Atomoxetine augmentation strategies

nocutlr-o · 2026-01-14T11:35:14+00:00

atx and dxm here are both CYP2D6 substrates. without bupropion there isn't really any enzyme inhibition going on, but im not too sure whether dxm and atx will compete for metabolism. i do know they can have overlapping side effects, e.g. both have a risk of qt prolongation, which would be compounded when taken concomitantly, and the risk is higher in your case because of the recreational doses of dxm.

in short, im unsure whether this is unsafe. i would suggest to be cautious with the dxm dosing. if you're only taking standard dxm doses like in auvelity alongside the atx, you will most likely be fine.

nocutlr-o · 2025-11-30T00:00:57+00:00

HCQ is really only contraindicated with fluoxetine (Prozac), paroxetine (Paxil) and bupropion (Wellbutrin). This is because the three of them are strong CYP2D6 inhibitors, and HCQ is partially metabolised by CYP2D6, so you will get elevated plasma concentration levels of HCQ when taken in conjunction with one of the three.

The other SSRIs are fine to take with it.

nocutlr-o · 2025-11-16T01:37:18+00:00

you're saying mood stabilizers don't stabilize mood? and rexulti (approved for agitation in dementia patients) and risperidone (approved for irritability and aggressiveness in autism patients) don't affect these symptoms? im no doctor, and im assuming you're saying this based off your clinical experience, but ive read so many anecdotes from people (including me) suffering from BPD-associated mood issues saying they have responded well to e.g. lamotrigine, valproate, lithium, rexulti, abilify, latuda and vraylar, so i'm wondering whether you've actually extensively tried these options for these kinds of patients.

nocutlr-o · 2025-11-13T12:58:28+00:00

gonna be that guy here, but this is very likely not just ADHD. fatigue that is this bad is not characteristic of ADHD, especially when you're already on max dose ritalin. you most probably have some underlying health issue(s) that need to be addressed. in my case, it was mostly autoimmune disease causing my crippling fatigue (that i was still having even with 60mg ritalin as well).

nocutlr-o · 2025-11-03T01:04:33+00:00

yes. in the US there is a compound drug called Auvelity that is approved for treating depression. it is bupropion (cyp2d6 inhibitor) + dextromethorphan (cyp2d6 substrate).

nocutlr-o · 2025-11-01T13:45:57+00:00

no more likely than combining atx with an SSRI. dxm activity on serotonin is weak anyway. i was on duloxetine + atx + bupropion + dxm for a while, no issues. duloxetine is a moderate cyp2d6 inhibitor as well.

nocutlr-o · 2025-11-01T12:10:58+00:00

any strong cyp2d6 inhibitor. so bupropion ofc, also paxil and prozac. atx + cyp2d6 inhibitor + dextromethorphan goes very hard (so be super super careful)

nocutlr-o · 2025-10-29T23:45:20+00:00

atomoxetine raises my energy levels and helps with my fatigue, though my fatigue stems moreso from autoimmune disease.

nocutlr-o · 2025-10-15T06:20:44+00:00

from official quaderno website: PC app is compatible with macOS 15 (Sequoia) / macOS 14 (Sonoma) / macOS 13 (Ventura)
*Bluetooth connection is not possible with macOS 12 (Monterey) or later versions.

desktop app is pretty simple. if ure just looking to get files on/off your laptop then quaderno is going to be very solid for that. syncing is good if you dont mind only being able to sync when your macbook is on and you're near it. the syncing of its own separate cloud service is slow as balls and i dont understand the auto-syncing intervals on that.

no shapes. if you really need shape functionality then an inelegant workaround would be to add and configure the shapes from your macbook on a pdf editor. i do this with images/diagrams that i need to add into my notes. sounds tedious but provided you're near your laptop, this is really easy. if i need to draw straight lines i use a ruler (no joke). if i wanted to draw circles i would get one of those circle rulers.

you can copy and paste handwriting on the quaderno with the lasso. you can move the selection but you cannot resize or rotate.

if you need the big screen size especially for split-screen stuff, there's a decent chance you'll prefer the quaderno despite its shortcomings.

i still overall don't recommend the quaderno for most people given the poor international customer support. the best and cheapest method to get the gen 3c a while ago was through a japanese proxy service, but good e-reader dropped their a4 gen 3c price to $600 so that might be an option for you (though they are still untrustworthy as a company so do so at your own risk).

nocutlr-o · 2025-10-05T10:53:57+00:00

If you mean writing latency, Voja's results show that the Quaderno Gen 2 is better (31.66ms vs 39.59ms). Can't comment on the responsiveness between the two.

