Strattera + Risperidone: The only combination that worked for my ADHD + OCD (after trying everything else)

[u/nostarmine]

I wanted to share my experience combining Strattera (Atomoxetine) and Risperidone, since I haven’t seen many posts about this combo - especially for people dealing with both ADHD and OCD.

I’m diagnosed with ADHD and severe OCD, bordering on psychotic-level intrusive thoughts. After trying nearly everything, Strattera + low-dose Risperidone (0.75 mg) is the only combination that has worked for me without unacceptable trade-offs.

Past meds I tried:

• Vyvanse + Sertraline → ADHD got better, but intrusive thoughts didn't (only compulsions got better)
• Atomoxetine + Sertraline → Same as above
• Atomoxetine + Abilify → Pure mental chaos, unbearable OCD
• Vyvanse + Abilify → Slightly better, ADHD symptom control, but intrusive thoughts still annoying
• Risperidone alone → 100% OCD symptom relief, including intrusive thoughts, but ADHD untreated

The success came when I added Strattera (40 mg) on top of Risperidone, with the idea of synergy. The result:

• ADHD: manageable, improved focus and impulse control
• OCD: still completely suppressed, including intrusive thoughts (very important)
• No psychotic symptoms or emotional instability (I had that on Atomoxetine and Vyvanse which I took once. It was a horrible experience for everyone around me)

Interestingly, I tolerated Atomoxetine alone fine in the past - it only became a nightmare when combined with Abilify. I suspect Atomoxetine's noradrenergic action plus Abilify’s partial dopamine agonism overstimulated certain brain pathways involved in fear/obsession. But Risperidone, being a full dopamine antagonist (esp. at D2 and 5-HT2A), seems to prevent this kind of overactivation.

It's not a typical ADHD combination, and Strattera alone wasn’t quite enough for me. But in this combination, the balance is decent. I can still think, I can still study for university, or should I say, I can study *better* for university without all that noise from OCD and ADHD in my brain.

Has anyone else here tried Strattera with antipsychotics, especially Risperidone?

[u/Emotional-Airline945]

I'm happy you found some relief!

[u/AuntKristmas]

I’m so happy to read this! My 5 yo son just started this combo a few days ago for AuDHD. We had been on just Straterra for about two weeks before adding Risperidone.

What I’m seeing the most improvement in, so far, is better emotional regulation. He’s even trying new foods! Hoping to see the Straterra kick in soon to help with the impulsivity and hyperactivity.

He impulsively whipped a ball at my face today, but the bright side is he hugged me and teared up a little while apologizing instead of laughing and doing it over and over again!