Metabolizing medication too fast

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    • #182176
      ladybiscuit
      Participant

      I was recently diagnosed and started on Vyvanse 20mg. There was a huge improvement in my symptoms but I would only get at most four hours until the medication wore off. We tried 30mg, then 20mg morning/20mg afternoon, then 30mg/20mg, then 30mg/30mg and every other morning/afternoon dosage within 70mg and it never changed how long the medication would last because it was just being metabolized too fast. I have had an issue with other medications in the past due to this, I was put on several different anti-depressants and I assumed they never stayed in my system long enough so I was just told I was treatment resistant.

      With Vyvanse lasting for such a short time, I end up with the dreaded Vyvanse crash incredibly fast and end up feeling worse than if I had taken no medication. I was told by my GP that my second Vyvanse dose was already a booster so nothing else could be done.

      We then switched to Concerta and I’m now afraid the same thing is happening even though Concerta uses osmotic-controlled release oral delivery system, which I thought would help.
      I am incredibly frustrated because I can feel the medication working so well and then my symptoms hit me extra hard and I don’t know if anything can be done.

      I’m just wondering if anybody here has a similar issue with metabolizing medication too fast and if you ever got help from your GP or your psychiatrist, and what did they suggest? Were you prescribed a medication combo, were you stuck with getting a few hours of coverage and trying to get everything done in that timeframe?

    • #182262
      shittinbricks
      Participant

      Almost identical experience for me. I was on 30mg vyvanse for 12 days lol. I crashed at the 3-4 hour mark each day. My doctor just switched me over to Adderall XR 20mg twice a day starting tomorrow. I’ll let you know how it goes. Most people I know that have ADD use and swear by Adderall. I’m recently diagnosed and hoping for a good outcome.

    • #182280
      Penny Williams
      Keymaster

      You may find this article on burn rate from Dr. Charles Parker helpful:

      Is Burn Rate Making Your ADHD Medications Less Effective?

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

      • #182333
        shittinbricks
        Participant

        Hi Penny,

        I read the article you mentioned and I have a question for you. Would you agree that someone who metabolizes these medications so quickly should be taking a short acting medication 2-3 times daily instead of the long acting (extended release) Medications these doctors are prescribing? Thank you in advance

      • #182337
        ladybiscuit
        Participant

        I have no experience with short acting medications but I do know that doctors avoid prescribing it due to a much higher abuse potential, which means that for people like you and I, who truly have an issue with extended release drugs, will most likely be unable to get these medications. I have tried so many different things to make Vyvanse work, you just get to a point where you start to wonder how much of your life do you have to change in an attempt to get something to last even an hour longer. Hopefully the Adderall works better for you!

      • #182351
        shittinbricks
        Participant

        So the Adderall XR works but again only for a short period of time. The vyvanse worked better to suppress the ADD symptoms, however the crash was so much worse. I took the XR at 8am and again at 12pm. The XR was most effective 1-2pm. That is when the the two doses were actually mixed with each other. By 4pm I was crashing. Again the crash was much more bearable on Adderall. My guess is when I report this to my doctor next month I will have to take 3 a day in order to make it to bedtime. Hope this helps.

      • #182357
        ladybiscuit
        Participant

        Talk to your doctor about IR. I know around here they won’t prescribe XR more than twice a day since twice a day is already uncommon. I’m not a doctor and I can only assume for me it’s the fact I metabolize it too quickly and if it’s the same for you, it might be worth to discuss with your doctor the IR route, or something like XR in the morning and IR in the afternoon, once or twice.

      • #182358
        ladybiscuit
        Participant

        I get no crash from the Concerta but I also can’t even tell I took anything at all so I’m curious as to whether it’ll end up being the same.

      • #182360
        shittinbricks
        Participant

        I also cannot tell I took anything until the XR doses mix with each other. Then it’s almost identical to the suppression delivered by the vyvanse. I asked her about IR the day I sent the reply to you about your experience. She did not want to at all prescribe the IR medication to me until I had first tried the XR. I’m concerned as well. I’m sure now she will want to up the mg, which is fine, but I’ve read a lot about “tolerance”. I’m 40 and haven’t ever asked for help with ADD because I’ve always been against pharmaceuticals. After experiencing the way this medication works, it’s no longer possible for me to deny my issues, and that there is a solution.

      • #182372
        ladybiscuit
        Participant

        I wonder if you would end up building a tolerance regardless due to having to take the medication at least twice a day. Either that or it goes so fast through you there isn’t enough time to build up a tolerance. These are both WILD assumptions so I would take it with a grain of salt haha. I’m in an unfortunate situation where all I can do is wait to see a different doctor and stick to Concerta for now. I keep hearing about Adderall’s potency when it comes to suppress certain symptoms but also hear about bad side effects and tolerance.
        The frustrating thing for me is I’ve spent my whole life not knowing you can actually function properly and now that I see that I can, I also wave it bye-bye incredibly fast haha.

      • #182373
        ladybiscuit
        Participant

        I found this quite interesting https://www.researchgate.net/publication/320861850_Stimulant_’rapid_metabolizers’_wrong_label_real_phenomena although it does not give any solid answers to a solution 🙂

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