Theoretical pharmacokinetics - can we manipulate dosing times to our advantage?

[JohnBoy2000]

Here it is: I've been dosing strattera and trying to figure out the appropriate strategy for almost 3 months now.

It appears - I need a large dose - 80mg, first thing in the morning.
When this is dosed effectively - I feel, almost remission.

But then I need a second dose later in the day - not to maintain symptom remission, but because if I don't take the second dose, at night, when I take the synergist Mianserin, my heart rate goes quite high and I don't sleep well.

For whatever reason, when I have two doses a day Strattera - that doesn't happen.
The only explanation I can seem to deduce for this is, possible excessive "troughing" of noradrenaline levels with once a day dosing (and then peaking again with night time mianserin, which gives rise to disturbed sleep) - evening though symptom remission remains constant.

Here's the catch:

I can't tolerate a total daily dose of - more than 100 mg.

For good sleep - it seemed I needed a 60 mg second dose in addition to the 80 in the morning - total 140 mg per day.

So, to compromise, what I contend is, dosing 20 mg, perhaps 6 hours later than I would have taken the 60mg, and given the half life, it should equate to the equivalent of what 60 mg would have been, at bed time.


In theory - does that hold water?

Basically, cliff notes:

- is the outcome of - at a time of 10 pm - 20 mg at 10 pm, roughly similar to 60 mg at 4 pm, given the roughly, 5 hour half life - ??


In theory, it sounds okay to me - but perhaps there's pharmacokinetic particulars I don't have familiarity with - maybe you guys would know?

 

[JohnBoy2000]

The alternate is to do what I'm doing now:

Dose 80 mg in the morning, then start with 10 mg at night together with the mianserin - and see does it work.

If that's okay - go up to 20 mg at night.

If it goes so high that I get night time activation however - forget about it.
I'm a delirious mess the next day.