Expert: Dr Billy Levin - 9/10/2006

Question
Dr Levin,

I had a question on effects of Strattera, and how their chemical properties can vary so greatly between individuals with ADHD.

I understand that too much or too little of certain chemical in the brain can cause various symptoms, but what I don't understand is how Strattera can make someone severely depressed when norepinephrine is suppose to increase mood.

I was just curious because I once took Strattera, but seeing much better effects with Ritalin I have looked more into neurotransmitters and what effects they give off. I realize that people with ADHD probably have different levels of these chemicals, but it is just interesting that an increase of norepinephrine made me more depressed, as well as all the other affects with too much of norepinephrine [sleepiness, anorexia, and no drive if that is a result in too much of the chemical].

Anyway, I thank you for taking your time to read this, and hopefully you can answer my question.

-Terese

Answer
Both Ritalin and Strattera are good products but each have their pros and cons. Ritalin appears more effective but not for everybody. Just so, the  side effects with Stattera are less  but once again not for everyone. Depression is a hot topic for discussion. When Strattera first came onto the market I suggested to Lilly, who market Strattera that it will cause depression in certain patients. I was reassured it would not happen. Time proved me correct as in your case. Both Noradrenaline and Serotonine play a role in depression. Unfortunately some patients with ADHD will become depressed  while on Ritalin, but not because of Ritalin,  and  also need an antidepressant. The  same applies to some patients on Strattera. Your doctor's skill and your comments/feedback  will decide what is the best medication or combination for you. Every patient is unique.