elvanse increase

[Sidequest]

Hi! New to this group. I’m 43 and just received official diagnosis ( though did have an educational psychologist indicate ADHD on an assessment years ago) Went for official diagnosis with psychiatrist so I could start medication. I suffer badly at times with PMDD, so I’ve been started on fluoxetine too. I started with the ADHD meds first though, started on 30 increased to 50 and just put up to 70 and given fluoxetine. Day 2 of increased dose and starting fluoxetine, my heart started to feel like it was racing a bit around lunchtime ( 2/3hrs after taking meds ) I had a latte and usually on drink decaf so wondering if this was the cause/exacerbated it. I have experienced muscle /back stiffness with Elvanse. Usually symptoms of stiffness and slight anxiety occur for first few days after I increase dose. Hoping the same with this heart racing. Anyone else had this and if so, did it settle down?? Don’t know if it’s the increase, the coffee or adding in the fluoxetine? Thanks in advance

[Sidequest]

Thanks, ended up still tachycardic at 9pm so rang 111 and took some diazepam. Diazepam brought heart rate down but will definitely stop the fluoxetine and speak to my dr! My pupils were dilated too. Was showing signs of mild serotonin syndrome I think

[El-Eektrified]

I think we’re missing something, why did you increase the elvanse in the first place? Did it help? In terms of decreasing ADHD symptoms? Did you monitor your blood pressure during those increases? Because it can help to learn and understand your (resting) heart (rate.)

It did help me, because I know “why” my heart is racing and how my body responds to the medication.

Antidepressants are also known to increase BP, so didn’t your psychiatrist inform you about the possibility?

[Sidequest in reply to El-Eektrified]

only been on increased Elvanse for 3 days but seems to be an improvement ( without the fluoxetine)

[Sidequest in reply to El-Eektrified]

Yes, we went through side effects but my heart increase was more than I experience with Elvanse. I increased Elvanse as I have been doing gradually since I started, it was wearing off very early with me so graduated from 30 to 50 to 70z No issues with that and experience slight heart flutter but nothing major and wears off. When I took the fluoxetine, within 24hrs I my heart was still tachy at 10pm, my toes felt strange and I felt like I need to breath deeper, as if I was not getting enough oxygen. My eyes felt more dilated and my body generally felt a bit odd. It seemed to meet quite a few indicators of mild serotonin syndrome, so I have stopped it! Fine today with Elvanse, was anxious how I’d be after the reaction yesterday. Last night I rang 111. I ended up taking diazepam to settle my heart and felt better but 111 advised to go to A&E. I did get triaged and ECG but didn’t wait for dr as it was 6 hrs wait as diazepam had helped anyway. I’ll call my psychiatrist next week.

[El-Eektrified in reply to Sidequest]

wow, that sounds like a terrible scary evening…

Elvanse wearing off too early, is something I’ve experienced… when I took my 50mg dose, at 7:00, around 12:00 I was really tired… so my psychiatrist divided it by 30mg at 7:00 and 20mg at 12/13:00. This works for me.

I don’t know what your baseline readings were, when I was on bupropion I also had high blood pressure and I got prescribed Intuniv as an add-on to counter restlessness and was also helpful getting my BP down. Now I’m still taking Intuniv which means my BP is artificially low… and Elvanse pushes it towards “normal” limits.

But, I’m not a doctor, so just sharing my experiences and hopefully you can find something that works for you! In my case it took several months, to find the right combination.

[Sidequest in reply to El-Eektrified]

Thanks, always useful to hear others experiences. I didn’t jot down my BP when I started but I know it had lowered slightly when he checked again! Last time slight increase but nothing to worry about ( I let the psychiatrist deal with the numbers as that ain’t my strong point 🤣) Just really thankful that I’m on my 70 of Elvanse today and feel ok, was worrying what was causing the weird symptoms but I guess the increase to 70 at the same time as adding fluoxetine was not a good combo for me!

[Pandapop21]

hi there,

I don’t know why you would increase elvanse and start fluoxetine at the same time? Well I mean I guess you were advised to, but that is not how any of my treatment has gone. fluoxetine increases the amount of elvanse available, this is what my adhd nurse tell me anyway.

I was told by my psychiatrist that you should first stabilise your ADHD and then try coming off the fluoxetine. Because when you get adhd to a more mangle level depressive symptoms can improve greatly.

Also I don’t believe you should start on stimulant medication with a view to titration to the maximum dose. You should be looking for improvement on the lowest dose. I took 80mg for years but my daughter only need 50mg and she weighs a lot more than I do. It is about how you personally process this drug everyone is different it’s not like paracetamol there is no standard dose. I personally could not tell I’d taken 30 or 50mg but I still took them for 4 weeks before moving up to the next dose. I had swapped from the maximum dose of concerta plus instant Ritalin in the afternoon so maybe that made a difference.

I did try to stop the fluoxetine but it didn’t work out so I do take both, so I know you can anyway sorry for the rant. I would like to offer some advice about your questions aswell 🙂 yes I was very stiff but it does get better and any small aches seemed do much worse this was more on concerta but still happened to a lesser extent when I change to elvanse. Also I had to completely give up coffee, even decaf gave me palpitations and made me feel awful. I can drink coffee again now but it took over a year, I’ve been on adhd meds for 11 years now. It’s not even nearly perfect but it’s a million times better than when I run out! If it was me I would stop fluoxetine for now and see how things go. I had PMD, say had because menopausal now, and major depressive disorder. I hope that helps I am not, in anyway a professional though so just take it as my experience and not advice.