New to elvanse/vyvanse and need huge dose any advice about mixing it with other meds for depression and why I only get 4 hours effect ?

[mandyholly]

Hi im new here and new to this drug . I’m prescribed elvanse 70 mg for severe depression and severe adhd after a year of concerta suddenly stopped working, don’t know why as it was working well. I’m not getting more than 4 hours effect on 70 mg ! I’ve taken 70 mg twice a day which works but does anyone else need such a massive dose? I was the same with concerta needing 108 mg a day and these stimulants only work if I take caffeine with them ? Any suggestions welcome if I can’t get 70 mg twice a day prescribed what can be added primarily for depression as I can’t cope with that I can try cope with the adhd ! I’m seeing my adhd specialist on Tuesday and live in the UK so can only get elvanse/ vyvanse or concerta, Ritalin wasn’t helpful but maybe it can be used to boost elvanse effect ? I’ve only been on elvanse for 2 weeks and the effects are unpredictable some days 1 70 mg works well but can take 3 hours to work then other days I’m just in a brain brain fog without getting much effects though usually when I take 70 mg x twice a day I get the 14 hours with no crash or side effects. I find from trial and error it works best taken on an empty stomach with 30 mg of caffeine, even my adhd specialist doesn’t know why I need a stimulant like caffeine to make a stimulant work ? Any advice welcome as I’ve asked these questions everywhere I can think of including on quora with no answers .. it’s nothing to do with any other meds I’m taking I’ve checked, I’ve heard some people can be ‘super metabolisers’ of stimulants is this true and after some months off concerta is it likely to work again?

Thanks for any advice

[Kerickson]

Vyvanse was a miracle drug for me...at first. Then needed higher and higher doses. Then the depression started and in a week I was in the hospital terribly suicidal. Beware.

[mandyholly]

Thanks for the warning, I was a daily speed user for 20 years and never got depressed, been clean and sober for 22 years. My depression started when I stopped self medicating with speed. My adhd specialist realised the link so seems I’m drained of dopamine which is why I need more to function so thanks for the reply but stimulants seem to stop me being depressed. I’m sorry to hear that happened to you and thanks again

[Ruthie2002]

Hi Mandyholly, I can totally relate to you!!! Been scouring the internet to see if anyone had the same issue as me. I feel like 2x70mg is perfect and keeps my mind nice and peaceful so I can get on with things. I drink a lot of caffeine as well. With only 1x70mg my mind is still pretty foggy and disruptive and it makes it exhausting to do anything as simple as deciding what to do that day. I. The afternoon I start feeling lethargic, anxious and sad. My psyc is very strict about giving me only 70mg per day so I’m struggling and just sort of dragging myself through each day.

Have you found something now that works for you or are you having the same issues still? I hope you’ve managed to find something that works well for you.

If you have any tips for me, I would love to hear them :). Xx

[mandyholly in reply to Ruthie2002]

Hi I just wrote a long answer then lost it lol 😂 here’s a quick summary . I tried 70 mg vyvanse plus 80mg atomoxatime (strattera) that got me 5-6 hours, a year or so later 10 mg dexamphetamine booster pm was added which gave me an extra hour. 18 mths ago I saw a new specialist who treats refractory ADHD and after having all the appropriate heart/blood checks etc I was prescribed just vyvanse but 110 mg a day which I take all at once which is highly unusual in the UK . Theoretically this shouldn’t work longer it should be stronger but it does work longer taking it all at once as I’ve tried splitting the doses getting little effect proving all brains are different! This is working well for 10-12 hours as long as I don’t it before 11am, I have no idea why it won’t work well early mornings it just sort of whooshes in and out like an IR drug and leaves me exhausted by mid day if I take it early morning so I just accept that and don’t ‘do mornings’ hope this helps, I’ve found it a nightmare battling with psychiatrists who read the vyvanse literature that says it lasts 14 hours for everybody when you know yourself it doesn’t . I don’t know why they think I would want to be over medicated at 57 years old when I’m just trying to get through the day as a carer with severe ADHD . Good luck

[Cassepipe]

How's it going these days? I want to write here for others to read.I take 110mg vyvanse, which is actually not uncommon in Sweden. I went up by 10-30mg a week till I felt right. Not to get high, and not set to just some arbitrary, one-size-fits-all limit. To say 70mg is the limit is still treating the taking of medication as drug abuse.

We all know the idea ov vyvanse as slow release is a big, big exaggeration, and the problem probably starts there. It works well for 4-5 hours tops then I'm beat, and I take 40mg more. That's okay. I'm still tired come evening, I whinge more, but it's okay.

Now I was on a lower dose a year ago and I stopped it myself because it made it all worse, my mental health was falling apart (again), nearly lost my relationship with my wife, and I was a pretty average dad.

It's now 4 months since my lowest point where I was taking opiates secretly, I'd been gambling, I was fired from my job, and the doctors wanted to keep me in hospital: I legged it, and returned. I agreed not to die and they let me go.

Fast forward 4 months and I am a better dad, I'm usually on time, me and my wife are good, and I am studying psychology at university.

I started on antidepressants, then 2 months ago Vyvanse. The start was difficult, probably worse than before, but they have to follow the guidelines.

I wouldn't be here without the higher dose of Vyvanse. I cannot function well without it in an environment where I am a responsible parent of 4, and my duty is to get it done every day.

To be clear, I don't want and never wanted to take drugs or medication every day. I took drugs in the past for relief. I was diagnosed many years ago but I was told simultaneously I was seeking medication. Well, of course I was. I was obviously unhappy and ill.

I really hope the personal word, the wishes, the dignity and the psychology of the ADDict is taken into far more serious consideration in the future. The best doctors I've met (one a GP, one my childrens' paediatrician, and the system at my local psych clinic) have the same thing in common: trust the patient in an intelligent manner. Treat the patients as individuals, within reason; no like a greedy lump of no-hopers within a fairly arbitrary set of diagnoses.

I only managed to implement all the helpful habits of handling ADHD after good implementation of medicines. Before medication I could only survive at best. Everyone knows that's no living. Why hold this from millions of people if there's a way around it?

You can't bet your life on medication, but with the right information and implementation there's probably a very good reason behind people seeking medication.

The stigma and humiliating treatment of so many adults as helpless children has to stop. Give us our agency. Stop treating us as useless and a good number of us will probably be able to live our lives.

[mandyholly in reply to Cassepipe]

Hi I’m still on 110 mg of Elvanse as it’s called in the UK , it’s still working ok , some days better than others. my 21 year old daughter has been recently diagnosed with ADHD and she got no effect from 70 mg of Elvanse either . The psychiatrist she’s seeing is acknowledging that some people are rapid metabolisers but we would have to pay £1000 for a test as the NHS won’t do it . He thinks it’s genetic and not much point in testing. My daughter is currently trying Concerta XL, they will only go up doses 18 mg a month so she’s currently on 72 mg which does nothing for her in the morning either and not much at all ( I went up to 108 mg of that) . I’ve read of other people with ADHD having trouble getting their meds to work in mornings . She has been told she can go up to 90 mg Elvanse if Concerta doesn’t work . She can’t possibly be accused of drug seeking as she’s never taken a drug in her life . There’s so many people on a mixture of different ADHD meds and antidepressants ( me included) when a higher dose of stimulant is needed but they stick to their guidelines unless in ‘extreme’ cases … which is just getting out of bed and getting through the day for me . I think they’ll always be a ‘ drug seeking ‘ stigma to adult ADHD especially when higher doses are needed.

All the best to everyone x