Drug withdrawal is a legitimate concern for many who have to use medication, but some drugs are not as difficult to discontinue as others. While Strattera is one example of this, there are still risks and dangers with suddenly stopping its use.
Strattera and Norepinephrine
Strattera is a nonstimulant medication that is prescribed for the treatment of attention deficit hyperactivity disorder (ADHD) in children, teenagers, and adults. It is the brand name form of the generic medication atomoxetine, and it is used to manage impulsivity, distractibility, and hyperactivity. Strattera gained attention for being the first nonstimulant ADHD drug compared to other widely known drugs used to treat the condition such as Adderall.
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One reason Strattera is a nonstimulant medication is that it is a norepinephrine reuptake inhibitor. Norepinephrine is a neurotransmitter that the brain produces in moments of stress. It helps people manage their focus and anxiety, but it also plays an essential role in the regulation of sleep, mood, and energy.
Strattera works by preventing the brain from reabsorbing norepinephrine as it normally would, thereby ensuring that increased amounts of the neurotransmitter remain to help people who experience the effects of ADHD.
In this way, Strattera is similar to the functioning of selective serotonin reuptake inhibitors such as Prozac and Zoloft, in that those medications prevent the brain from reabsorbing the serotonin neurotransmitter, which helps patients with depression.
Strattera has a similar chemical structure, mechanism of action, range of side effects, and length of time needed for effect, as SSRIs even though it is specifically a selective norepinephrine reuptake inhibitor.
There are a few typical side effects that come with Strattera consumption. Patients normally experience appetite loss, nausea and vomiting, indigestion, mood swings, fatigue, and dizziness. They are not causes for alarm in and of themselves, and patients will usually be advised to continue their Strattera intake until the effects subside. However, if the effects persist, or increase in frequency or intensity, it will be necessary to see a doctor before discontinuing or changing the dosage.
Withdrawing from Strattera Use
Most prescription medications come with caveats of withdrawal; that is, if their use has reached the point of inducing psychological dependence in patients, then it is significantly dangerous to abruptly stop using that medication. The sudden deprivation of the medication causes severely distressing and possibly dangerous side effects. Instead, patients should gradually taper off their consumption of the medication, in consultation with a doctor, until they are free of the need for the drug or their use of it is sufficiently low.
With Strattera, on the other hand, the withdrawal symptoms tend to be mild and short-lived. There have been no established adverse effects from discontinuing Strattera consumption. However, patients who have been using Strattera for a long time, who have been taking high doses, or who quit cold turkey are at risk for developing withdrawal symptoms.
The dosage of the medication is one factor that determines the possible side effects of Strattera withdrawal. Strattera is administered in doses ranging from 18 mg (milligrams) to 100 mg. In most circumstances, a doctor will start a patient at a small dose and gradually move toward the dose that is most effective at eliminating the patient’s ADHD symptoms. If a patient is going through Strattera withdrawal, the best course of action is to taper back down instead of going straight to zero.
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Dosage and Withdrawal
Patients who take doses above 60 mg are more likely to feel the brunt of withdrawal symptoms. At higher doses of Strattera, there is a greater degree of norepinephrine being denied reuptake, so it will take longer for the brain to reestablish natural production of the neurotransmitter. The longer that process takes, the more there will be difficulty with mood and sleep regulation, along with the other functions that the norepinephrine neurotransmitter manages.
Most patients who experience withdrawal from Strattera usually have taken the medication for a long time at an unusually and unhealthily high dose. If a patient has been on Strattera for a few weeks, then discontinuing it should not induce any significant withdrawal effects, although there might be some light disruptions to mood and concentration. However, a patient who was on 80 mg of atomoxetine for months at a time will more than likely experience some form of negative reaction to the sudden stop.
Broadly speaking, most patients can stop their Strattera use cold turkey without having really bad withdrawal symptoms. This is primarily due to the atomoxetine targeting the norepinephrine neurotransmitter. Unlike medications that work on serotonin or dopamine, Strattera’s nature as a selective norepinephrine reuptake inhibitor means the drug tends to have fewer side effects if it is suddenly removed from a patient’s routine.
Of course, withdrawal is still undesirable and potentially dangerous. If a patient experiences any adverse reaction after discontinuing Strattera, it is advisable for the consumption to be gradually wound down. A doctor might recommend some other medications to ease this process while still ensuring that the ADHD receives necessary treatment.
