Kelley… WOW! Thank you so much!! Obviously I have found the right place… I was wondering where one turns for really knowledgeable advice about brain chemistry, because neurologists sure don’t seem much interested in it (at least not the ones I saw). Psychiatrists–that makes sense! And I would love to borrow YOUR psychiatrist! 
Clearly you have learned a lot, and I THANK YOU very much for the info you provided. That is one of the big questions I had–what is the relative strength of the norepinephrine effect in Strattera and Effexor? and you say that it is not so strong with Effexor. Indeed I would hate to lose any of the benefit I get from Strattera.
I had actually wondered about Wellbutrin too, because of its effect on dopamine. I thought perhaps that would combine the best of the Strattera and Ritalin.
But your advice to try adding Celexa sounds very good (as Greg also suggested). I am so grateful for the advice–and to have a starting point for talking with my GP. I do not have a psychiatrist, have never seen one, but my GP is smart (looks things up right away on the Web and the Kaiser internal info site if he doesn’t know it offhand) and seems very willing to try to help me figure things out.
Here’s how I got started on Strattera: When I saw the big dizziness-specialist neuro in 2000, he had me try Provigil for the fogginess. Perhaps he was still suspecting I might have MS, as he’d brought it up, and Provigil is often given for fatigue and to some extent cognitive problems in MS. At that time, he said “We used to use Ritalin for this,” but now they used Provigil because it had fewer side effects.
Provigil helped me focus and certainly gave me more energy (made my arms and legs feel light), but after about a year and a half of taking it as needed (not every day, just when I really really needed focus and energy on workdays, because I was starting a new job) it did not seem to work so well and I didn’t like the late-afternoon letdown effect. I lost my job (budget cuts) and had to go back to freelance copyediting, which demanded more concentration than I could muster, so I asked this neuro if I could switch to Ritalin. He obliged and it was a great help, and after a year or two of taking it (again, sporadically, only when really needed) it was not working well and sometimes even seemed to make me worse–I’m not sure what was going on. Anyway, eventually I asked my GP if I could switch to Strattera (I wasn’t seeing the neuro anymore) on the theory that if one ADD med helped me, another one might (even though I didn’t have ADD). And wow, what a difference. After the first day and a half, during which I felt yucky and was sure I wouldn’t be able to take this med, THE FOG LIFTED and I could concentrate!! With every weekly step up in dose over the next month, I’d have the same strange-feeling 1.5 days, then I’d feel excellent again. And it’s worked so well for me ever since (7 years now). Doesn’t help the dizziness, and I still feel foggy and woozy, but somehow I can concentrate reasonably well THROUGH the woozy-dizziness.
So, in a nutshell, Strattera was NOT prescribed for MAV in my case (I wasn’t thinking too much along those lines then–my big focus/concern was MS), and in fact I don’t even know what the docs have in mind when they continue to prescribe it (I’ve switched GPs twice since then). They never say “it’s for this-or-that,” they just continue it for me with no questions!
I have not tried Klonopin and I only took Valium once, a big dose (5 mg? if that sounds right?) prior to an MRI (I had gotten antsy because at my previous MRI my neck had gotten scarily HOT during one scan, so I thought a Valium would keep me comfortable, and it did). It made me very woozy. Between that and the lack of success with Xanax and Ativan, I thought benzos weren’t for me. I need STIMULANTS, it seems. Uppers, not downers.
Thanks again, Kelley & Greg–and sorry I’m so long-winded.
Nancy W.