Qelbree - New Treatment for ADHD | ADHD | Episode 48

The first new FDA-approved non-stimulant for ADHD in 12 years, viloxazine has some interesting similarities to other agents, but has a unique pharmacologic profile as a Serotonin and Norepinephrine Modulatory Agent (SNMA).
Join the conversation on FB: / drjohnkruse

[@apbls]

Thank you for this presentation. I wish more people knew about this alternative to existing non-stimulant treatment for ADHD. Qelbree’s effect lasts 24 hours, a game changer for patients who need a “booster” dose. It is also a life-saver for the parents of children with ADHD who struggle to get their kids to get school work done when the effects of the medication have worn off in the middle of the afternoon.

[@DrJohnKruse]

I'm glad that some people are getting good results from this newly introduced medication.

[@shanelocky6004]

Are you saying that you wish that people would try non stimulants more often?

[@apbls]

@@shanelocky6004 It will be up to the individual to seek being open to options as opposed to simply preferring stimulant vs. non-stimulant treatment. However, it is a fact that stimulant medication may affect weight gain and growth in children. More education is needed about side effects of ADHD medication in general, however helpful they may be to many patients. Medication must be regularly monitored as symptoms might improve over the years. A child who needs one type of medication early on might no longer need the same type later on as their brain develops. My argument is in favor of more education and also for parents to be advocating for a comprehensive approach beyond medication. For example, low sugar diet, mindfulness training, exposure to sunlight and exercise can help reduce symptoms of anxiety and depression, often comorbidities to ADHD.

[@webbedshadow2601]

Thanks for the information! I didn't know qelbree starts working so fast, I'm looking into non stimulant options for my ADHD and might give it a try over Strattera

[@DrJohnKruse]

I hope it goes well.

[@heatherhart3301]

thank you so much for this video. my son may need to switch to this according to his Dr. if the newer prescribed dosage of Concerta doesn't work. this answered all the questions I had when the Dr. handed me a pamphlet on Quelbree.

[@DrJohnKruse]

I appreciate the positive feedback. Feel free to share this video or others with those who might also benefit.

[@OsamaBinMoggin]

For me personally qelbree has not been working well, Ive been on it for about 4-5 weeks. My doctor recommended maybe a combination of stimulants and this. Around the second week when I started taking two per day I would get dizzy sometimes but not very much. There was one time when my body was shaking but it wasn’t a whole lot. It also gives me massive headaches sometimes, you have to take into account that some pills can make you dehydrated and for me I already don’t hydrate very much so it may be because of that. Idrk tho. I haven’t felt anything positive.

[@reinerwilhelms-tricarico344]

Have my doubts about this stuff. It’s viloxazine, another norepinephrine reuptake inhibitor, that wasn’t really working well as antidepressant, and after 30 years on the market they basically renamed it and now it’s suddenly used for ADHD. At the same time they suppress the classical well proven ADD medications like methylphenidate, which have been around for more than half a century and have way fewer and less severe side effects than all these reuptake inhibitors. The DEA in cahoots with insurances and pharma producers created a total drug shortage on these generic drugs just to open the market for more expensive b.s. replacements. It’s a scandal.

[@DrJohnKruse]

Except, as I explain in the video, it's not just a simple reuptake inhibitor, it actually was an effective antidepressant. The reuptake inhibitor don't have the risk of addiction, and lower risks of severe cardiac problems and psychosis than stimulants, so it's quite hard to make the case that the stimulants "have way fewer and less severe side effects". And no, none of the drug companies are paying me for talking about what I see and read.

[@dariusshojaei5036]

@@DrJohnKruse I agree. Stimulants can be highly addictive and have many negative effects. However, I've been on non-stimulant medications for my ADHD, which also come with their own set of side effects. After living with ADHD for almost 40 years, I've come to realize that relying solely on medication isn't a long-term solution. I’m learning to adapt the world around myself, instead of changing myself for world with chemicals. Drugs may offer temporary relief, but they're not a sustainable solution in the long run, and could potentially have serious consequences.

[@jaeshasway]

My issue with anti depressants and even stimulants is emotional blunting. It’s been debilitating. What suggestions do you have for those that struggle with his issue when taking antidepressants for depression and stimulants for ADHD?

