First time Adderall XR use- is this normal?

[Nagevasehs]

Hi all! After years of putting it off because of fear of doctors/medication I have finally been diagnosed with ADHD inattentive. I took my first dose of Adderall XR (20mg) yesterday for the first time and after about an hour/2 my brain finally felt like it was resting (I guess “at peace” is how I would describe it) However as the day went on, I started to get really weak and shaky feeling. My toes would tingle occasionally and I would randomly get chills and feeling like tiny twitches and tightness in my legs. I know that the recommendation is to speak with my doctor, but I also just didn’t want to be dramatic if these are normal side effects that will eventually go away. I’m sure that my medication anxiety is causing me to be more hyper aware of them and yeah.. I just wanted to know if they were “normal” or if anyone else has experienced those symptoms upon first taking Adderall xr. I also had the classic symptoms of loss of appetite and insomnia last night which I was expecting and I’m not worried about that, just more so the nervous system response. Even as I’m typing this I still feel shaky and weak (I took one dose at 11 am yesterday). I ate normally yesterday even though I wasn’t hungry and drank lots of water so I know it’s not that.

Anyways, sorry for rambling. Just hoping to find some peace of mind. Thanks <3

[radical_change]

Hi, I'm not sure about the numbness, but the rest of it seems pretty familiar. The first few days was pretty rough in some respects, you're pretty high depending on where they start the dosage. It is all a weird feeling. Personally I found that I reacted negatively to XR, especially with insomnia and emotional dysregulation. That was about the same for the instant... I ended up stopping medication so I could remember what baseline was. Honor your feelings if you still feel uncomfortable in a few days.

Also the rambling on is very common

[Nagevasehs in reply to radical_change]

Thanks for getting back to me! Your response definitely makes me feel a little more at ease. The idea of switching medications to “find what works” is such a strange concept to me but I know that if this doesn’t get better I’ll have to find something that works or otherwise I will just go without as well. I couldn’t make myself take it this morning because I still felt so weird and uncomfortable, but I’m going to try to take it earlier in the AM tomorrow and monitor side effects closely. Do you still prefer to go without medication?

Good to know the rambling is expected 😂

[radical_change in reply to Nagevasehs]

no problem!I had to put my foot down, my reaction to amphetamine salts was not favorable. I was just perscribed Strattera, which I'm considering. I do enjoy being unmedicated in some respect, I can attribute my behavior and flow rather than meds. For me it was important to come back to baseline so I had something to contrast. I did find the instant release was better for insomnia as it metabolizes quicker, the deterioration of your sleep cycle is murder on your nervous system, especially when you are already being amped up.

From my experience there is still a lot of feeling around in the dark with medicating. ADHD for me is part of a gradient of brain pathways, not a pathology. Understand the benefits of your brain pathways. The only reason we are at a deficit is due to how our society is constructed.

[LifeIsLearning in reply to radical_change]

Oooh! "The only reason we are at a deficit is because of how our society is constructed." You put that soooo well!

I read a similar opinion in this article.

nytimes.com/2014/11/02/opin...

Also, thanks for sharing your experience about the side effects of meds. That is helpful!

Nagevasehs , I do still recommend calling your doctor just in case. I also feel like it's easy to be too dramatic and shy away from mentioning stuff like that, but honestly, it's not mentioning "small" symptoms that left me till I was in my 30's to get diagnosed with ADHD.

[Nagevasehs in reply to radical_change]

Yes I agree and beautifully put. I would love to live in a society where being “on time” for things didn’t exist! Jokes aside, I feel similarly- I mean I made it 31 years without medication, but some of my “personality traits” which I know now to be adhd quirks are exhausting my fiancé so I’m going to see if maybe medication can help me for a period so I can at least make new habits that will hopefully stick once I come off the meds (like finishing a task to completion 🤯)

As an update, I halved my dose this morning and what a world of a difference it made. No bad symptoms (as of now) but just the calm clear mind and the ability to do something without thinking about a million other things.

I’ll be interested to see the difference in my sleep it makes tonight. I also took it much earlier today so we will see!

[DrBrand in reply to Nagevasehs]

When thinking lf switching remember there are two main classes of stimulant. Maybe the amphetamine side is too much for you. You could do better on the methylphenidate side. If insurance covers new drugs there is Azstarys a new prodrug from the maker of Vyvanse. Doesn't have the suppression of appetite or insomnia like others. Also has a more smooth release so the "jitters isn't as common.

[Nagevasehs in reply to DrBrand]

I did not know that! I’ll definitely talk to my doctor about that! Halving the dose seemed to cut most of the side effects as of now, but did not give me the same “calming” feeling as the full dose. So I will definitely be looking into Azstarys!

[DrBrand]

It could just be your anxiety to trying a new med. Sometimes we can think ourselves into having "weird sideeffects". But you r body does have to get used to it. Lack of appetite and Insomnia is not something to write off as ok. Unless you eat too much and sleep 15 hrs a day normal lol. Hopefully they wear off as you get used to it. If not may have to find a drug that doesn't.

