Combination therapy: Elvanse + Strattera

[iLikeChadd]

Hi!

Here's something very interesting I found about combination therapy. Anyone have experience? Especially with small dose of Elvanse + small dose of Strattera. Or Elvanse with a small dose of something else.

additudemag.com/adhd-medica...

Perhaps this is “news” to me, and no news to others.



I'm newly diagnosed (tested meticulously a couple of months), near 50 years old, single mom of a son with adhd. We're both "high cognitive function" types, hyper-structured A-types. I was extremely successful at school and university, and for the most part, same with career. I did however change jobs and relationships FAST and OFTEN, and have been very spontaneous in pretty much all life choices. As mom, it seems my adhd finally became undeniable. (Menopause and hormones probably play into this. Estrogen clearly helps.)



I seem to be incredibly sensitive, and the smallest mini-dose of Vyvanse aka Elvanse is good for me. I take 1/6th of the smallest dose, and it truly helps. I realize this sounds a bit unbelievable to some, even doctors - but I know my body - and a higher dose was no good. I get things done pretty easily anyhow, and the higher dose made me a "fast steamboat" or a "train wreck" - just way too much energy and momentum, and more of the hyper-focus I already tend to have. The low-low dose seems perfect. Just the right lift of mood and general focus throughout the day.



But I feel like I would still benefit from something else. I still have slight unnecessary anxiety and also irritability.

Still learning.

[8TheGlen]

Hello, I am afraid that I can’t help you with any of your issues but I was delighted to hear that your life is improving.

I have a 30 year old daughter who was diagnosed 4 years ago, who sounds similar to yourself. We are in Wales UK where she has only be offered the ADHD medication once, which didn’t suit her. She is very hard working and never gives up but has changed jobs often and has disastrous relationships with a repetitive type of man. She is a journalist with 2 degrees but needs help so I take your experiences on board. The only medication she is on, at present, is an antidepressant to help with the anxiety. She gets exhausted, stressed, overwhelmed and anxious which obviously has a huge impact on her personal and professional life. Reading your message has given me hope and I am so pleased that you have at last, found some relief

[iLikeChadd in reply to 8TheGlen]

P.S. Which anti-depressant is she on?

[iLikeChadd]

Glad to hear you found this encouraging/uplifting

I'd encourage to think about Elvanse at a super-duper low dose. Elvanse is one with (from what I hear) the least side-effects. 1/6th of 30 mg - or even 1/12th. Testing such a small dose wouldn't hurt... give it 3-5 days and if no good - perhaps still look into something else. The little bit of help it gives me is still really a big help.

The exhaustion and overwhelm you describe sound familiar. I mean, I didn't really think I was overwhelmed, but in hindsight, I probably was. Streamlining life - making it simple - also helps. I also believe exercise is essential. I danced classical ballet for 16 years as a kid and then again as an adult, and believe it helped because it involves both brain and body. Adequate sleep, also important.

I think it's many small tweaks in many areas of life - and maintaining them best you can - that makes or brakes it all.

[SunniM]

Hello

I am fairly sensitive to a lot of medications. My Dr had prescribed Vyvanse to me and kept increasing it all the way to 50mg because I kept describing symptoms like you of anxiety and irritability. I kept saying it was too much and she did lower it some but honestly I now think it just wasn't working that well. It did help motivate me some but I really think it increased my anxiety. I say that because I had a change in insurance and had to switch to 30 my Adderall XR. I was leery about it but the very first day I took it, it was like Holy Shih Tzu! This is amazing! Not only was I able to focus and stay motivated, but I noticed an incredible decrease in the amount of anxiety I felt. It was like all those worry thoughts spinning around in my head suddenly cleared. I could actually think about each one separately and know what to do about it or at least be able to relax about it and think rationally. I still do get anxious but the difference is like night and day. I’m also sleeping better even though I take an additional 10 mg immediate release around 4pm or so. Anyway, I’m not saying you should switch. I’m just saying for me, that’s what has worked. I guess my point is that I didn’t even realize this was possible or that the vyvanse wasn’t the best fit for me. I am also reading about supplements that are helpful...like magnesium and a bunch of others. I hope you find what works best for you.

[iLikeChadd]

Thank you SunniM, and yes, all that you say makes sense! So glad you found the better/best solution!

For me - journey continues:

I was JUST able to convince my dr to consider combination therapy. I started with 10 mg Strattera / Atomoxetin in addition to the mini-dose of 5 mg Vyvanse that I'm already on - and wow! Day one, all anxiety gone, and total focus on more than one thing at the same time. Focus on work and my child - both - clear mind, and a feeling of happiness and calm! Wowza! I know it takes several weeks to truly see how Strattera / Atomoxetin works for me - but I can say based on initial experience that it seems to possibly be THE answer!

In my country, they don't have Adderall, and don't give e.g. Concerta to people this "OLD" (around 50 and up). My only options (per my dr) are:

- Wellbutrin (made me spacey, euphoric, less focus)

- Medikinet (made me anxious and aggressive)

- Vyvanse

- Strattera / Atomoxetin

I've continued on my 1/6th Vyvanse (1/6th of 30 mg = 5 mg) and feel it truly does help a little tiny bit; enough to make it noticeable. Anything more is too much and makes me anxious.

Atomoxetin (1st day) did make me drowsy for the first 6-7 hours, and I felt some nausea but not so intense that I'd mind. And since they say that the side effects will decrease after some days/weeks, I will continue. Read some people take it 2-3 months at night before sleep, then switch to morning. The idea there is that the side effects will have subsided by then.