[@DrJohnKruse]

It may be a dosage issue with the stimulants, so reducing the dosage may reduce blunting. Most of my patients report better emotional regulation, rather than emotional blunting, when their medications are adjusted optimally . While I have worked with many people who have experienced emotional dulling or blunting with serotonin reuptake inhibitors, usually they find that Wellbutrin (bupropion) or an agent with strong norepinephrine reuptake action (like Fetzima) don't blunt their emotions. If these classes haven't been helpful, maybe something that works differently, like guanfacine (see my video) or modafanil might be a better fit for you.

[@jaeshasway]

@@DrJohnKruse Thank you 🙏🏽

[@richwilson5969]

By the way. Straterra was a God send for. It improved things 100 percent for me. I ciuidht believe how well it helped me. Altho after 3 months tsking 60 mg. It seemed I needed to go up on dosage. I’m 55. And I read starting dose is around 40 mg. And go up from there. I started 10 mg and finished with 60 mg due to sexual side effect. Sorry. This is my 3rd post in a row. Obviously I have adhd.

[@twalsh1801]

gonna stick with my latte regimen for now

[@foraminutethere23]

Hey doctor. This medicine worked pretty well for me as I couldn't tolerate the side effects of stimulants. Oddly enough other SNRIs would make me hypomanic or extremely anxious but this Qelbree seems to be a lighter boost that helps me to focus.

[@DrJohnKruse]

Thank you for sharing your experience.

[@braillynn]

I seem to have a negative reaction to Straterra, it closes up my throat and so they took me off of it. They want to start me on Qelbree next week. I'm worried that the medication doing the same thing will have the same type of side effects. I already have asthma so it scares me.

[@DrJohnKruse]

But it's not doing the same thing. And IF your reaction was an allergic one, then it means that your immune system was responding to something about the specific shape of Strattera, which usually has nothing to do with its mode of action in the brain.

[@calderonjd30]

Thank you sir

[@plymix8389]

How effective is qelbree compared to other treatments in your experience. Honestly I might give up on treating ADHD. It seems that no drugs are perfect. Either they work for some time and stop and become detrimental. They don’t work, or they cause side effects. Maybe the thing or person who created this world just made it for us to suffer.

[@DrJohnKruse]

It appears to work for some people who have not had success with other agents, but it certainly doesn't help everyone.

[@plymix8389]

@@DrJohnKruse I see, maybe some of these disorders are just traits that come with us and we shouldn’t try to fix them with medication, maybe just use medication to help manage it. I’ve realized that my ADHD is very much a strength in some ways. When I find somthing interesting, I can focus and work on it for such long periods of time without fatigue compared to others. So maybe some peoples ADHD is a trait and not really bad or good. Much like how having a slow twitched muscle fibers makes you a better long distance runner, but makes you worse at sprinting. On the inverse having fast twitch muscle fibers makes you better at sprinting and worse at long distance (all else equal). I learned that treating ADHD means you loose some strengths. When I treated my ADHD with Guanfacine, it actually changed me from a person who’s hyperactive, always pacing, full of ideas, very emotionally volatile. into someone that just has nothing in their brain. No spontaneous thoughts, no noise in the brain, no desires. I felt like I could work a mediocre job for 30 years and feel very very fine about it. It’s crazy to think some peoples brains are naturally wired to be like that. So this is when I realized that there is no winning without sacrifice in ADHD. But thankfully even though I stopped it i kept some of the benefits and I don’t pace anymore, i think it was a good trade to trade away some of my imagination to reduce that restlessness, noisy brain I had.

[@TheOneTrueMaNicXs]

I have high blood pressure and that has made it so doctors don't want to prescribe medication to me. I swear they want me to be homeless before they think my ADHD is bad enough for treatment but I did once lose a job because of it. Anyway I also get migraines, would this drug exacerbate either of those issues?

[@DrJohnKruse]

Headaches and increased blood pressure occur in rather small percentages of people on Qelbree. Conventional antihypertensive agents usually can address any additional increase in blood pressure that any ADHD medication may cause.

[@caseyspears2767]

I started drinking molecular hydrogen 2-3x per day. Within 10 days I lowered my BP 18 points. This was in conjunction with adhd medication.

