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New here-Vyvanse works wonders for binge eating but does NOTHING for focus (30mg to 60mg over 10 weeks) also on Wellbutrin 300mg

MomNotFocused
MomNotFocused

Hi! Early 30's mom of three here. Dealt with ADHD my whole life, but it wasn't too bad (the "forgetful one" in my circle, but did well in school, always inattentive, never hyperactive). PPD after my second child's birth in late 2014 (in the form of ZERO energy, ZERO motivation, ZERO willpower against food, crippling low self esteem from weight gain) and the ADHD sailed out of control (inattentive and forgetful to a nearly dangerous degree). After about four years (which included another baby, taking in a relative's toddler, and plenty of marital issues) I talked to my doctor. I started on Wellbutrin (150mg) and Vyvanse (30mg) in mid-October. Wellbutrin was up'd to 300mg after one month, and I'm not sure that's working really well either at this point. Vyvanse was chosen over the more common Adderall because of the binge eating I was doing, in addition to the inattentiveness (2 birds 1 stone sort of thing). From day one, it cut my appetite in half or better, amazing really. But I still wasn't focusing much better if at all. After a month, went up to 40mg. No difference. NONE. After another month, went up to 60mg. Still, basically no difference. The only thing it's helping with is my eating. It's been amazing. I have lost 26 pounds in about 3 months, losing inches, gaining confidence, feeling better about myself. But I still can't focus to save my life and I still have ZERO energy and motivation. And I can feel the Vyvanse wearing off mid-afternoon, because I find myself searching out food, like on the hunt when I'm not hungry. Doc suggested last month if going up to 60mg wasn't enough, adding a small dose of Adderall in the afternoon (5-10mg). But I'm thinking I may need to change up meds altogether. We chose Wellbutrin because I was so afraid of the weight gain side affect of so many other depression meds (a small part of why I waited so long to seek help). But I just don't think it's helping. It's been about 10 weeks, and on that front, I don't feel very different. Any boost in mood is primarily due to the weight loss. And the Vyvanse hasn't helped focus at all since the beginning. I'm so worried about gaining weight back, that I don't want to stop taking it, but I don't know if combining it with another stimulant that's better for focus is a good idea. And I desperately need some energy, so get-up-and-go, some want-to. So, any suggestions on a different anti-depressant that would work in concert with ADHD would be appreciated, or any suggestions at all that I could bring up with my doc. I trust her, and she's very open to suggestions (as long as they are medically sound, of course).

27 Replies
oldestnewest

Empathy for your plight! Just to mention that I took adderall for 30 years, and found it a godsend for motivation, getting things done, sticking to tasks, plus you just feel happier. Plus you don't feel hungry. So I wholeheartedly recommend it. Good luck!

Thanks, I'm going to bring up Adderall at my next appointment, either backing down Vyvanse to the lowest and adding it, or switching altogether. All those things you said, that's what I need. I need motivation, focus, checking things off a list, and I need to just FEEL BETTER.

I’m 19 and took adderall from seventh grade until my senior year of high school. I’m now taking Vyvanse because it’s more consistent with providing me the focus I need. In your situation I would recommend trying Adderall because it does actually lower appetite, any ADD/ADHD medication does, and it helped me a lot. I just metabolized it too fast for it to help effectively. Best of luck and feel free to PM me with any questions you may have.

toobusy7
toobusy7
in reply to metaphor

Im interested in if you preferred the instant release twice a day or took the extended release once? Thanks

toobusy7
toobusy7
in reply to metaphor

May I ask if you preferred the extended release or instant twice a day? What was your daily regimen?

Im curious too!!

I didn't have much luck with vyvanse for ADHD. It killed my appetite to the point I ate breakfast and nothing else. Not eating can affect ADHD symptoms.

Maybe your doc could give you a lower dose of vyvanse for the binge eating and a different ADHD med? I don't know if that is legal.

