1st week on vyvanse unsure - CHADD's Adult ADH...

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1st week on vyvanse unsure

Salz90 profile image
18 Replies

Hi all

32 y/o male just diagnosed with inattentive add. I take 20 mg prozac and have just started 20 mg vyvanse moving up to 40 in a few days (to mitigate some effects).

I just wanted to reach out and see if what in feeling is normal adjustment to the medication or not.

Days 1-4 were great my focus was fantastic and I didn't feel all that different other theb the subtle shift in my ability to focus and refocus.

The last few days (5 and 6) as soon as I take the medication I feel super tired and "out of it" for lack of a better term. When I need go focus on a task at work I can but in-between tasks etc the feeling of being out of it and tired is quite unpleasant.

I take the medication same time everyday 6 am with food.

Is this just because the dose is too low and I just need to wait to adjust up to a more common adhd dose or is this a not normal reaction to adhd medication?

Thanks in advance for your thoughts.

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Salz90
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18 Replies
STEM_Dad profile image
STEM_Dad

I'm glad that you're keeping track. It's always a good idea to do so when on a new medication or new dosage.

There's often an adjustment period, as your body adjusts to the medication. Perhaps you will need a higher dosage, but I'm not a doctor.

Does your sleep seem to be effected by the medication?

Some people find out harder to get enough sleep on a stimulant medication, and what you describe sounds like you might not be getting enough rest at night.

-----

(I was actually well treated on a lower dosage of stimulant medication, Adderall in my case, than the higher dose...but I seem to be atypical. I have Inattentive ADHD, and my symptoms are well treated by the lowest adult dose of non-stimulant atomoxetine, aka Strattera.)

Salz90 profile image
Salz90 in reply toSTEM_Dad

Hi thanks for the reply

At least in terms of falling asleep and staying asleep my sleep is fine. Perhaps the quality of that sleep has changed who knows?

I've never had trouble sleeping thankfully.i feel a lot more alert when I wake up in the morning than an hour after taking the medication. Hopefully just an adjustment period and the bump up to 40 will fix it.

STEM_Dad profile image
STEM_Dad in reply toSalz90

It might just be part of the adjustment for you. You've only been on the medication for a little while.

If you are concerned about how tired you are, and if it makes anything unsafe (like driving or operating machinery), then definitely tell your doctor.

-----

Besides the few months that I was on Adderall, the only stimulant I have used most of my life is caffeine (mostly via coffee).

I've noticed that about once or twice a year, I develop a tolerance to caffeine, but it takes a long time to get there. I know that the tolerance has kicked in when the caffeine not only doesn't make me feel more alert...it actually makes me feel sleepy.

When that happens, I go a few days without caffeine (switching to decaf brew, because I drink coffee out of habit and because it's my favorite beverage). After 5 days of fasting from caffeine, I can go another 6 months to a year before I develop a tolerance again.

-----

You shouldn't develop a tolerance after such a short time, but perhaps it's a reaction to the medication due to your unique biochemistry. By I'm not a doctor (just a computer techie with an interest in learning all I can about ADHD, and trying to help others whenever I can).

Salz90 profile image
Salz90 in reply toSTEM_Dad

Yeah could be. I had a rough time getting started on the prozac years ago to so wouldn't be surprised if this is a temporary side effect.

I've read some things about prozac not being the right choice for people on vyvanse to. I'll speak to the pharmacist today anyway and see what they say.

El-Eektrified profile image
El-Eektrified in reply toSalz90

I’m on sertraline (50mg) in combination with vyvanse, without the Zoloft I had a similar experience (being tired after a few hours after taking my vyvanse) At the time I was on 50mg vyvanse in the morning. I split the dose, diluting it into water, taking half at 8am and the rest at 12am, so it helped a bit. My doc didn’t appreciate this method, decided to split my dose into 30 mg / 20mg pills.

Then they added zoloft, which really improved a lot in terms of energy… and sometimes I don’t even need my additional 20mg anymore.

It really is finding out what works for you…. Def. when there is a combination of meds, which complicates things… you’ll never know “what” is causing a certain side effect!

