Expert: Dr Billy Levin - 10/7/2008

Question
Hello, I am 21 years old and take Straterra for A.D.D. And Cymbalta for mild anxiety. I was told that with Straterra I should not consumer anything that has a lot of caffeine or raises my heart rate (such as diet pills, energy drinks, and coffee). I have always had an increased resting heart rate (not within an abnormal range, just in the far upper range). I started drinking coffee and by this I mean triple shots of espresso. It does not affect me like a stimulant, but makes me feel calm and relaxed.  Also, I consume a lot of caffeine in Dr. Pepper, a.k.a heaven in a can. Since it has this affect on me should I worry that the doctor told me not to? I do sometimes feel my heart rate increase drastically when I become anxious, though this happens whether or not I consume and caffeine beverage or not and I feel that it is still to the same degree.


Answer
If you do not have a cardiac condition there is no reason to avoid coffee as it helps ADD. However everything in modiration ,so tooooo much is obviously not good for you. It will make you calm just as Ritalin would, which is also a stimulant, used for ADD. Strattera is a non stimulant but it also works for ADD as long as the dose is optimal. If there are any doubts, speak to your doctor.