Screw you, Strattera.

So a few weeks back...I forget how many...I started Strattera again. Instead of fighting my ADHD, it made me feel disembodied/dissociated. Okay, no big deal, I can handle that. Especially because it goes away or gets less noticeable after a few days of taking Strattera. Then the dosage went up. Bam. Whatever part of my brain thinks about sex was suddenly broken. Truth be told, it's one of my favorite things to think about; I think about it a good deal of the time and enjoy doing so. But on 18 mg of Strattera, it doesn't cross my mind unless somebody mentions it or I force myself to think about it, and either way it isn't as appealing as it was before. I consider that a fundamental change in the structure of my thoughts, and not a pleasant one. It unnerves me that 18 mg of a chemical can take that away from me. But for the sake of waiting it out and getting some stimulants I put up with it. Only three more weeks of this and I'd be off Strattera. Worth it, right? So I waited.

Then the dosage went up again to 25 mg. And what happened? It gave me depression. I took my first raised dose at night before I went to bed. The next day I woke up feeling like I did before they put me on Wellbutrin. Less severe, but unmistakable. I didn't feel like doing anything. I wasn't hungry (had to force myself to eat) or thirsty. I didn't even feel like getting out of bed. Heck, I didn't even really feel like being IN bed. I felt no emotion about the things in my life that tend to make me feel strongly. Towards the end of the day, when it would have been time to take another dose, it started wearing off and I started feeling normal again. I did NOT take the next dose. I'll put up with disembodiment, I'll put up with it screwing with my thoughts, but depression is not something I'll put up with. So I was off Strattera for the next three or four days until my psych appointment. I didn't feel depressed and thinking about sex was the same as it had always been. It was a relief.

And what did my psych do? She put me back on it. Not the 25 mg dose that gave me temporary depression, but the 18 mg dose. She explained that since both the Wellbutrin and the Strattera affect norepinephrine, the raised dosage of Strattera had been enough to more or less edge the Wellbutrin out of the way and take up the receptors. (So I guess we know what would happen if I ever went off my Wellbutrin. Thank God I have it.) And she gave me 28 days' worth of Strattera 18 mg capsules. I went home and later e-mailed her to ask if she still planned to put me on the stimulants if this didn't work. Her response:

"Plan to eval response with 18mg as adjunct with wellbutrin. Plan to do more formal eval for attention/focus at that time. Still doubtful about stimulants because of health, nutrition & mood concerns."

...

You said stimulants were the next course of action...are you going to renege on your word? Part of me wishes I'd just not said anything about it making me depressed and waited it out. As it is, I'm back on it and not only has it made me stop thinking about sex again, it's also more or less screwed up the corresponding physical functions. Remember what I was originally given the Wellbutrin for? The unfortunate side effect of the Zoloft? Well, it's that all over again.

Strattera isn't helping me--it never has. And I seriously doubt it's going to over the next month. I told Laura what it was doing but her response wasn't a very helpful one. I am only putting up with this in the hope that she'll do what she said she would do and use stimulants on me as the next course of action. I see Laura again in early July.

As far as I'm concerned her "mood concerns" are fairly baseless...I think my mood is at a much, much higher risk if she leaves me in this desperate state where I'm angering the people around me and increasingly hating myself for these problems. Yes, okay, whatever, the stimulants aren't some magic cure-all. But they have a very good success rate, and I need SOMETHING to work, and soon.

Her nutrition concerns...are probably fairly sensible. I'm aware that I don't weigh much. Last weighing I was 121 including clothes, cell phone, and iPod, so that probably puts me at about 118 pounds. But dammit, if I have to eat a box of donuts every day for the week before I see her next to bring my weight up, I will do that. I really don't have that much of an appetite and I'm in weight training now so I'm actually using up energy. So I suppose it makes sense that she wants me to eat more. But stress has a tendency to make me eat less. Meh.

...and her health concerns, those I can't argue with, and that's what scares me. Yes, my heart rate went up on Zoloft. Yes, I had tachycardia for a while. Yes, my heart is sensitive to some medicines. But I've never been on stimulants (other than caffeine, and that doesn't count), and statistically, very very few people without preexisting heart conditions have a bad cardiac response to these meds (and the clinic VERIFIED that I don't have an actual problem with my heart; it was just the meds that I was taking at the time). Surely the risk is not too great for her to put me on the lowest possible dose for one day and then take me off of it if my heart does something bad. I don't actually know what the risk is, I just know that I'm scared and I really really need something to work.

...sigh.