Q:  Strattera

I'm bipolar but ADD too. I have almost no attention span and am very unmotivated. I tried adderall (which worked well for the attention span) and ritilin in the past but they both made me very irritable and shot me into mania.

My dr. says she has seen great results with Strattera. It's the first non-stimulant medication proven to work in adults and children with ADD. It also works 24/7 and is usually only taken once a day. 

I was wondering if you have any bipolar patients that have tried this medication. I  am just starting it but my dr. says that she has given it to adults and children and seen amazing results but never to a bipolar adult. 

So...naturally I'm nervious. If you know anything about this new drug or have taken t yourself, please let me know.

Thanks! :-)
Kim
 

Hello Kim -- 
I can understand the nervousness.  My usual approach when a new drug comes out is to wait, preferably a year, two if I can stand it, and let other doctors and their patients find out what the drug is really like before I use it -- as long as there are some pretty good options among the medications we already have available.  

However, I've also had some folks with bipolar disorder who also seemed to have ADD on top of it, i.e. their mood symptoms were perfectly controlled, it seemed, and yet the attention/focus/concentration problems remained.  A couple of those folks have done so well on stimulants added to their bipolar medications that I think I can understand how "waiting" may not sound too great, and understand your willingness to take some risks. 

Maybe we could translate your question into "how risky is this idea?"  Well, that's the problem:  at this point, I'd say we really have almost no idea.  In fact, about all we have to go on is your previous experience.  To get really concrete about it, I'd say, guessing, that if you're not willing to take an 80% chance of going through what you went through with Adderall and Ritalin, you probably ought to wait.  Maybe that figure should be 50%, but I think one could make as good a case for 90%, since it's just guessing.

There are probably a few child/adolescent doc's out there who could speak from experience, but since the stuff has been around for so short a period of time, I would think that would be very limited experience (still better than my zero).  

Dr. Phelps

Published June, 2003