Adderall and a new one mydayis always seemed to work for me. They always worked for less time than advertised. That is why I switched from Aderall to Mydayis. It's supposed to last like 12 hours. I say 8ish.

I have thought about reducing the Vyvanse and adding something else as well. The affect on my eating is the same at 60mg as it was at 30mg, and lasted about the same amount of time through the day. So I'm going to bring that up at my next appointment. A couple years ago, I took an Adderall (20mg I think?) "recreationally" and found that it helped a lot (for that one day). I felt great, plenty of motivation, no jittery feeling at all, but I got things done around the house, and my mood was much better. I don't know if I felt "normal" (what's that anyway?) but I felt like I wished I felt on a regular basis. So I think I'm going to suggest either backing down the Vyvanse and adding Adderall or switching altogether.

Stray thoughts. Please pardon my not organizing them better—ADHD, you know:

- Most ADHD medications do more to support norepinephrine levels (associated with sustained attention and loss of appetite) than dopamine (associated with initiating attention)—unavoidably so, because, in addition to direct effects, norepinephrine is synthesized from dopamine.

- Carbohydrates often make ADHD worse by triggering serotonin surges that impair dopamine production; whereas proteins provide amino acids required to synthesize dopamine—the principal deficiency in ADHD.

- Some of us (myself included) do better on ketogenic diets because the ketone bodies the liver generates from fatty acids both are excellent brain fuel and don't trigger a serotonin-and-insulin-driven craving rollercoaster.

- If you're taking antidepressants other than Wellbutrin, they could actually be interfering with ADHD treatment by raising serotonin levels high enough to interfere with dopamine—on the other hand, if you're prone to anxiety, they might be worth it. (Wellbutrin [bupropion] is an exception because it acts on norepinephrine and dopamine rather than serotonin, and is known often to ease ADHD.)

- My own experience has been that stimulants ease emotional flooding and rejection sensitivity more than they aid concentration directly: I still have to make a conscious decision not to shift attention, but the prompt to do so isn't quite as insistent and I seem to get more of an opportunity to recognize and ignore it rather than discover hours later that I followed it.

- I switched from Vyvanse to Concerta to ease some “rebound” side effects: it releases more smoothly, acts longer and wears off more gently—but this is specific to the name brand and to a generic (marketed by Actavis) made on the same production line. (Fixed allotment of ingredients under U.S. controlled-substance regulations leads to some weird arrangements.) While your “going on the hunt” is a fairly obvious rebound effect, you may or may not get the same appetite control from a substituted amphetamine (methylphenidate) that you get from an amphetamine prodrug (lisdexamfetamine as in Vyvanse).

- Regardless, supplemental glutamine (an amino acid—in fact, the most common one in the human body) may help curb cravings as your stimulant wears off. As it's an ordinary nutrient, common in protein-bearing food, it won't screw up medications, either. It may also account for the tendency of proteins to ease ADHD symptoms—in recent research, a previously-overlooked glutamate chemistry in the brain is emerging as a potentially significant ADHD contributor.

Sorry for such an “info dump”: unfortunately, you're the only one who may really be able to sort out what does and doesn't apply.

Much of this comes from my own reading to support treatment of my ADHD, and from that of friends who have taken a similarly active approach to their treatment: fortunately, we have had doctors happy to work with patients willing to devote study time where they might not be able (due to the greater diversity of their patient base—after all, doctors get the same twenty-four hours in a day that the rest of us do).

Good luck!

Rocksmack
Rocksmack
in reply to HadEnuf

Yes, I have read similar info.

"It may also account for the tendency of proteins to ease ADHD symptoms—in recent research, a previously-overlooked glutamate chemistry in the brain is emerging as a potentially significant ADHD contributor."

My ADHD docs have recommended increasing protein intake and limiting carbs especially breakfast. My current ADHD doc recommended "the mind diet" book. It is basically increased protein, decreased carbs. Certain fruits and veggies, fish for omegas. I think its similiar to keto. I will have to read more on the keto.

