“Strattera? I Hardly Know Her!” Confronting ADHD with Non-Stims
My experience with noodled norepinephrine
I’ve been taking Strattera for inattentive ADHD* for a couple months now. Unlike its well-known treatment-option cousins, stimulants like Adderall or Vyvanse, Strattera (generic name atomoxetine) doesn’t provide instantly noticeable effects and takes several weeks to build up in the system. That’s where I am now — about three months in — and as far as whether it’s “working” or not, it’s a “Yes! I think!” for me.
This is my first rodeo with ADHD medication, so I have no comparison. It’s positively impacted my life in (at least) one extremely concrete way. I’ve been wrestling with impulsiveness — and a sort of love/hate relationship with it — my whole life. Most recently, this would manifest itself in beer.
And, okay, beer. It’s easy, not over-the-top, and just… right there. But if I even had the faintest waft of a whisper of “…Beer?” in my brain, or happened to pass a store, nine times out of ten I would be like, “Okay, beer!” And, slight joy, slight naughtiness indulged. Beer is great. But what isn’t great is battling the compulsion to crack cans all week long. What’s worse is the disappointment of feeling un-self-governable despite logically understanding the negative impacts.
Relatively quickly, maybe two weeks after being on 25mg of Strattera, I found that the multiple days a week had dwindled to one or two, or sometimes none. To me, that’s huge. There’s clearly something happening on the impulse-control front. Is it the placebo effect? If so, does that matter?
I will say meds haven’t been a magic panacea enabling me to switch from workday focus to the other tasks and goals on my docket, both short-term and long, cheerfully tackling everything with energy and enthusiasm until it’s all been crossed off the list. That’s an unrealistic ambition… but it’s kind of what I would like — getting all the things I’d like to do done, start to finish, in one fell swoop. My counselor calls this an “Elon Musk-on-crystal-meth” level of productivity and drive, and I gather this isn’t the point of Strattera (or I daresay any ADHD medication). Maybe it’s just hustle culture seeped into my bones. Regardless, Strattera hasn’t gotten me there (sigh).
I stayed on 25mg for a little over a month. Then, because I was kind of uncertain if it was working in other ways — there weren’t tons of clock-able results aside from curbed cravings — I went up to 40mg. Either because of that increase or because it had really built up in my system, I found a good cruising altitude with 40 and have maintained there. (The most common adult dose it seems is 80mg).
So How Does Strattera Work? *Shrug Emoji*
When first trying to understand the specific brain effects this medication has, I was tickled by the amount of articles stating the “precise mechanisms” of how Strattera/atomoxetine works aren’t super understood. It’s “thought to” (another common refrain) interact with the neutrotransmitter norepinephrine. I suspect this great unknown may relate to the nebulousness re: the various brain-workings that contribute to ADHD. However, when it comes down to it, atomoxetine’s norepinephrine element seems to be pretty agreed upon.
In a most layperson of understandings, this is my takeaway:
Norepinephrine is a neutrotransmitter, which carries signals from the brain to nerve endings that control cells and muscles. And…
Once released, NE travels to its target nerve, binds to the nerve’s receptor, and directs it take an action. That directive might be go to sleep or wake up, be more focused, feel happy, and much more. — Verywellhealth
In my understanding, with ADHD it’s thought that the neutrotransmission can get cut short, like the nerve receptor will suck in the norepinephrine before the message is fully received. A norepinephrine reuptake inhibitor allows the norepinephrine to hang out until the message is fully received. Furthermore, having higher levels of norepinephrine in the brain, the MO of Strattera/atomoxetine, is said to help with alertness and focus, and reduce impulsivity. (I once came across a cute and simple graphic of neutrotransmitter messengers but am unable to find… if someone sees something like that please send!)
However Strattera impacts the brain, it sort of hurts mine to think about.
Strattera and Focus
Prior to medication, I started using a habit-tracking app (I like HabitBull) and it did help me maintain goals and pursuits — though mostly at first when the app was novel. That sort of tapered off. Now that atomoxetine is full-on in my system, I’m seeing an uptick in more consistent tracking again. Or, if I’m not sticking entirely to the days-of-the-week schedule laid out in my HabitBull, I am more consistently doing the things I aim to, and experience less of the peculiar sinking feeling of watching goals and desired actions dwindle into the rearview, never to be visited again. I feel motivated to give the time of day to valued pursuits (despite lack of evidence with this blogspace ;D), and I require a lot fewer total-zero do-nothing hours to recharge. Mostly, I recognize that “progress, not perfection” is okay. Overall, win!
Any Side Effects/Downsides?
This is what I’ve experienced (and attempted to mitigate):
- Upset stomach (had to start eating more substantial breakfast as I take in the AM)
- Dry mouth (I drink lots of water, chew gum bc breath feels bad)
- … that’s it thus far.
The Takeaway
My experience with atomoxetine has been slightly life-changing. It hasn’t prompted a complete 180 from a general type B+ personality to A-to-the-max, but it has contributed to notable improvements (just ask my beer gut!). I have more work to do moving toward greater consistency, but the highs and lows of desiring hyperproductivity —and instead loafing and mourning — have balanced out.
I’m curious to see what dosage gets me to take out the recycling in a timely manner (lol jk?).
*Inattentive is often considered a misnomer, as myself and many of this ilk are able to pay deep attention, just toward certain things.