[Nagevasehs in reply to DrBrand]

Yea I think my anxiety definitely played a role in how I was feeling. The insomnia really only happened the first night thank goodness (probably also anxiety 🤪) But halving the dose seemed to help for now!

[Neurolancer]

Dear Nagevasehs, please give your body time to adjust. It was smart of you to try a lower dose. That’s what so great about the amphetamines – you can play around with them to get the right dose for yourself. Sometimes your body will get used to a dosage and you’ll need to increase it. Every body is different – this is very true . Take a really big breath and try to relax. Stimulants have been used by children and adults for decades now and the research is solidly on the side of relative safety. In my opinion the damage done by a life of ADD or ADHD without treatment is a much greater concern to me.

I was diagnosed with ADD at the age of 45, my father was never diagnosed, and we endured a lot. All three of my children have ADD and their lives are better because of the medication, no doubt. My kids and I all take different doses and combinations of Vyvanse and Adderall an Adderall XR — My daughter greatly reduced her dosage recently to 30 mg of Vyvanse and my older son went off his Vyvanse and Adderall for the most part because he was experiencing a lot of PTSD and it was adding to his feelings of anxiety— he now takes it when he really, really needs to focus. My younger son and I, on the other hand, take high doses of Vyvanse and Adderall on the other hand — it’s my son’s “calming medication“ according to him and I would not find my way out of the box in the morning if I wasn’t taking my meds.

One question: Did your doctor ever talk about Vyvanse? It’s longer acting and comes on more gently and eases off more gently than Adderall XR or Adderall.

[Nagevasehs in reply to Neurolancer]

First of all, thank you for taking the time to write such a heartfelt and well thought out response. I am happy to say that halving the dose made a huge difference in the shakiness I was feeling and managed to keep me focused on tasks albeit not as well as the full dose. I’m hoping to try a full dose again next week to see if it was just an initial reaction.I completely agree though, after taking medication and seeing how my brain works vs without it really makes me wonder how I successfully managed to make it to 31 😅. I guess we find ways but I do think I missed out on lots of opportunities because I was too afraid I wouldn’t be able to organize or manage the task load. It’s interesting how genetics work, right? I’ve been saying for years that my dad has adhd but it wasn’t til I was diagnosed that I was like ohhh that makes sense now lol.

I have not tried Vyvanse but I am definitely willing to! I have a recheck with my doctor in a month and I will definitely talk to her about it then. I’ve heard nothing but good things about it.

[HCStymie in reply to Nagevasehs]

How have things gone for you in the last couple years with the medication?

If I was to answer a couple years ago I would have recommended stopping altogether and letting your brain go back to homeostasis. Then starting again on a lower dose IR. 20mg XR is too much to start someone one when you don't know how they were going to react. Adderall XR is designed to be the same as 50% IR and the other 50% released 4 hours later. Using smaller dose IR you could time that second dose or half dose later that works best for you. And take half a pill if it was too strong. Can't do that with XR.

Problem is, when you are on any dose, your brain wants to get back to its normal. So it starts to counteract the medication. You need the break in the evening and overnight for your brains counter effects to undo so you are starting at the same baseline the next day. Too high of a dose and your brain won't be able to reset for the next day, especially since you will have a high dose that stays in your system overnight. So, your new normal becomes the modified brain that is trying to counteract the meds constantly. Eventually your brain just doesn't work as efficiently and you end up with dependence. And have to increase dosage trying to get that therapeutic feeling you miss. Better off to go back to homeostasis and get the right dose that isn't over stimulating without trying to find the right dose with a brain that is out of stasis. Because you may not be able to downregulate at that point to the proper dose.

[Interesteddad]

Hi There,

I am the parent of someone who lives with ADHD, but I am also someone who feels drug side effects intensely. Please don't ever feel sheepish or uncertain about contacting your Dr. While, yes, I am sure that some can be dismissive and difficult, we literally pay them to consult with us about our health and medication. You have every reason (and right) to inquire about your side effects, and I hope that you feel confident in doing so.

Best!

[Nagevasehs in reply to Interesteddad]

Hey! Thank you for the pep talk! I always feel weird and guilty about going back (just based on a horrific experience I had years ago) so it’s nice to be reminded that MOST doctors are not like that. And you’re right, thinking about my doctor now, she was so nice I couldn’t imagine her being annoyed with me. Luckily as of right now and from halving my dose, the side effects has disappeared but if they come back I’ll definitely be talking to her about my options!

[radical_change]

Checking in to see how it's going. Just remember there are other options if stimulants aren't enough. I do highly recommend looking outside yourself as well... what things in your environment could accommodate YOU and YOUR process. It is vital that we as a society embrace all forms of diversity.

A note on Vyvanse mentioned above... it is 1/4 ingredients in adderall, acts in much the same way... it is just much much more expensive. I am steering clear of those highs and lows it brings on.