I have read reports about foods to not eat. They are related to the "inflammation diets". Cut out milk, breads except for ancient grains or good whole wheat. I can't remember all of them off the top of my head but they were related to food allergies that can cause leaky gut, inflammation in the brain and body. The reports were talking about how food allergies can cause or increase ADHD symptoms, thus removing them from your diet helps. Also, food allergies causing inflammation leading to autoimmune disorders, thyroid issues, can exacerbate ADHD issues.

Dr. Amen, Dr. Kharrazian are usually good reads

HadEnuf
HadEnuf
in reply to Rocksmack

Keto is very low carb, but high fat rather than high protein: at low enough carbohydrate intake, the liver begins converting amino acids into glucose: too much protein can produce enough glucose to stall conversion of fatty acids into ketone bodies—again, in the aptly-named liver, without which we die. As long as I get just a little more protein than I need for "repairs", keto seems to ease my symptoms, slightly.

You may need a higher dose. I am in my 20s and have been mediacted and diagnosed as a child. I have tried to get off the meds after college but i couldn't stay awake at my job. I recommend from my experience a higher dose and try concerta. I also had a binge eating prob and sometimes i relapse. It may sound silly to you but first j would cut out all the bs on social media like unrealistic fitness models so u dont compare yourself. It helped me a ton! You also need to find a new outlet for your stress and anxiety. Binge eating will only give u a temporary release from anxiety and stess. Meditation, taking breaks, therapy, lighting candles, aromatherapy, and breathing techniques. To help you stay awake avoid coffee. Trade it for green tea it will also help with digestion. Also camanile tea at night and during the day if u are upset. Drink so much water especially after a binging episode. To help your body. Also u should carry a large waterbottle around to remind yourself to stay positive. I gained weight when i went off. But clean eating really helped.

I have trouble with exhaustion but the best thing u can do is get a good nights sleep. Lavender spray on your bed is great. Melatonin helps u fall asleep. Also your meds. Wellbutrin made me so tired and it takes like a month to work. Tall to your doctor about the meds. Some medication can make u less tired.

And stay strong. Sorry for my grammatical errors.

I also have ADHD inattentive type, have had the same experience with Vyvanse (good for binge eating, not much else, wears off mid afternoon). My doctor ended up prescribing me 10-20mg adderall IR to take at 3pm once the vyvanse wears off. It worked for me for about a year, but lately vyvanse has been less and less effective for me. I'd say it's worth a try though, it did help me for a solid year. Best of luck with everything!

My doctor suggested this at my last appointment, when I was at 40mg. We decided to go up to 60mg for a month and try that before adding another Rx into it. There has been little to no difference in the 30mg to 60mg, so I'm wondering if it might be an option to back down the Vyvanse to 10-20mg, and then adding Adderall as the primary Rx and whatever normal dose (I keep seeing 20-30mg 2x daily). That's what I'm going to suggest, and see what the doc says. I need the focus and energy that I think Adderall will do a better job of providing, and I need it more early in the day than late. (So I can get things done while kiddos are at school).

UPDATE: Had to stay on Vyvanse an extra month, at 60mg, because my doc was out the day of my refill appointment, and the doctor filling in wouldn't give me the time of day to discuss any changes. This month, I still didn't get to see my doc (she's moved from a group practice to start her own, so I should be able to get back to her next month at her new office), but the doc filling in this time (not the same as last month) was quite nice, listened intently, and agreed to switch me. He Rx'd me Adderall, instant release, 20mg in the morning, and 10mg in the afternoon. It helps with focus, for sure, but not in the way I thought it would. It sort of amplifies whatever I'm doing. If I'm just watching TV or something, I don't even feel anything "kick in" and my day can be useless, like I never took it to start with . If I'm sitting at my computer working (graphic design work) when it kicks in, I'm on it, getting stuff done, productivity in spades. If I'm already doing housework when it "kicks in" I'm good, the motivation kicks in with the meds and I can get on a good roll getting things done and feeling good doing it. But if I stop, if I stop to take a break, or feed children, the roll is essentially over. And it's super hard to switch modes, from work to house cleaning.

