Vyvanse on busy vs empty days

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This topic contains 8 replies, has 7 voices, and was last updated by  grcicotte 2 weeks, 2 days ago.

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  • #104004

    justinattentive
    Participant

    I find that on busy days/deadline days, the meds really help, but days alone at home with nothing but my to-do list make me almost manic. Irritability at 115%, crying, panicking, no capacity for distance or reflection. It’s like I’m still the same person with the same inclination to avoidance and attendant shame and anxiety, but on speed. Is this familiar to anyone else?

    I’ve recently got a dx and am now in the process of trying to get the titration right so my prescription can be transferred from private to NHS (uk).

    Am currently on vyvanse 40mg, and am meant to be trying to out a top-up of amfaxa but keep getting up too late to use the top-up.

    The problem is I’m not working full time atm, and so the situation described above happens pretty frequently.

    I’m thinking of postponing my next appointment till I’ve got more on my plate. Or do those side effects sound like they’d happen regardless?

  • #104282

    sstyles
    Participant

    I’m not a medical professional, but as a mom of a son with ADHD plus taking ADHD meds myself, here are my thoughts:

    1) This might be the wrong med for you. How many have you tried and how did those make you feel, especially compared to this one? My son’s psychiatrist talks a lot about how slightly different the different meds are, but the right one interacts really differently with your personal chemistry and feels “right” to you where the other ones wouldn’t. He would probably ask questions to determine whether you should try a different med.

    2) If it’s the right med, it might be too high a dose. The right dose is supposed to help without having intolerable side effects. It sounds like on your empty days you are having too many side effects. I work full time and find that my meds help me immensely on busy days at work (help me actually have productive days), but they also help me on my days off. While on my meds, I can even take a nap on a day off if I am tired (sick or was up too late). I have heard other people describe that as well. People without ADHD can’t sleep on a stimulant, but ADHD people can!
    My meds don’t feel like “speed”, they make me feel normal instead of unfocused / going in 10 different directions. Even if I do have a few different things happening at once, I feel that and have to rein it in, like a normal person. I am not manic or thriving off having that many things happening.
    Assuming you have tried other meds, this would be my first guess on what is happening – too high a dose.

    3) Would it be possible / reasonable to have different doses on different days? I truly don’t know if that is recommended, although kids sometimes don’t take meds on weekends and only take them on school days, so I would guess it might be a possibility. IF you know ahead of time which days are busy vs. empty, maybe this is something you could discuss with your doctor?

    4) Another possibility – ADHD is often comorbid with other diagnoses, and living with undiagnosed ADHD as a child may have caused you to have a problem with anxiety. Could you perhaps need anxiety medication in addition to the ADHD? The irritability and panic are what made me think of that. But those could also be side-effects of the wrong / too much medication. Just something to think about. My son and I both have anxiety in addition to our ADHD. Rather than increasing his ADHD med, his doctor added on the anxiety med and that was the right choice for him.

    Best wishes,
    Sue

  • #104290

    mdg0424
    Participant

    Hi! I came here to say the same as styles 1 & 2. I’m 34/f diagnosed in my late 20’s. I was put on Vyvanse and it was hell. I was a monster: mean, crying, frustrated, my muscles hurt. Tried lowering the dosage…still made me irritable. Vyvanse works quite well for my slightly younger sister.

    Finally the doctor tried (the cheapest drug) Ritalin. Tried XR …had issues. Now I take 20mg in the morning and 10mg around lunch. When I remember. Ha!

    Sstyles (Sue!😃), #3 is not recommend as your medication is there to keep you at an “elevated baseline” as much as possible. When you constantly make changes you’re requiring your body to continually adapt/adjust. It’s hard to gather data for what’s workng.

    …Then again it was me telling my doctor what worked after some wiggling in my Rx. 🙂

    My point is, justinattentive, you may need to discuss dosage adjustments or try another drug. It can be so frustrating. You’re not alone. *Hugs*

  • #104292

    mdg0424
    Participant

    …also, CBD helps my anxiety!

    -Melissa

  • #104307

    Mhturgeon
    Participant

    Interesting to read this today as i was experiencing something similar this weekend about the at work vs at home effect. I dont know yknow Vyvanse. I am on Modafinil. I actually noticed the opposite effect you describe where i am just aimlessly floating about when not at worl. I think it has been ore to do with the lack of plan and structure in my day. Meds are only one part of the treatment, for me making a plan and refering to it throughout the day is an essential part of managing my ADHD. When i dont have one, i feel aimless, then frustrated i go in circles and disciuraged i did nothing at the end of day and that can get expressed by lashkng pi ut at kids/spouse.

