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Glad to hear that Remeron helped you sleep better! I've been using Trazadone for the same purpose. Trazadone and Remeron share the ability to enhance slow wave sleep (the kind that supposedly restores you). But I'm thinking of switching to Remeron because of the very reasons it helped you.....thanks for sharing your experience!

I'm not presently taking Strattera, but because of my work, I've learned alot about its background. I have a very open mind to Strattera. In theory, the stimulants should work better for ADD....but I'm willing to believe there is a big subset of people for which Strattera is really effective. I'm interested to see if its particularily effective for people that get distracted by their own internal thoughts and dialog - in theory, Strattera should help you "externalize" better....

So, another small technical diversion on coffee and smoking. Each one of these drugs works on different brain systems. Coffee works on a system called "the adenosine system". And smoking works on the "acetylcholine system". Strattera works on the "norepinephrine system". Each of these has different roles and purposes in the working brain.

Adenosine is nature's way of tracking how long we've been up and alert. As we go through the day, adenosine builds up in our brains, and tells us to get sleepy. Caffeine blocks adenosine, and thus keeps us alert. Caffeine is especially good at helping us resist accumulated sleep deprivation. Chronic use of coffee supposedly makes you tolerant to its diuretic and other effects, but should still have some efficacy in helping you resist sleep. It should be synergistic with strattera (i.e. they should work together). One small issue: the combination may actually make you jittery, since they are both very alerting. There are about 200mg of caffeine in a cup of coffee, which works for about 3-4 hours in your body. To gauge the effects, take your strattera, and after 2 hours, drink your coffee. Compare how you felt before the coffee and after the coffee....this is a kinda rough way to check out how the mingle together.

Acetylcholine does a lot of different things in the body. In the brain, it's closely tied to cognition, and is thought to help us encode new memories. It's also implicated in mood, and other stuff. Nicotine stimulates our acetylcholine system. In the short term (first day), it makes us feel smart and alert. But in the long term, it actually hurts your cognition! Your brain's acetylcholine gets rapidly desensitized by all that nicotine, and ends up acting like it's not there anymore. So, after a couple of weeks of smoking, you need to smoke to keep feeling smart. The data I've seen shows that your baseline of cognition actually goes down w/long term smoking, and you end up having to smoke to bring yourself back up to a level that's slightly below normal. But, given that you have ADD, your brain may react differently to smoking (e.g. schizophrenic patients often smoke to help them think clearer - the nicotine actually helps them). It's hard to know exactly how strattera will interact with should be synergistic.

So, my guess is that strattera + caffeine + nicotine = more attentive. It may also make you feel more jittery. Let us know how it goes!


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