I'm realizing now that I have to provide at least the first inch of motivation which is so hard (I'm on Wellbutrin 300mg also) The new medicine definitely helps turn that inch into a mile, but if I don't give that inch, it goes NOWHERE. So that's on me. I am trying SUPER HARD to create better habits, setting reminders for myself to do certain things at certain times of day so that I get the most out of the medicine when it kicks in.

Hi there! Hope things are leveling out. Wanted to share my experience. Diagnosed with anxiety at 18 and was put on 10 mg of lexapro. It made me gain 40 pounds. Diagnosed with adhd at 21 and was prescribed 30 mg of vyvanse then uped to 50 mg. Still on the lexapro but my weight stayed up. Went off everything when I got pregnant. After baby I realized I had pdd. I continued back on lexapro and vyvanse (which was at 70mg now) but this time my brain acted totally diffent and didnt respond the same this time around. Didnt lose any weight after the baby after a year. Talked to my doctor and we tried 150mg (24 hours) of wellbutrin, going off of lexapro, and staying on vyvanse and lowering the dose to 50mg. I loved the first 2 weeks and then started to revert back to depression. I started to see a psychiatrist finally and we found out that my body produces an extremely small amount of serotonin. This is why the lexapro didnt work. He put me on a supplement called deplin to help boost my serotonin and it has worked wonders. I am also now on wellbutrin 100mg (12hours) and 70mg on vyvanse. Never had a problem with the vyvanse other than it not lasting long enough in the day. I have also dropped 26 pounds in 4 months. This I am happy about because I'm not as sluggish as I was before. Hope this helps, my doctor did a blood test as well to see what medication response best to my body.

TLJ828
TLJ828
in reply to Pinkmama14

So, with all of these things we are on,

Like in my morning I take

1-Wellbutrin

2-Lexapro

3-Lamictal

4-Naltrexone

5-Topamax

6-Birth control

Then at night I take 2 Topamax and a Lamictal...

I’m 36, no kids... took a long time to get on all these meds.. I finally met the LOVE of my LIFE. Reunited from hs actually after both of our divorces...

I want a baby....

wtf do I do. Lol

Sounds like a joke, right.

If I don’t start doing something I will do nothing and my opportunity will pass and the days and years just fly by.

I’ve been on meds since I was 21..

continuously adjusting and adding...

I’m scared to come off, yet I know that a lot of these things have prolly become cover ups and over lapping coverups to balance myself out...

I just don’t know where to start.

Yeah with my Dr... I haven’t spoken abt it. I say one day...

I don’t know how to start.

What did you guys do?

I seriously feel like you are living my life! The similarities are CRAZY!!

Vvyanse didn’t do anything for me focus or energy wise either! I was actually being noticed at work for being much more careless...

but yes, the weight mgmt was pretty nice... but I wasn’t getting shit done... so that made me sad... I felt kinda ditzy like I didn’t care at the time but overall, like you, was sad I wasn’t getting what I wanted out of it... I was calmer, skinnier but not productive. I could sit at my desk and pretend tho lol

I take 300 Wellbutrin in the am too.. which I don’t know what that does at this point...

but I had to go back to Adderall... needed some clean clothes LOL

Vuyg
Vuyg
in reply to TLJ828

I am currently on 30 mg dose of vyvanse and it didn't work I literally feel no difference it didn't decrease my appetite or increase my focus I don't know what to do also today is the first time I try adhd medication maybe it needs to built in your system for it to work idk do you have any advise?

Thought I should chime in. I am also inattentive taking 150mg of Wellbutrin and 20+10mg of vyvanse: I have tried almost every medication over the last 15 years. Research suggests that a large percentage of the time, inattentive types do not do well on mid to high doses of any stimulant medication, and sometimes can show a therapeutic response at a very low dose of the adderall family of drugs. Vyvanse does fall into this family. 90% of the time, regular adhd folks see drastic improvements when taking stimulants and inattentive types do not.