[@Cnsalmoni]

I’m sorry you had such an excruciatingly painful reaction. Perhaps try a support group or counselor who can help you find nonmedical ways to adapt. Not everyone takes meds, but if you are still struggling, know that the vast majority stop with the meds because they don’t know they all work differently. I’m curious why you were placed on a no stimulant? Had you tried the stimulants before? Very different.

[@thebeatles9]

Thank you Doctor. Do you have any thoughts on if Qelbree / Stratterra are better suited for adults with primarily executive function, emotional dysregulation, and set shifting symptoms--compared to stimulants which may seem to be better for distractibility and hyperactivity?

[@DrJohnKruse]

In my clinical practice I haven't seen classes of medications align with symptoms that neatly.

[@r3alityisnotreal]

I'll be testing it out for now, for adhd, but will taking qelbree affect my bpd, or make my hallucinations or mania worse?

[@DrJohnKruse]

As with other medication that can act as an antidepressant, anyone with bipolar disorder should be doing well on a mood stabilizer before an antidepressant is added. I don't know of any research linking viloxazine with hallucinations.

[@msizzylou]

Do you have any concerns with Latuda and Qelbree?

[@DrJohnKruse]

Individual results can always vary from the "norm" but there are not strong, direct interactions between the two. The most common concern might be that for some Latuda can be sedating, which might then require more of Qelbree or another agent to counteract that.

[@msizzylou]

@dr.johnkruse6708 thank you so much. Navigating BP2 and ADHD diagnoses for my 17 yo daughter. I read that there was potential to trigger hypomania and the severe nausea side effects were concerning. We'll give it a try.

[@Lewesis]

Do you know if the pharme company also wants to bring Qelbree to the European market? Are there plans for that? Is there a timeline for that?

[@Lewesis]

@John Kruse Thanks for your answer!

[@Lewesis]

@John Kruse btw Have you ever thought about making a video about "sluggish cognitive tempo" (sct) it's a possible new adhd subtype/distinct disorder, most of sct people are right now considered to be adhd inattentive. Russel Barkley and Stephen Becker wrote about it

[@rouxtadili7122]

I fell asleep mid convo, does that mean I have add?

[@calderonjd30]

How about ADHD and insomnia?

[@DrJohnKruse]

Some of my earliest videos in this channel address insomnia and ADHD. Also relevant would be my video on Belsomra and related drugs, and my most recenty video on cyclic sighing.

[@cliriano38]

Both, strattera and Quelbree side effect excessive dry mouth, very painful and uncomfortable.

[@DrJohnKruse]

Sorry that was a problem for you. Stimulants can also cause that side effect.

[@richwilson5969]

It’s so new here that I cannot find a single review. You tube. Unlike straterra.

[@shaylen1000]

Hi Dr. Kruse, My 6 years old daughter starts her adhd med. her doctor gave her Ritalin. She has agitated when take 5 or 10 ml so now her doctor recommends to adjust the dosage to 2.5 ml and this make her emotional. She is either very happy or very sad and cry. To me this med seem does not work for her. Base on this senecio what adha med would you recommend? Thanks!

[@shaylen1000]

@John Kruse thank you Dr. Kruse!

[@Kimberlyxoxo77]

Never put a child on that

[@johns966]

(Sunosi) Solriamfetol seems like it would a better and novel treatment for ADHD. Too many me-too drugs.

[@DrJohnKruse]

I've been surprised that I haven't seen more research trials of Sunosi for ADHD.

[@finity9316]

So when is this medication available for people to be put on ?

[@DrJohnKruse]

The FDA approved it April 2, 2021, so, with a doctor's prescription, any pharmacy should be able to order it if they do not have it in stock.

[@Bosworth123]

First day on this medicine made me lethargic. By the evening of the first day I was screaming at my wife that I was going to kill myself. The second day was filled with contemplating checking myself into a mental hospital and crying nonstop. I almost quit my job. The third day brought pain throughout every muscle in my body, especially behind my eyes, trouble breathing and nausea. All of this because i wanted help with concentrating. I will never go back to another psychologist for as long as I live.

[@jaiplays661]

You might just be batshit crazy, dont think psychologists are responsible for that

[@themeltingpot784]

did u stop taking it, I’m worried now 🥹 I got prescribed it a month ago but I’m just starting today.