  • #104375

    biggrlsdntcry44
    Participant

    I am finding out that a great deal of my reactions to different drugs and/or drug cocktails have everything to do with the doctor I am working with and how responsive he/she is when I say something is off and just not working for me. I’ve had doctors who put me on certain meds and when I told them I did not do well on them, they insisted I give it time. I may be the patient, but if a drug makes me gain 25 pound in 2 months, or another makes me so super manic that I want tho rip the skin off my face or bang my head against the wall, then my doctor HAS to listen. If he doesn’t then he’s a bad doctor and I fire him and move on. I always try to remember that I am the consumer and he is being paid to provide a service. If a plumber “fixed” my sink and it still leaked then he is a bad plumber. Just because someone went to med school it doesn’t necessarily mean they are good in practice. I can read about fixing a car all day long but until I rip an engine apart and put it back together and it actually runs well, then I may have the certificates on the wall, but it doesn’t mean that I know what I am doing. I learned a long time ago-a good doctor isn’t afraid of questions and if he doesn’t feel like he has to discuss his deck decisions about your care with you, he thinks he’s God and I don’t think God belongs in a therapist’s office. That’s what church is for. Tell your doctor what is going on with your vyvanse. You may need a mood stabilizer or some other helping addition to your needs to fix the problem.

  • #104390

    LynnSuzanne
    Participant

    Sounds to me like the wrong med, or wrong dosage.

    I was diagnosed in my 40’s, and had some trial and error with meds until finally landing on Ritalin. From the first day of Ritalin, I felt like now I am probably experiencing what “normal” feels like (I’ve since heard the term “neuro-typical” instead of “normal”).

    I never feel like I’m on speed, ever. In fact just the opposite. Meds have given me the experience of having my thoughts “quiet down”, so that I can think, process, focus, prioritize, and be productive. At work, and also at home.

    In addition to getting work and chores done on time, I can now also enjoy an entire movie without having to repeatedly get up to “get something”. I can take a nap if I feel tired, I can read more than one chapter in a book in one sitting, and so much more.

    Meds haven’t taken away the ADHD barriers, but meds do give me the ability to move past them, or step around them, most of the time. There are occasional days when ADHD is in charge, but most days, meds give me a chance to make intelligent choices about how to use my time and energy.

    Meds should increase your quality of life, not make you feel like you’re in an unfocused manic state.

  • #104531

    justinattentive
    Participant

    Hi all,

    Thanks for all your really helpful and considered comments. I’m going to reread them all and think how to proceed. Feels like it’s a chicken and egg thing – need the meds to help me build a life that’s conducive to good mental health, hard to judge the effects of the meds when I’m a mess. Got some relationship stuff happening too which can’t help. Still, there’ll be a way.

    I should add, saying I feel I’m “on speed” was lazy and inaccurate. Part of the problem is there’s not much of a physical feeling to go with it, so there’s nothing to flag up my disproportionate responses as being the result of something chemical. Speed has a euphoric effect for most people anyway, afaik.

    And I agree it’s mostly aimlessness when I’m left at home – but the sort of paralysed nervous avoidance aimlessness that makes it hard to enjoy myself and amplifies my bad habits. Punctuated by moments of high emotion.

    An

  • #104615

    grcicotte
    Participant

    Talk to your physician about other extended release options. Vyvanse is designed to peak slowly over about 4-8 hours and trail off the same way, whereas some others use a process of small almost immediate “bump” that trails off after 3-4 hours, then a later bump in about 5 hours from start that trails off in 3-4, then another that trails off by about the 12th-13th hour. The monograph for Vyvanse says that 70 mg is equivalent to a daily dose of about 40 mg of the amphetamine base.

    If that works for you, the NHS people should be pleased as well, because there are generics for things like Adderal XR (XL?), whereas Vyvanse generic is some years away. As a comparison, with private insurance in the USA, Vyvanse can cost well over $200 USD per month (depending on insurance, as low as about $25 USD out of pocket), where the Adderal generic extended release may be 1/10th of that with a co-pay/out of pocket cost around $5 per month.

    Not talking about what and how much I do or don’t take, but those numbers are what I know about from my insurance.

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