A good way of looking at this is inattentive types tend to daydream or get lost in things and are forgetful, but we are not high energy or fidgety. Regular adhd types take a stimulant medication and it calms them down. It slows down the thinking so you can organize your thoughts and be less impulsive. Sometimes the assumption is it ramps things up so you can get shit done and increases your heart rate).

For inattentive types, we are already slower paced and take our time in many cases, so the higher the dose, the more hyper focused you’ll become which slows you down- which we do not need. When you describe the experience of being taken off course by feeding your kids, you’re essentially being knocked out of hyper focus and you find it challenging to get back there. (This is partly related to practicing discipline to get yourself back to the most important task). However, when the medication is too high, it really makes it hard to switch out of the non productive focus and practice disciplined switching. The medication has sucked you in hard and you probably feel a bit trance like and stuck.

In my experience, you tell your doc the meds aren’t working or you feel tired and the natural course of action is to up the dosage. I can tell you this will never make you feel better or help you.

Also note that Wellbutrin will impact the stimulants ability to be absorbed. I got off all stimulant medication and just took Wellbutrin and I did really well on just that as it has a slight stimulating effect and it works off of dopamine. On its own, it does improve the desire for food binges. Eventually I re-introduced vyvanse at a very low dose (20mg) which is like the strength of 5 or 10 mg of adderall).

Vyvanse is a lot more smooth for me personally. Years ago I got down to 5mg of adderall after learning the high doses were making me worse, but I never felt great on straight adderall. You can take it for a week and feel amazing and get tons of shit done, but eventually you need to up the dose and it can be a rough ride and the come downs were tough. I didn’t feel healthy on it either, even on 5mg.

My doctor will tell me that 20mg is a dose he hardly gives to people as it doesn’t do much, but it does a lot for me. I find the drugs more effective the lower I go. He primarily deals with regular adhd and not inattentive.

I also REALLY recommend taking two magnesium citrate capsules right before bed. This helps flush out the stimulant medication out of your system and will suddenly make you very tired and will help you keep a good bedtime regime. I don’t use melatonin as it’s hormonal and don’t want to mess with it. I find magnesium to work wonders.

I stopped taking the Wellbutrin properly awhile back and I noticed I was just moody. (Stimulants can make you more moody). I didn’t think it did anything but when I reintroduced it I realized it really helps elevate my mood. I think if it’s working, you will only recognize what it’s doinf if you stop it.

Also,

these drugs are very dehydrating. Make sure to drink water with electrolytes or mineral water. Too much plain water all day will flush out your potassium and magnesium and dehydrate your further.

If you feel tired, force that water. The hyper focus can result in you not eating or drinking and that is bad news. Your body will stop functioning well.

I feel the best when taking a whole food vitamin (I take pranin and put it in a smoothie). Whole food vitamins are readily absorbed by the body. (Anything ending with Tate is usually synthetic ‘acetate’). Most vitamins are synthetic but in price a big difference in my energy when I use whole food vitamins. Good for if you may not be eating proper meals.

Also, get yourself some thyroid booster supplements. Canprev makes a good one. These can be synthetic as they are mineral based. Something with ashwaghanda and tyrosine. Stimulant meds can be a big stress on the body and can increase cortisol levels. It’s really hard to lose fat with raised cortisol. This will help support your thyroid. Also, take omegas.

Everyone loses weight the first while on stims but if you aren’t supporting your body with these things, eventually the weight loss stops and your body is in overdrive.

If you don’t eat, you are going to feel like shit quickly. I really really recommend getting in a smoothie habit with whole food vitamin powder. Making sure you are eating a protein rich diet and don’t totally cut your carbs. Carbs are your friend in my experience. At least some for hormone balancing and producing less cortisol. Carbs also spike insulin but insulin is not always your enemy.

