I need medication advice

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    • #46485

      I really need some advice. I’m stressing out!! Let met set the stage : I’m 53 and female. I took Vyvanse 60mg for many years, but had to change 6 about weeks ago as I could no longer afford the Vyvanse (no insurance, Shirecares card expired, Vyvanse costs $448/month). I also take Bupropion SR 200mg every morning with a second dose around noon. After I ran out of Vyvanse, I took some OLD Vyvanse 70mg for about a month. Then my doctor switched me to D-amphetamine salt com ER(XR) 30mg about 2 weeks ago. I have pretty high stress at my job right now. I’ve noticed withdrawal symptoms starting around 3 in the afternoon. Irritability, overstimulating, tearfulness. I called my doc, he agrees that it’s withdrawal. He wants me to drink a cup of coffee or a Dr Pepper at about 2:30 to alleviate the withdrawal. I know that caffeine often helps withdrawal, so that part is fine. What I’m stressed out about is that I will be UNMEDICATED from 3 – 6!! That is our busiest, noisiest, most active time of day. I would never dream of going to work unmedicated and this is basically the same thing. I’m terrified I’m going to fall apart and/or my performance will be suffer. I’m already embarrassed by my withdrawl behavior! I don’t understand why the doctor doesn’t seem to get it. I mentioned my concerns to his assistant, but she did not seem to get what I was saying. So – it’s Saturday and I’m already freaking out about Monday. I’m really terrified!! My question is: is there anything I can take or anything I can do that might make my medication work better or longer? Or anything I can do/take that will help me perform like I am medicated once the D-amphet has worn off? HELP!!!!!!

    • #46487

      I’m really sorry to hear about your situation. That’s a huge upset of long standing routine. Ug.
      I was recently diagnosed ADD and put on Adderall. Not sure that it’s quite the right med for me & have done a lot of research lately. I have started taking L-Tyrosine 500mg 2-3x/day (on an empty stomach)as a substitute stimulant. I found it at the health store, near the protein powders; it’s also one of the ingredients in my favorite convenience store booster, 5 Hr Energy. In fact, I’d skip the coffee or soda if I were you, too much of a peak and crash for 3 hours left to work; the 5 Hr Energy drink would be better in a pinch.
      Also- another thing that makes a huge difference for me- I take an extended release B12 supplement before bed. It’s an energy booster that doesn’t keep me awake but makes the mornings tolerable; that way, I can wait til after breakfast to have my first dose rather than before getting out bed.
      Check out the Amen Clinic 7 types of ADD, there is an article on this site that gives a list of supplement stimulants. And this article suggests Rodiola for a stimulant.

      10 Foods (and Vitamins and Supplements!) to Boost Your ADHD Brain

      • #170570
        Angie B

        I’ve heard taking a Magnesium along with your medicine helps some!

    • #46491

      Thanks for the encouragement and advice Romanjade! I will look into your recommendations. I have taken 5 Hour Energy a couple of times before. It’s been a while & I don’t really recall how it worked for me. I seem to remember that it made me sweaty, but that’s tolerable and MUCH BETTER than being irritable with Co-workers or crying!! Any particular brand on the L-tyrosine or B-12 that works for you?

    • #46500
      Penny Williams

      Can you not renew the Shire Cares card? I would contact their patient assistance program and see what they can do (https://www.shire.com/patients/patient-services/shire-cares). Obviously, getting back on Vyvanse would be ideal. If they cannot renew the assistance, I would work with your doctor on long-acting generics until you find one that gives you better coverage. There are many options out there, and a few that have a smoother wearing off period, like the Vyvanse does.

      You can certainly try supplements to help with ADHD symptoms as well. I’d work with your doctor on that, as supplements aren’t regulated and can have interactions with medications.

      6 Essential (and Often-Overlooked) Supplements for ADHD

      Free Guide to the Best Vitamins and Supplements for Managing ADHD Symptoms

      ADDconnect Moderator, Author & Mentor on Parenting ADHD, Mom to teen w/ ADHD, LDs, and autism

    • #47426

      Equivalencies aren’t exact, but based on your previous history with 60-70 mg. of Vyvanse, your dosage of for Adderall (or it’s generic) should be 30-40 mg a day. As you’ve noticed, the problem with Adderall is that it has a shorter window of effectiveness. See if doctor will prescribe 30 or mg per day but as 90 or 120 10 mg. tablets, or maybe 60 20 mg. tablets, so you can cut them easily. Then try a first dose of say 20 mg. when you normally take it and a dose of 10 mg. around 2:30. Or even dosages of 15-20 mg each. You get the idea: you just have to play with it! I’m afraid it will, however, take twice daily dosing.

      I know this is a PITA, but I do have some idea what you’re going through. I had to do this year’s ago with Concerta, not because Concerta wouldn’t work for me, but because doctor wouldn’t prescribe high enough dosage, so I had to get generic Ritalin (still in an inadequate total dosage) and decide how much to take when to cover what situation…work, school, home. Luckily, your dosage requirement doesn’t seem excessive, so it should be just a matter of playing around with it. In my case, it was trying to make inadequate dosing work in my life: it didn’t.

    • #48435

      Hi! I had to send a quick response to you. I too was without medical coverage for 3 months. My meds were costing almost $600 a month, then a kind pharmacist asked me if I had AAA membership. Yes!! AAA has a prescription discount for many meds if you DO NOT have health coverage. You just give your card to whatever pharmacy you use and they apply the doscount. It’s a percentage off most meds and varies meds to med. it saved me $200+ per month! Hope this info helps. And it was a larger discount than what some other discount cards offered. Best wishes!

    • #49451

      I don’t know if you found a solution yet but maybe you could consider with your doc trying an IR of 15 mg twice/3 times a day?

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