Advice please! Newly Diagnosed UK woman with ADHD – Elvanse 20mg

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This topic contains 3 replies, has 2 voices, and was last updated by  Raph 3 months, 4 weeks ago.

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  • #125612


    Hello everyone

    I’m newly diagnosed two weeks ago, and still at the early titration stage of Elvanse 20mg, and seeing the Benenden Psych again tomorrow morning for an adjustment.

    The biggest things I’ve noticed so far:

    * I’m very, what I can only describe as alert. I don’t need to nod off in the pm like I would normally.
    * Decreased appetite
    * Restless Legs have reduced a bit.
    * Appetite reduced
    * Mentally very, kind of astute, sharp, quick-witted etc (though I tend towards these these descriptors anyway, but have noticed a definite ramping up)
    * A bit skin-picky – fingers, scalp etc
    * Not really noticed a big increase in motivation/productivity/tackling procrastination, which I really was hoping for :o(
    * Psych called me midweek for an update, and asked me to double my dose for two single days before tomorrow’s appt. The day I took 40mg, I was mentally very sharp all day, but did not get out of bed until 6.30pm, and ate at 8pm. I almost felt like I just wasn’t able to move, or didn’t need to/want to get out of bed. It was… odd. I didn’t sleep or anything, just sat there reading and posting stuff on SM.
    * She’s asked me to make the second day I have the double dose the day that I’m seeing her, so that’ll be tomorrow morning. I’m guessing so as she can check my heart rate etc.
    * She also asked me to have two days off the tablets, which I did last week. I found myself particularly short-tempered on the first day with no meds, and I think I slept both days in the afternoon…
    * I’ve no idea what the crash is that everyone’s talking about. I’m awake until at least 1am each night – it was nearly 4 am on the double-dose day, Dear God! And still I woke up early again the next day, but still didn’t feel like I wanted to get on with anything.

    Main thing missing for me is still the lack of motivation/procrastination, which I really thought would have shifted. I pictured myself bustling about and cleaning a lot. I’m not yet! Hmmm…

    I have no idea if any of this is ‘normal’, so thought I’d post to see if anyone has any similar experiences, or advice, before I head back to the Psych tomorrow.

    Thanks all,


  • #125651

    Penny Williams

    You should only increase the medication if and when needed. While your side effects sound like it’s possibly too high a dose or the wrong medication for you, symptoms of ADHD can get worse on too low of a dose too. You need to discuss everything you shared here with your prescribing doctor.

    Here’s a primer to help you understand ADHD meds as well:

    A Patient’s Primer on the Stimulant Medications Used to Treat ADHD

    ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism

    • #125928


      Thanks Penny

      Yes, have already read the primer – very helpful.

      My psych has raised the dose to 40mg of Elvanse. She did consider adding in Bupropion (Wellbutrin/Zyban) to help with motivation, but was concerned at my ‘excitability’ and consequently higher pulse rate when in a lively state, so I think that has been parked for the time being, until I prove I can control my pulse rate through biofeedback, and remain calm at rest ongoingly.

      Quite skin picky still… Managed to bring my sleep time forward by an hour though last night, to 12.30am

      So as of yesterday, am on the higher dose, and we’ll see where that leads over the next few weeks…

      Thanks for your advice,


  • #132324


    Hi there

    **Update, and request for others who’ve experienced the same**

    Have been on Elvanse for three months now – slowly titrating up from 20mg to maximum dose of 70mg.

    It stays in my system comfortably for at least 10 hours, and the main indication I have that it’s wearing off is my RLS starts up! No major crash like some have described with other meds.

    My chief concern is that while I feel alert, I’m feeling little other benefit, irrespective of the dose size.

    I was hoping for a big motivational surge in wanting to do the army of things I’ve been neglecting/putting off/avoiding for a long time, but no shift at all, really.

    I just don’t want to do them, but really need them done.

    I’ve also noticed that each time the dose is titrated upwards, I have a day of what I can only describe as physical inertia (not tiredness) but coupled with intense hyperfocus/overfocus. An example: The day I moved to 70mg I spent the whole day in bed, barely moving, until 6.30pm. I was reading twitter on my phone, scanning articles and links – lot of interesting things. I didn’t eat, I didn’t drink, I didn’t pee. For hours.

    I was almost held in a kind of focus-trance-limbo. Aware I really should get up, but not being able to do so.

    This also happened right near the beginning of taking Elvanse, on a lower dose.

    I’ve shared this with my nurse-prescriber, who in conjunction with the psychiatrist has asked me to trial Concerta XL (slow release). I know the delivery method and uptake process are different, but ultimately as they both help my brain release norepinephrine and dopamine, won’t the result be the same? Or is it less mathematical than that?

    I am desperate to find something that will alter the way I feel about getting important things done in my life, as while I feel more alert, I feel I’m still drowning in unmet responsibilities, which is only adding to my overall feelings of inadequacy and ever-rising anxiety levels… 😔

    Three months on, I had expected a significant shift, so feel rather disappointed.

    I’d be interested to hear from anyone else who has experienced this, and found a solution that works for them.


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