Straterra Treatment For Pots?

[Patricia]

Hi everyone,

I am someone that brings medication suggestions to my doctor to try to help my symptoms as he does not research things. I heard someone mention that Straterra may help POTS as it vasoconstricts. I am not looking at it for improved mental clarity, though that would be great! I have hyperadrenergic POTS, cannot tolerate caffeine, decongestants, etc. as I get irregular heart rhythms and strong anxiety. Anyone know anything about Straterra?

Thanks,

Patricia

[doctorguest]

Although the advertisement for Straterra emphasizes that it is a non-stimulant, it is still a NorEpi receptor inhibitor and with its vasoconstricting properties, it may also act on cardiac receptors and possibly exacerbate arrhythmia. I would be cautious in trying Straterra if you cannot tolerate caffeine. Perhaps you can start on a pediatric dose and see how you do with the drug before going up to the adult therapeutic dose.

[Sunfish]

i don't know a lot about or have experience with straterra in specific, but do know that it's a distant relative of ritalin, as are adderall, daytrana, concerta, & some others. it is true that these meds can have a vasoconstrictive effect. some of them have been helpful to me over the years...for the vasoconstrictive effect and/or for cognition/ severe fatigue issues. but first a bit more about the meds in general...

i'm not certain if any of the "kissin cousins" have been specifically researched in regard to dysautonomia but do know that there has been research done on ritalin. i can't recall what the profile of the patients was (NCS, POTS, etc) but am thinking that it might have been NCS. interestingly enough (at least it was/ is to me), midodrine is a more distant relative of ritalin, and - if i remember correctly - was initially derived b/c of initial work with the effects of ritalin in some with orthostatic hypotention of some sort. i am solely going off of recollection here, so do NOT take my word as gold as i may be mixing a few things up along the way! if i'm able to find more concrete info i'll post that or confirm what i've posted. but i digress....

essentially - in very nontechnical terms - the chemical composition of midodrine is part of what makes up ritalin & it's related family of drugs. as one of the top autonomic docs explained it to me years back, midodrine is essentially the vasoconstrictive component, and perhaps most distinctly different, does not cross the blood brain barrier. this in many cases is great b/c it's a more targeted effect in the body, but for various reasons some dysautonomia patients do better with a med that does cross the blood brain barrier....in realms of vasoconstriction and, more understandibly, in regard to cognition &/or fatigue issues. another difference with some of these meds is that they are longer lasting; depending on the individual and the situation this can be a positive or a negative. for some people - me included - these meds can be used in with midodrine, so it's not necessarily one or the other.

in regard to heart rate, the meds can definitely raise heart rate further for some. i would think - but don't know - that this might be more likely in people with the hyperadrenergic diagnosis and /or issues with higher BP. for some, however, it can actually have the opposite effect b/c by raising blood pressure they can (potentially) decrease the body's need to have a compensatory increase in heart rate. again similar to the reasoning of why midodrine helps decrease tachy even in some without hypotension. with your intolerance to caffeine, decongestants, etc, my non-medical thought is that this class of meds might not be best for you, but obviously it's something to talk over with your doctor.

POTS is no longer my diagnosis so i can't comment so much in ways that would be relavant in terms of my current experiences b/c i don't have the same issues with tachy (sounds good, but in reality it's not). but that said, in the past my clinical picture was more clearly what seemed to be POTS, though not hyperadrenergic. and i've actually never had a problem with - and at times have been helped by - things such as caffeine & decongestants. so my experiences may be of zero help in that regard. when more "POTSy" i had a lot of success with concerta, using midodrine as an extra "boost" upon waking & as needed. after a few years it no longer helped, but when it did help it benefitted me greatly in regard to orthostatic tolerance as well as other issues (which at the end of the day aren't always easy to distinguish, at least for me). later on adderall wasn't so helpful; i didn't notice any benefit & had some bothersome side effects. currently i use daytrana, a med in patch form, and while i can't notice much in regard to help with orthostatic issues, it does help me cognitively & takes the edge off of my constant fatigue.

hope this helps....

melissa

p.s. you may want to do a forum search not only for straterra but for some of the other meds i mentioned as it may bring up other relevant discussions that could be helpful for you.

[Poohbear]

Here is a new Pub Med Abstract you may want to read and think about further.

http://www.ncbi.nlm.nih.gov/entrez/query.f...l=pubmed_docsum

[Patricia]

Wow. Thank you all SO much for your help. It is scary doing these things blindly and my gut was telling me this might not be a good idea. I will print your replies to take to my physician.

Thank you!

Patti

[Sushi]

Hi Patti,

I take strattera 10 mg two times a day. It helps me a lot, but then I don't have POTS. What I notice is the vasoconstriction--if it is wearing off and I stand up and walk, my legs feel like lead and a get a bit fainty. It has also helped remarkably with fibromayalgia--circulation improvement? I now back up the strattera with one dose of cymbalta and small doses of adderall and this combo has pretty much stopped my BP from falling.