Withdrawal affects every person differently. Some people can stop Strattera immediately and not feel any worse for the experience while others require care and monitoring.
Factors of Strattera Withdrawal
A large part of what determines this is the person’s physiology. This can cover everything from a family history of substance abuse and mental health issues to the level of stress and access to controlled substances.
Those who are very sensitive to the effects of medications, in general, might feel more withdrawal symptoms if they stop their Strattera consumption compared to those who respond to medications with markedly reduced sensitivity. Every person’s central nervous system (and all the systems that work off it) is unfathomably unique and complicated; therefore, everyone who takes Strattera can have a different reaction when they try to come off it.
In general terms, many people can cut off their Strattera use without having typical withdrawal symptoms. There is currently no recognized “Strattera withdrawal syndrome,” and most of the people who experience some discomfort when they switch off Strattera intake will feel better within a few days.
Nonetheless, atomoxetine is still a psychoactive substance, and it does change the functioning of key neurotransmitters in the brain. What few established withdrawal symptoms exist for Strattera fall in line with what can be expected when the norepinephrine neurotransmitter is impacted: namely, disruptions to concentration and focus as well as anxiety.
Anxiety, Cognition & Depression
A mild period of anxiety is a typical response to discontinuing Strattera. Users will feel more stressed than usual as a result of the brain trying to rediscover its natural norepinephrine balance.
There also may be cognitive problems, such as an inability to focus. This is to be expected. Strattera is designed to treat ADHD, and abruptly removing it from the equation would cause norepinephrine levels to drop temporarily.
In patients who have a likelihood of developing depression, the Neuropsychiatric Disease and Treatmentjournal warns that reduced norepinephrine levels can induce periods of depression.
While Strattera withdrawal is not dangerous in and of itself, this is an example of how some people are at risk for mental health or medical complications arising from their termination of medication. This is why the decision to stop using Strattera should not be carried out without physician supervision.
Fatigue, Insomnia & Memory Problems
Some people may feel fatigued when they cut off their Strattera intake. Since the medication is intended to provide a stimulating effect (albeit while technically being a nonstimulant), there is a noticeable drop in energy levels, resulting in a short-lived state of fatigue and exhaustion. Again, this should fade as the body can quickly compensate for the unbalanced norepinephrine levels.
Headaches tend to be commonly reported during atomoxetine withdrawal; similarly, migraines are not unheard of. This is a natural part of the withdrawal process, and they should fade away on their own after a couple of days.
Some people experience insomnia as a result of stepping away from Strattera. There is the potential for a complication here if the person is taking another medication for pre-existing insomnia. The interactions between the two drugs and the chemical changes that arise from the discontinuation of Strattera could induce or exacerbate insomnia.
A patient should consult with their doctor before stopping Strattera and before increasing the dosage of their insomnia medication.
There are anecdotal stories of Strattera withdrawal inducing mood changes. This is similar to the effects of withdrawal from other drugs. With careful supervision, the patient should be able to ride out the storm until they regain full control of their emotions.
Lastly, the discontinuation of Strattera may lead to problems with memory. One reason the drug is prescribed to treat ADHD is so it can help patients with short-term memory recall. As the brain can start producing norepinephrine again, any lapses in memory should fade.
How long does Strattera withdrawal last? In most cases, the process is over within seven days of the last dose of the medication. People usually report that the symptoms listed above will afflict them for a few days and then gradually fade.
There will be people who experience absolutely nothing, and there are patients who have pre-existing medical conditions, or who are taking other drugs at the same time, who will likely have some form of withdrawal.
Generally speaking, the people who have the greatest risk for experiencing the side effects of Strattera withdrawal are those who have been taking the medication for a long time at high doses. Patients who take the drug as they should — for a few weeks, at a low dose — likely will not have to deal with any significant withdrawal symptoms. What symptoms they might experience will be gone within a few days.
In summary, out of all the medications out there, and out of all the medications for the treatment of ADHD, Strattera is a fairly easy one to withdraw from. Deciding not to take it anymore does run the risk of allowing a return of ADHD symptoms, and there is the chance that the right combination of risk factors is met for there to be some unpleasant withdrawal effects. As with any prescription medication, users should not discontinue their consumption without careful consultation with their doctor.
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