!

Cheers,

Mungo

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