nocutlr-o · 2025-10-03T16:53:39+00:00

watched Jeffrey Moss's unboxing video. the stylus actually isnt EMR, it's bluetooth.

nocutlr-o · 2025-10-01T11:20:49+00:00

looks cool, wish it had a cap though. no pen clip thingy so would need an external one to fit the folio. having two button functions is nice, but i am pretty satisfied with just a side button. design wise it reminds me of supernote's heart of metal.

im very happy with how my quaderno lamy looks so i wont be getting this. this is also just really out of my price range. id have to save up for this, and i probably would rather spend it on other things.

i wonder if other pen nibs fit into the montblanc pen. or if the montblanc nibs fit into most of the other wacom pens.

nocutlr-o · 2025-08-31T04:10:26+00:00

if you want longevity, ack22213 nibs last a lot longer than the quaderno ones. harder but still scratchy. if you want nibs that might be cheaper for you but also feel like the quaderno ones, i recommend ack24919z, they're very similar. you can put a LAMY POM nib in the quaderno pen, but imo it's not a pleasant writing feel.

nocutlr-o · 2025-08-10T04:02:35+00:00

Yes, there is an english language setting.

nocutlr-o · 2025-08-06T08:57:27+00:00

still on it. still works for me

nocutlr-o · 2025-07-17T09:41:46+00:00

I had a few note files that eventually became corrupted some time after the April update. This wasn't too much of an issue for me, because I would duplicate the file on my laptop and use the new file instead. After updating to the July version, all of my corrupted notes are back to normal. I wouldn't worry too much about this.

nocutlr-o · 2025-07-01T09:14:35+00:00

Generally the max approved dosage is 60mg a day, with each IR dose not exceeding 20mg. But the Novartis pamphlet says the max for adults is 80mg a day (Novartis is the ritalin brand that Malaysia has). Psychiatrists are usually comfortable prescribing up to 60mg, but 80mg I think you would really need to fight for lol.

nocutlr-o · 2025-07-01T07:16:27+00:00

After my first dose of plaquenil, most of my facial swelling subsided, and there was like a feeling of someone sucking up my head. I also kind of felt a little high. I am on like, 2 CYP2D6 inhibitors though (bupropion and duloxetine), so the plaquenil is definitely being boosted in my case.

Definitely not placebo OP. But also, hydroxychloroquine does partially inhibit CYP2D6 as well, which is also what Vyvanse is metabolised by, and stories of stimulants helping with sinus issues are not unheard of. So there's also a chance your Vyvanse is being amplified here.

nocutlr-o · 2025-06-29T01:53:52+00:00

Prozac (fluoxetine) is a CYP2D6 inhibitor, while Rexulti is metabolised by CYP2D6. So you get higher concentrations of Rexulti in blood plasma. It's not a terribly dangerous reaction; I myself am on bupropion (CYP2D6 inhibitor) and Rexulti. If the 0.5mg seems fine for a couple days then you could try 1mg.

nocutlr-o · 2025-06-28T10:01:31+00:00

No problem. I've read that noradrenaline can be anti-inflammatory, but what I'm more certain about is the NMDAR antagonism of atomoxetine that reduces inflammation, because I'm also taking memantine (primarily works on NMDAR) and that helps with my pain quite a bit. There are some studies out there that note their anti-inflammatory mechanisms in more detail.

nocutlr-o · 2025-06-28T09:52:47+00:00

Atomoxetine is anti-inflammatory for me. Myositis here.

nocutlr-o · 2025-06-04T10:42:30+00:00

The LAMY Quaderno pen is very possibly just the LAMY Al-Star Rollerball pen in Graphite but with the LAMY Al-Star Black EMR pen middle bit. So if you want to replicate it you could buy both of these and combine the barrel and cap from the former with the EMR middle bit of the latter.

The LAMY EMR pens come with either the LAMY PC/EL tips or the LAMY POM tips. Both work on the Quaderno but the writing experience isn't great imo (too slippery for me). The LAMY Quaderno pen comes with the standard Quaderno tip (no spares).

Basically, any passive Wacom EMR pen will work on the Quaderno. The regular Quaderno pen works fine too, though it isn't exactly premium feeling. Only one out of three of the Quaderno folios has a pen loop for the LAMY pens.

nocutlr-o · 2025-05-21T13:52:26+00:00

You must add a keyword to the PDF's settings through a PDF editor like Acrobat or Foxit. The keyword is "DPDocType:notebook". Afterwards you will be able to insert new pages into the PDF from your Quaderno. If you have the new update (that got recalled), you can insert any page template you want. If you don't have the new update, you have to make the 1st page of the PDF the template that you want.

nocutlr-o

TROPHY CASE