Nancy W

Nancy,

Wow, sounds like you’ve been through a lot over the years. Sorry it’s been such a rough road, and you’ve lost hearing in one year cause of this garbage. I would say if you’re getting good results with just the Strattera right now, but not exactly where you want to be, I think I might ask the doc if you can take Strattera with Celexa. I’d hate to see you get off Strattera and try something else and not be as good as even the Strattera was for you.

I might do that first because as far as I know, Celexa isn’t as bad with side effects and I don’t think it’s bad with withdrawl either. (I’m speaking for majority, I know there are exceptions of people who might think differently). Your already hitting the norepinephrine, so it seems that Celexa would fill in the blanks there. And if that don’t work, I’d go with the Effexor.

The reason I wouldn’t go with Effexor first is 1. because your already taking the strattera and 2. because I have read many posts from people here that say Effexor has a terrible withdrawl period to it, and 3. You’re getting some good results already with the strattera so why not just fill in the rest with Celexa.

Celexa by the way is also been shown to be very effective for MAV. It is one of the meds that Dr. Balou prefers. He is one of the well respected MAV dr.'s that’s around.

Definately check with your doctor if to see if you can take strattera and celexa together though. I don’t see why not, but I’m no doctor either so I don’t know for sure.

Best of luck to you Nancy!!!

Greg

Greg, thank you SO MUCH for the info and the idea about just adding Celexa. This sounds quite sensible and is exactly the kind of input I am looking for here.

(And I hope I will be able to make myself useful here eventually with info and experiences of my own–I still need to do a lot of reading and get familiar with the board and all the information posted here.)

Indeed I do have worries about what might happen if I went off the Strattera; I really don’t want to revert to those days when I’d spend many hours a day sitting around in a dizzy-foggy stupor.

Thanks again, and I’ll definitely be posting again soon! (On the general forum.)

Nancy

You’re welcome Nancy. That’s what we’re here for.

Greg

Hi Nancy and Greg,

I split your chat from the Post Your Story thread into the main discussion here where you guys can chat away. I think it’s best if we keep the Stories section to just individual stories and move chatting into this general discussion area.

Cheers … Scott

ps. Nancy, I can restore your other log in if you like?

Thanks very much, Scott–both for reposting the comments here and also for the offer to restore my first login attempt. I think I’ll just keep Nancy W., so as not to confuse my own self. :slight_smile:

And thank you EVER SO MUCH for hosting this forum. I am glad to have found it and hope to be participating a lot more in the near future.

Best wishes to all

Nancy

HI Nancy
I just read your story and it sound like some crazy brain chemistry going awry…you could call it MAV, as it sounds like it might have it’s roots based in migraine…but then again, what the heck is migraine? It encompasses so much!! So on to my favorite subject…psyche meds!
You are the only one I’ve met on Strattera. I am supposing they put you on it for the attention stuff, but I am surprised they did it for migraine. Usually the meds they use will incorporate serotonin first, and many of the meds hit NE second. The tricyclics and Effexor hit both, but Effexor only hits NE at the higher doses…higher than what Dr. Hain likes to use (37.5mg). I think it’s over 75, and maybe even 150mg before Fex starts hitting the NE…and then it will hit Dopamine once it hits like 350…but who wants to use that strength!!
I take Cymbalta, which hits both SEro and NE pretty much evenly. If I were you, I would consider trying the Celexa, since it’s pretty easily tolerated, and see how it goes? You can then switch to Welbutrin, which hits both NE and Dopamine from the STrattera if you want to try to hit all neukrotransmitters…an SSRI augmented with Welbutrin is a very common combo…
You mentioned that Ativan didn’t work for you…have you ever tried Valium or Klonopin? It’s quite possible that you don’t need your GABA tweaked, so when you give your brain what it needs…bingo…but if it doesn’t need it, then no affect, or just bad side effects…Good luck!
Kelley

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! :slight_smile:

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. :slight_smile:

Thanks again, Kelley & Greg–and sorry I’m so long-winded.

Nancy W.

P.S. to Kelley–my reference to your psychiatrist was from a thread you posted on last fall–I was starting to read it.

Nancy,
I have 2 psychiatrists, and the one who really gets me and my interest in psyche meds, is in Cali. Where do you live? He’s very unique in his approach. I keep his book bedside, along with Dr. Stahl’s guide to psychopharmacology. Hilarious, right? But when I started these meds, and realized they can change your brain, I wanted to get as educated as I could. It is fascinating!!
I think you are on the right track with Celexa, and I wouldn’t hesistate to see if that can help you. I was told that the stimulants are good for a short term, but not for long term. I wonder if Welbutrin might do the trick for you? Maybe you can talk to your pharmacist (they are good in this dept) to find the equal amount needed to match what you are getting from strattera?
Feel free to PM me anytime…this is a subject I never tire of…
I do think many women, who haven’t been migraineurs their whole lives, get this stuff around perimenopause, so I think the depletion of serotonin as we age, along with the hormonal changes can activate this condtion…just food for thought…

Kelley

Nancy, I had good sucess with Celexa and am now on Prozac. I’m not sure Prozac is the right med for me, as it is a bit too stimulating for me. But Celexa felt a bit numbing. I dunno. But it might be a good med to try.

Kelley, I called Dr. Jensen to ask about appointments with out-of-state patients and he called me back the first time getting my voicemail and then later that day at 6pm on a Friday! I was impressed that he did that, and obviously shows his devotion to patient care.

I’m going to be in San Deigo in August and thought maybe I could meet with him. The question is insurance coverage of lab work in another state, as he said it typically runs $1500 for all the lab work. And then he’d like to work with one of my physicians here on the meds. That is my biggest concern though, as I don’t have any docs that are as open-minded and I’m not sure they’d go for his approach. Especially low dose benzos, which he mentioned on the phone can be very helpful. Anyway, I’m going to look into my insurance and check with my primary doc and see if I could make it work, because I’m interested in his approach and testing for viruses. He asked about cold sores, and I’ve had a ton of them since this all started, whereas I hadn’t had any in the previous 3 years. Who knows!?!!

Anne,
That’s great that you reached out to Dr. Jensen. He is a really caring guy, and sure seems to have a different approach than most docs. I hope you make the appt to meet him. The blood work is a lot, but the nurses are very gentle, so it wasn’t any big deal. The $$ is though…just got hit with a $500+ biill for my second set of blood work…and he’s a cash pay as well…
Hope it works out for you!
Kelley