My pulse is up a bit (10 points) and my BP is classically normal. After they all wear off, my BP goes back to the low end of normal. I have no bottersome side effects now from strattera, but it was devilishly hard to tolerate it while trying to get up to dose. I had to start with a tiny dose every other day and it took a couple of months to get to 10 mg. twice a day. Hope this helps.

[Patricia]

Hi Sushi,

Could you tell me what you were feeling that made it difficult to get on it? I react to meds at baby doses and I do not know what I could do as it is in capsule form. I too suffer from Chronic Fatigue Syndrome- UGH. I am glad you are able to tolerate the meds and are feeling better!

Patricia

[Sushi]

Patricia,

Here's what I felt though some others have felt nausea. For me it was like speed at first, and, if I remember, some itching, though not hives. I actually opened the capsules and dumped some out, then put them back together. My doctor gave me permission to do this, though it wasn't exact dosing, I did it by eye. However it worked and I am glad. My doctor usually starts people on an every other day or an every third day initial dose for a couple of weeks.

I forgot to mention another great benefit I find from strattera: I am no longer freezing cold in the winter. I got through the winter in normal winter clothes, normal indoor temperature, without that freezing to the core feeling I used to have.

[gwen]

I was on strattera for a while for cognitive reasons and it was fabulous!!! unfortunatly it did not help my low bp, so we went to adderal. this helped the bp but i've now gotten to 30mg a day and have horrible side effects on higher dose. the cognitive help has started to fall. My cardie says we can try a combo of both and are planning a start on that next week (visit). I def have to take midodrine and do have scalp itching/goosebumpy feeling but i just made up my mind to tolerate it.

so in summery midodrine - amust for bp

adderal - a must bp

strattera - hope combo will have no sideaffects and i won't be so foggy. zip on bp.

hope this helps:-)

[Patricia]

Thanks Sushi and Gracie. I am so scared of drugs that make me come out of my skin....I am unfortunately so sensitive in that way. I need to tolerate SOMETHING so I can be up longer. Sushi, I will give it a try with your doctor's idea of not taking it everyday. Thanks so much!

Patti

[corina]

hi patricia,

i am on methylfenidate (brandname of ritalin) because during the day i kept on falling asleep. although i am not officially diagnosed with any sleeping disorder, it very much helps me staying awake!!! also, i feel much more clear in mind which is of course a very welcome side effect. i don't know much about strattera other than that it is related to ritalin.

hope this helps, and good luck on your journey trying meds that make you (feel) better!

corina

[Maxine]

I heard straterra can be helpful for POTS folks with plood pooling problems, and I also know a couple of people who have NCS did well on it, and it was helpful for the fatigue, but they also did not experience some of the common POTS symptoms like the hyper-adrengic spells that some of us get.

Although it sounds tempting for me to take this class of drug for my fatigue and blood pooling issues, I don't think I could tolerate it well. I have arrhythmia problems, but they are very infrequent. I have had really bad ones with grey out, but none like that since the cardiac loop recorder was put in-----Of course not-- I also get rather hyper-adrengic at times, but do not have "hyper-adrengic POTS.

I was given ritalin when I was a child for ADHD. My parents said I was miserable, and ready to climb the walls.

The wellbutrin helps the fatigue, but the effects seems to wear off by evening. I also find it does not give me the overstimulated feeling some other people might get on it. I take a baby dose of 100mg SR. I tried to increase it, but I got a ZONED feeling. I wanted to increase the dose to help with the crippling fatigue I get at night. I think there is a little more to my fatigue other then my POTS------------------I have other problems that contribute to the fatigue. Another added bonus of wellbutrin is it does help my ADHD a little. I found this out when I took a medical terminology/coding program in 2003. I got a 4.0 gpa--- When I went to a private collage for business classes before the POTS crash and wellbutrin I still did well, but I had to try much harder. However, now that I have had an increase of other health problems, my cognitive abilities have been affected, and my attention span is the main target-----and the wellbutrin doesn't help as much as it used to in that respect.

Maxine :0)

[DanniBunny]

I will be honest and say I didn't read through all the previous responses so I aplogize if I repeat anyone else's comments.

I haven't tried Strattera personally - however from what I understand in terms of its relation to use in patients with any type of heart/blood pressure type issues, it is preferable over other various 'adhd' medicines. My mom is highly a.d.d. she was on various other medications, but a severe pneumonia infection triggered heart disease and a MPV (which runs in our family so we're not sure if the chicken or the egg came first for that part). Her add is so bad she truly cannot function normally with out treatment but because of her heart, she couldn't be put on any other medications. Finally strattera came out and her cardio actually suggested it because it would be easier on her system and it would get her back to normal functioning. its been 5 years now since the switch. ALL her heart symptoms have cleared and she is sitll doing very very well on the strattera.