Lastly, exercise. Any kind. I lift heavy weights and do HIIT and steady state. I would avoid long runs as this is hard on your body. Remember, as a female, your body is very sensitive to stress. Stress can come in many forms including marathon running or over exercising. Your body was designed to make babies and if it senses you are overworked or not getting proper nutrients or you are over exercising and not eating enough- it will not help you.

Hopefully this helps you. It’s long I know but it took me many years of feeling like shit and trail and error to get to a place where I am happy and functioning. These medications are powerful so proceed with caution and don’t let anyone convince you a higher dose will be better. Best of luck!

Grateful for all this info!! Thank you

Hi Megamill

I found your post really helpful, thank-you, and you sound rather like me. I'm in the UK, and just been upped to 70mg Elvanse (Vyvanse).

It's made me alert and even more witty (lol) but nothing much else. No real motivation or signs of Getting Shit Done, which I was so hoping for...

I'm Inattentive Type, I think, tho have been sitting here reading about ADHD for four hours now, and still not eaten breakfast... Due a phone review with the Nurse Prescriber in about 20mins, so thought I'd explore as much as possible.

Non-productive focus as you call it is *exactly* it. The first day I took the 70mg dose, I stayed in bed until 6pm, not having moved, eaten, drunk, or peed (!) all day, just reading and posting on twitter and being *cough* intensely entertaining. I could see myself doing it, and yet couldn't stop.

Rather frustrating and disappointing. Not eating much, (won't do me any harm) but am aiming to eat well/healthily when I do, and I already take really good supplements. I have zero thirst, which is of course dangerous, as you mention.

Have asked about Bupropion (Wellbutrin) twice now, but it's less easy to get that prescribed here, so am hoping to get somewhere today if I can.

I also have anxiety (perhaps related to my ADHD, but have never taken any anti-anxiety meds. Hence my also being interested in the Wellbutrin...

I'd be interested in an update from you as to how you're doing now, given that we seem rather similar.

Thanks!

Raph

Palomino07
Palomino07
in reply to Megamill

Hi Megamill! I wanted to thank you for your comment on this thread. It was so helpful. I am new to this journey with stimulants and some things you mentioned struck a chord with me. I have been on Wellbutrin and have really found it so helpful. My mood is brighter, I have a bit more motivation in life and all in all, life doesn't feel so scary when I'm on it. My doc added a very small amount of Adderall (2.5-5mg) because it appears I more than likely have ADHD that was never diagnosed (I'm 42 years old). I felt very strange on the Adderall...you mentioned like being in a trance and that was very much how I felt. Sort of loopy. I was constantly looking for food (maybe in an attempt to not feel so out of it). I was focused but not on anything productive...I was super talkative. But what I found interesting is that it brought my resting heart rate down. My resting heart rate has always been on the high side of normal (maybe anxiety). Adderall calmed me and brought my heart rate down. I truly enjoyed that. I felt like my body finally got a break. I'm not sure if that means I have anxiety due to ADHD or what. Anyway, I can't take the "out of it" feeling so I was going to try Vyvanse along with the Wellbutrin. I was wondering what dose of Wellbutrin you were on? Currently I take the xl version at 300mg. Also, had you ever tried another stimulant family such as Concerta or Focalin? I wasn't sure if that was the way to go instead of the Vyvanse. Anyway, any thoughts would be appreciated since clearly you've been on this journey for awhile and seem extremely knowledgeable. Thanks so much!!!

Did it cause you to have acne? I was on 60mg and I got acne so bad I had to stop taking it 😞

Hi there. No it didn’t...

I’m sorry it did for you. Acne can be miserable... 😖

You don’t say how old you are — might it have been coinciding with another hormonal life phase?

I wonder also — what happened to your eating habits when you were on it?

Were you perhaps lacking in some vitamins as a result of reduced appetite, that may have impacted the condition of your skin?

Just a thought... 🤔

And what was your skin like on the lower dose?

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