July 24, 2019 at 1:30 pm #123018joelbthatsmeParticipant
Hello, I have been through the titration process for vyvance and a now at 70mg which feels like a bit too much but even at 70 it only lasts 6 hours. I plan to take some articles to my apt. From Dr. William Dodson that shows 60% of patients need a higher dose than theFDA reccomends.
Have brought up the idea of doing a twice daily dose to doc and he seems opposed to the idea, but Vyvanse works well for me just doesn’t last long. Has anyone been successful convincing a doc. To
Prescribe a twice daily dose of vyvance?
September 1, 2019 at 11:16 pm #126884Guitarplayer1985Participant
I’m in the exact same boat. I’m seeing my Dr next
Week so I’ll let you know how it goes.
September 18, 2019 at 4:35 pm #128482Guitarplayer1985Participant
Ok so this is what I got for you. I found out that upping the dose doesn’t really change how long it’s going to last. So in my case 70mg of vyvanse worked great for the 6 hours it worked. Because the way vyvanse metabolizes my Dr. Said 2 vyvance a day isnot is a bad first option. I guess because vyvanse wears off slowly it can linger in the system, yadayada. So she started me on 20mg adderall IR which last about 3-4 hours for me so I can just extend my day as needed. So the first day I took a 20mg adderall as soon I started to crash from the vyvanse and it kept me from falling asleep but didn’t do much else. So my Dr. said try 30mg that and that did work better but still not as well as vyvance worked in the beginning of the day. I don’t want to exceed 30mg without a getting new scrip though because I don’t want to run out before my next appointment but I think 40mg every 3-4 hours as needed (after the vyvanse wears off of course) is about where I need to be. How ever just note that I’m recording my blood pressure throughout the day and writing it in a log book that I show my Dr. I recomend doing this as it shows your Dr. That your being careful and your reaponsible when it comes to your health. And it really helps when you start asking for more meds because it makes you look less like a drug seeker and more like someone puts.their health first. Oh one last thing. When I went to get my scrip the pharmacist told me that she’s starting see allot of adderall being added onto vyvance scrips lately. So we’re not the only ones. Good luck my friend and I hope this is helpful!
- This reply was modified 1 year, 7 months ago by Guitarplayer1985.
September 18, 2019 at 5:14 pm #128486nighttimeistherighttimeParticipant
I have been on Vyvanse 20mg twice daily for about 4 years now. Only had push back refilling my prescription once from a Nurse Practitioner. Otherwise, all the other physicians i’ve seen didn’t have any problems refilling it when I explained it wears off after 6 hours.
April 30, 2020 at 1:38 pm #170777bdodsonParticipant
Hello, I am Dr. Bill Dodson who was quoted above. I just ran across your posts while II was searching for something else.
The FDA is responsible for a huge number of misunderstandings about the use of ADHD stimulant medications. The ones that are interfering with your care are the notions of “once a day medication” and “maximum daily dosages.” The FDA only approves practices that they themselves actually studied. The FDA has never studied taking more than one dose of an extended release formulation and so they approve them for just one dose a day. As all of you know from personal experience, this is complete nonsense.
You are not alone in this. A recent article from Dr. Tom Brown (one of the clearest thinking people in the ADHD field) on what are the unmet needs of adults with ADHD found that overwhelmingly the most common and most impairing problem was not having enough medication to cover all of the time they needed to be functioning at their best. The Standard of Care from the European Union Adult ADHD Network is to “medicate at all times and situations in which there is impairment.” The reference is Brown TE, Romero B, Sarocco P, et al. (2019) The patient perspective: unmet treatment needs in adults with attention-deficit/hyperactivity disorder. Primary Care Companion CNS Disorders. 21(3):18m02397. If you cannot find it easily, email me at firstname.lastname@example.org and I’ll send it to you.
We are lucky if we can get 10 hours worth of benefits from any extended released product. That leaves the other 14 hours of the day uncovered. The duration of any amphetamine formulation is determined by the acidity of your urine (I’m not kidding here). Amphetamine is not metabolized by human beings but rather excreted in the urine unchanged. If you urine is acidic, even extended released amphetamine is gone in 4-6 hours. If it is alkaline, amphetamine can stick around for 20-24 hours. Each person is unique.
I ask my patients to take a nap on their dose of medication after lunch so that they can see that the stimulant will not keep them awake if they take a 2nd or even a 3rd dose. Once you can nap on your medication you will know that another dose will not keep you awake.
BTW the statistic is that 40% (not 60%) of adolescents and adults will get their optimal level of symptom relief at doses higher than those approved by the FDA. That is a lot of people but the FDA refuses to even consider changing their arbitary misinformation.
I hope this is helpful to you in your work with your clinicians.
Bill Dodson, M.D.
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