Edit: added some updates 2024-03-01
Edit: I’m no longer taking Atomoxetine because the side effects were just too much. But I’m leaving this post in case it helps someone in the future!

I’ve been quite open about the fact that I was diagnosed with ADHD in December of 2021, and in January I started taking Atomoxetine (brand name Strattera) for it. I think it’s important to talk about neurological health and mental health; the stereotype of guys not talking about mental health is true. When I revealed to my friends that I had ADHD, several of them confided to me that they had a similar diagnosis – which I didn’t know! I think if we’d all been open about it, the process would have been easier for me to navigate. So: I have ADHD and am happy to talk about it.

Everything else in here is Not Medical Advice. Talk to your doctor. I just want to share my experience.

I was *very* nervous about getting a prescription for ADHD medication, since I feel like I get addicted to things easily, and I’d heard that many of the drugs on the market (especially the stimulants like Adderall) were habit-forming. The idea of adding something to my life that would be difficult to remove later really scared me.

To theorize for a moment, I think that the availability of only the stimulants, and perhaps also a lack of data on correct dosages + lack of time release pills led to the “adhd zombie” stereotype that I saw a lot of in the oughts and tens when I was really struggling to exist in the neurotypical-centered school system, and really could have used the diagnosis. I was afraid of this “zombie” outcome, which is part of why it was only after lots of therapy that I was willing to attempt a diagnosis.

My psychopharmacologist ($10 word) told me that there are newer (well, since 2002, compared to Ritalin in 1944(!)) non-stimulant drugs for ADHD that are less likely to be effective, but without the habit-forming effects. With my doctor, I decided to try Atomoxetine (brand name Strattera), and I’ve been on it since January.

I only have a layperson’s understanding of how Atomoxetine works, but here’s my attempt: Atomoxetine is an noradrenaline reuptake inhibitor. This means that noradrenaline that I produce will linger in my system for longer, leading to an increase in my alertness level, but without artificially increasing my noradrenaline creation or release – just the rate at which it’s reabsorbed if not used.

The effect is that I no longer need to stim as much to keep alert and not bored. And as a dad of a three-year-old who wants to play doctor for the 1000th time, not needing new stimulation to avoid wandering away or becoming distracted allows me to stay focused on play with my daughter, which makes it incredibly worth it. Being able to focus at work is also good 🙂 The medicine just makes it like, 30% easier to say “no” to distractions (e.g. phone, internet) which is enough for me.

My Experience with Vyvanse

After taking Strattera for a while but getting sick (lol) of the side effects, I finally got over my fear of Stimulants and tried Vyvanse (I can’t recall the dosage, but IIRC I started at half the normal amount, so, 10mg? 20mg?). My layperson’s understanding is that Vyvanse is basically Adderall (amphetamine salts) with a lysine amino acid attached. Your body metabolizes off the lysine at a certain rate, which then activates the stimulant. Because your body can only metabolize so much lysine at once, it causes the stimulant to slowly enter your system instead of all at once, making for a smoother experience.

At least, that’s what’s supposed to happen. Even on half the normal dosage, I ended up feeling incredibly high and light headed for the two days that I was on, and my memory and executive function were much worse than normal. I took a half dose and then nothing, but I still experienced a deep depression afterward for a few days.

I talked with a relative who also has ADHD and they said they had the same experience with Vyvanse/Adderall, so maybe we just metabolize it in a weird way? I’m sure stimulants work for some folks but they don’t seem to work for me. I did like that you could split the dose up or mix it in with food.

Erty’s Non-Medical-Advice guide to Atomoxetine/Strattera

This is my own experience based on about two years of taking Atomoxetine. The main side effects I got were nausea/lightheadedness, high heart rate, anxiety, and some acid reflux/heartburn. However I’ve mitigated most of them using the methods below.

Heartburn

The heartburn isn’t super bad and I can take tums for it. Sometimes it leads to a phlegmy throat, which goes away with tea and throat clearing. I’m not entirely sure that this is related to the Atomoxetine, it might just be that I’m getting old, lol.

Nausea / Anxiety

I think the nausea and anxiety are related to an empty stomach OR too much meds at once. My doctor started me at 40mg which I eventually figured out was way too much for me (For reference: I’m 130lbs) so I dropped to 25mg and felt much better while still feeling like I was getting the benefits of the medicine. I also found that I could resolve the nausea/anxiety by eating a large, protien-filled meal. For example: I would get the side effect if I ate a bowl of cereal (carbs), but not if I ate a bowl of cereal with a bunch of peanut butter on top (oils/fats/protein). I finally tried 10, and am now on 18 (just starting it!). So it took me a while to find the “right” dose.

I also think the nausea is worse at the beginning of the meds (or if you skip a few days). It seems like my body got used to the meds and figured out a homeostasis with them that didn’t involve nausea. Thanks, body.

The anxiety also seemed to crop up when I ended up with an empty stomach and meds still in my system. This was most pertinent when I would wake up in the middle of the night and feel “chemically anxious” – not anxious about anything in particular but just like, anxious. I eventually realized this was because my stomach was empty. I started eating a healthy midnight snack just before bed and that helped resolve it. I also started taking Magnesium Glycinate supplements which really helped reduce the anxiety.

High Heart Rate

I found that my heart rate would spike if I drank caffeine at the same time as my meds – like, a resting heart rate of 90 when it’s usually more like 55-65. In fact, I was able to completely drop my two-cups-a-day caffeine habit without any withdrawal. Nowadays I can have one cup of coffee in the morning without making myself too anxious, although I sometimes opt for decaf or half-caf.

Taking the Meds at Night

At the advice of my doctor, I tried taking the meds at night right before I went to bed. The idea was that the worst of the nausea happens a few hours after I take the pill, so if I’m asleep, I won’t notice. This worked ok! But it also made me wake up at 5am or so most nights. That … might be a good thing? But I don’t know, I ended up more tired later and my sleep schedule was sometimes biphasic which left me exhausted the next day.

Eventually I switched back to taking the meds in the morning / early afternoon.

Overview

I don’t like eating a big protein breakfast though, so my current (working for me) system is:
– Morning: Drink a small cup of coffee with a very light or no breakfast.
– Around noon: Eat a large lunch with some protien/oils/fats and take 25mg atomoxetine.
– Around 6pm: Eat a normal dinner.
– Around midnight: Eat a medium meal with Mg supplement and some sleepytime tea, fall asleep.

All in all, I’m quite happy with the meds. I don’t notice anything really different when I take them, but when I don’t take them, I can tell that it’s much harder to get things done, and my partner especially notices. In fact, there are days where I’ve later said, “Oh, I forgot to take my meds yesterday” and she’s replied,”oh, that makes yesterday make so much more sense”. So obviously they’re doing something.

I hope this helps someone!

From Grand Rapids,

Erty