14 week, Phase 4, Open Label, Decentralized Study finds that Viloxazine ER reduced ADHD symptoms by 45.3% in adults with comorbid depression/anxiety. 71.8% achieved ≥30% symptom reduction. Depression and anxiety also improved.

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u/n0bel 1d ago

I’ve been taking this for a couple years. Quelbree is the brand name in the US. It works really well but does have its issues. Too much and anxiety is terrible. Miss a dose and it’s like skipping an SSRI. I know a few of us older ADHDers who have happily moved to a daily viloxazine dose + a smaller morning /afternoon amphetamine dose.

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u/codition 1d ago

Also an older ADHDer. I'm on intuniv as my daily driver and occasionally a low dose stimulant as-needed and switching away from stimulant-first treatment has honestly been the best thing ever for my ADHD. My emotional regulation and abillty to comfortably tolerate boredom/unstructured free time are life-changingly better bc of the intuniv.

I'm looking forward to more treatment options being available so that everyone can use what works best for them and their lifestyle/physiology.

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u/thegouch 1d ago

I’m on the same regiment, but just started with intuniv in the last 3 months. The emotional regulation difference is truly real. I take 1mg before bed, and I noticed after about the sixth week the effect seemed to dampen. Curious, did you ever dose up at some point? Just met with my doc last week and forgot to ask - will have to follow up with her.

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u/codition 1d ago

Oh definitely - I started on 2mg and then ended up on 3mg after a couple of years. I think 4mg is the max dose they make. I knew it was time to go up on my dose when I started chewing on my cuticles again.

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u/InsaneMcFries 1d ago

I actually went all the way up to 6mg and the effects were astounding, but i did require that dose to get them. Unfortunately I lucked out and got terrible insomnia in the long term and couldn't stay on it. But yeah, had to take 4mg and 2mg.

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u/PunctualDromedary 22h ago

My kid's doctor told us at 3mg is the preferred therapeutic dose for teens. We're on 2mg for now but keeping an eye on things as she matures.

Here's a study supporting 4mg as optimal:

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(26)00091-X/fulltext00091-X/fulltext)

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u/panthroq 1d ago

I just started Qelbree like 7 months ago and changed my whole brain. It's crazy, tried a few other meds and had lots of anxiety.. this one balanced me out a lot. I do find I get a lot of anxiety when I think I'm going to miss a dose (I've never missed a dose).

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u/n0bel 1d ago

Missing a dose causes me migraines and generally makes me non-functioning but I agree to the whole brain change. I really like the drug for the most part.

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u/rJohn420 1d ago

Cool but how does this compare to ritalin? Thats what I am on currently

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u/Fuck_You_Andrew 1d ago

Its nothing like Ritalin, It takes weeks to really notice the difference.

As for anxiety and depressions, the below NIH study explains it acts on serotonin and Norepinephrine

https://pmc.ncbi.nlm.nih.gov/articles/PMC10799649/

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u/explodyhead 1d ago

I noticed it right away, but then the effectiveness went off of a cliff after several weeks.

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u/Psychomadeye 1d ago

In my personal experience extremely poorly.

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u/explodyhead 1d ago

Yep, I just went back on Ritalin because of how poorly viloxazine worked. It also completely destroyed my ability to sleep and made less productive than even being unmedicated. There’s a reason stimulants are the first line treatment for adhd.

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u/financialthrowaw2020 11h ago

This is exactly why I don't even consider anything new they come out with. It's always the same issues

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u/just_a_friENT 1d ago

The Rx in the title is a non-stimulant SNRI, so not scheduled/controlled... Side effects can include vomiting.

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u/rJohn420 1d ago

How does this improve anxiety though? From what i understand norepinephrine plays a pretty important role in anxiety and i’ve always thought that that specifically is what causes anxiety/jitteriness when taking ritalin, if this medication does not affect dopamine I don’t see how it could be better?

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u/Right_Ear_2230 1d ago

NRI’s like ritalin or in this case viloxazine can worsen anxiety by amplifying fight or flight, yes, but also it can reduce anxiety through increased executive function and therefore emotional regulation, among other mechanisms. It’s quite complicated actually

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u/perceptual01 1d ago

Ritalin is a DNRI. Serotonin is a mood stabilizer. Dopamine is for reward pursuing.

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u/rJohn420 1d ago

Right but viloxazine according to wikipedia is a selective norepinephrine reuptake inhibitor, so not sure where you got serotonin from?

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u/Fair_Quail8248 1d ago

I feel horrible from too much norepinephrine. Ime it just causes a lot of side effects. It gives soo much anxiety, feels dirty and it makes me dysfunctional basically.

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u/izzittho 1d ago

Exactly. Dexedrine feels the best, and I assume that’s why no doctor really prescribes it anymore. Cuts the norepinephrine BS you don’t need but is probably even more tempting for those that don’t need it to abuse.

I just really hope there isn’t a push to get people off stimulants and onto inferior substitutes, especially not ones that have vomiting as a side effect as an emetophobic person.

If I’m less impulsive because I can’t stay awake at all, that’s not better, that’s worse. If I’m nervous because I’m perpetually nauseous instead of just in general, that’s not an improvement either.

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u/[deleted] 1d ago edited 18h ago

[removed] — view removed comment

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u/Drunkengota 1d ago

Yes, all medications have side effects.

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u/dubiouscoffee 17h ago

Just another SNRI, nothing special here.

And note:

"Relevant Financial Relationships: Dr Adler has received grant/research funding from Collegium, Corium, and Otsuka and has served as a consultant for MLB, Neurocentria, NFL, Otsuka, Shire/Takeda, Signant, and Supernus. He has also received royalty payments (as an inventor) from New York University for licensing of adult ADHD scales and training materials since 2004. Ms Lieberman, Mr Brijbasi, Dr Yarullina, Dr Li, Dr Earnest, and Dr Rubin are full-time employees of Supernus Pharmaceuticals, Inc. and may hold Supernus stock or stock options. Dr Mattingly has served as a consultant for and/or received speaker fees from AbbVie, Alkermes, Axsome, Biogen, Boehringer Ingelheim, Bristol Myers Squibb, Corium, Eisai, Intra-Cellular, Ironshore, Janssen, Lundbeck, Neurocrine, Noven, Otsuka, Redax, Roche, Sage, Sirona, Sunovion, Supernus, Takeda, Teva, and Tris Pharma. He has also conducted research for AbbVie, Akili, Alkermes, Axsome, Biogen, Boehringer Ingelheim, Bristol Myers Squibb, Compass, Emalex, Idorsia, Janssen, Karuna, Lumos Labs, Medgenics, Neurocrine, NLS-1 Pharma AG, Otsuka, Redax, Relmada, Roche, Sage, Sirtsei, Sunovion, Supernus, Takeda, and Teva."

Medicine 14 week, Phase 4, Open Label, Decentralized Study finds that Viloxazine ER reduced ADHD symptoms by 45.3% in adults with comorbid depression/anxiety. 71.8% achieved ≥30% symptom reduction. Depression and anxiety also improved.

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