[@shanelocky6004]

Wow.. They didn’t try you on the safer drugs that they know works well? Adderall or Ritalin? Those are pretty much sure things.. 🤷‍♂️

[@shanelocky6004]

@@themeltingpot784 How’d it go? You hanging in there?

[@jeremyy4866]

Dawg you didn't have to keep taking it you could've just said it didn't work for you and try something else.

[@jimmyrotten1652]

Watch the video just to learn the pronunciation.... lmfao

[@richwilson5969]

Are there sexual side effects. I was prescribed yesterday, prior I was taking straterra which I had to stop recently. I’m married and cannot deal w those type of side effects. Thank you.

[@JoseGonzalez-br9bg]

@Rich Wilson…. It’s been 6 months since your comment. Are there any sexual side effects? I had to stop taking Strattera because of the sexual side effects too. My doctor just prescribed me this today.

[@richwilson5969]

@@JoseGonzalez-br9bg hi Jose glad I saw this. Ok there’s a few things. Straterra yes. Weird ejaculation, worked wonderful on my mood. I hated to stop it. Then put on quelbree almost same in a way. Both non stimulatnt. It works for hyper ness and focus. Altho I’ve been on it for several months feels like it’s not enough. I’m on highest dose 600mg. Sex? I think so. I’m on lamictal , Guanfacine, buspar and now vaylar. I’m on so many. Oh, trackzafine for sleep. I need lot of stimulation. I’ll tell ya this. I will purposely stop several of those mentioned for 2 days maybe 3. But def 2. Then all the normal urges come back. Jose if your on any of these and you stay on it say for 2-3 months. And you have ED . Or can’t ejaculate. I can’t tell you what to do but try stopping it for couple days and you may see what I’m saying. Does this help? Reply if I’m not getting what your asking. I have severe adhd, bipolar. Mainly. Peace brother. It’s a hard life. I look to my Father in heaven for help. That’s my go to.

[@richwilson5969]

@@JoseGonzalez-br9bg ok. I re-read your text. See the adhd. Uggg. Yes straterra has sexual side effects.

[@richwilson5969]

@@JoseGonzalez-br9bg unfortunately all these drugs for brain seem to have this effect. Except for wellbutrin. ( bupropion) they use it to counteract side effects. Best this Jose. Just jump in and try it. Only way you’ll know. Straterra is no big deal. I was instantly happy on it. Everyone noticed. Why can’t they made meds without sex effects. ??? Sucks.

[@JoseGonzalez-br9bg]

@@richwilson5969 Yeah I agree. Strattera was amazing for my ADHD. I took about 2-3 weeks for it to kick in but when it kicked in my focus and concentration was amazing. I just hated the sexual side effects that came with it so I instantly stopped taking it. I told my doctor about the side effects and he prescribed me Qelbree. The pharmacy here doesn’t have it in stock so I have to wait a few days until I get it. I hope the same side effects doesn’t come with the Qelbree.

[@sharonblac]

I had problem hearing this video...

[@DrJohnKruse]

I'm working (very slowly) on trying to improve the sound of some of the older videos. Some may just need re-recording.

[@sharonblac]

@@DrJohnKruse Thanks so much as there is not much material on this subject matter.

[@dopefree9719]

Does it make you smarter?

[@mohamedhaji1746]

No, no med can make you smarter! I’m on Vyvanse + guanfacine which helps me study and focus as an electrical engineering major, but doesn’t necessarily make me “smarter” at all.

[@rouxtadili7122]

If you weren’t taking it you wouldn’t be in school studying, so it does make you smarter.

[@OaklynMediaLLC]

0:04 he said Kill me under his breath did he not?

[@Waterfallcreationsevents]

Qelbree

[@ubahfly5409]

I mean, he said *everything* under his breath so I really couldn't say.

[@hotcheetoqueen9505]

I'm dead really finding conspiracies where they aren't there LOL

[@calderonjd30]

Lol

[@jamesf8783]

1:30

[@hotcheetoqueen9505]

this bish is smarttt uh purd

[@davidm8121]

This dude talks like his family is being held at gunpoint nearby.

[@TheRealJohnDoe2.0]

Sounds like a bunch of BS.

[@DrJohnKruse]

It seems to be helping some people, and not everyone.

[@Dryde85]

This is fraud.

[@wesside-333]

Dude, speak up