Good luck!

ADDandMe profile image
ADDandMe

I’m not on meds yet but reading your experience and responses with interest. I’d really like to hear how you get on with things if you have time to update us. I hope things fall into place.

STEM_Dad interesting insight into the caffeine use/ tolerance/ tiredness. I’m definitely keeping your points in mind. Thanks 🙏🏼

Salz90 profile image
Salz90 in reply toADDandMe

Hi

Coincidentally, I managed to get an appt with my psychiatrist today to ask the question.

His view was that my brain had calmed down so much (which is true btw) that it's having a temporary sleepy effect.

We have decided to stay on 20mgs for another two weeks given the positives I've seen from such a low dose.

Will let you know how I get on in the coming weeks.

Hope this helped.

ADDandMe profile image
ADDandMe in reply toSalz90

thank you! Knowledge is power. So yes, this is really helpful.

STEM_Dad profile image
STEM_Dad in reply toSalz90

Doctors' training and experience can be very helpful in cases like this. We expect medications to work it not work, but it can take time for the body to reach a point of balance.

I didn't have the same sleepy reaction, but I can remember when I first went on Adderall, I felt like having so much more capacity to focus was great...but then didn't know what to do with it. (I was more productive at work right from the start on Adderall, but not as much as I expected to be. Partly because I was so excited at the new "me".

FreddyBooger profile image
FreddyBooger

Hi. 46 year old here. Diagnosed in April. I started on 30mg Vyvanse which was ok for a few hours then wore off way too soon. Then I think I went on to 50, then 70 because again, 50 was wearing off too quick. Now I'm on 70 with an Amfexa 10mg boost when required because I'm doing stuff from 8am until 10pm with work and chores and an autistic son who has ADHD too. Before this, I couldn't really get much done. Had no motivation to do anything, even stuff I liked. Was told it was depression and anxiety for years.

Anyway, it's taken a few changes to get the dose I need. But not only dosage. Diet and exercise has been very important too. And it's been so much easier to make those changes because of the meds.

Take your tablet first thing. Eat a healthy whole grain breakfast right after. Do some exercise, like a fitness video or a walk. Avoid caffeine and anything with too much vitamin c in it.

When I started doing the above, it really helped my meds work better too.

I'm not sure why it makes you feel tired or out of it. I feel a bit tired during the day, bur always have. I often need a quick nap in the afternoon but I thought this was an ADHD thing. I used to be able to sleep on energy drinks and all sorts.

I know it can make you feel drowsy but maybe you should mention it to your doctor.

Make sure you get lots of sleep. You can't afford to be going to bed late when you're on stimulants.

Finally, I've been on citalopram for years. I've been reading that SSRI's do not help ADHD at all, and can infact make it worse. So when I got to a comfortable point with my meds, I started taking less anti depressants. I will completely stop taking them soon.

I hope you find the right level for you

Wasted71years profile image
Wasted71years

I had the same paradoxical outcome when I started on my initial (20mg) dose.

It calmed my brain but also made me feel sleepy. My interpretation or rationalization for this was that my brain had been active, jumping around and likely fighting to get enough dopamine before I started the medication.

After I began, there was just enough increase that my brain could choose what to focus on and that it wasn't struggling like a drowning person fighting for dopamine. That was why I felt the tiredness and calm as it activated.

As my dose was increased, that sensation disappeared. I then focused on changes to my ADHD symptoms to decide when I was getting enough Vyvanse. It took a few months carefully stepping up.

Salz90 profile image
Salz90 in reply toWasted71years

Hi wasted

I managed to get in to my doctor yesterday and funnily enough this is what he said. On reflection my mind has calmed down so much as well.

Although given the positives I've seen to my symptoms on 20 mg we have decided to stay on that for a few more weeks rather than bump up on Wednesday in the hope that everything adjusts.

Thanks for sharing your experiences I appreciate it.

ADHDinCa profile image
ADHDinCa

I am on 40 mg of Vyvanse and it works well for me, but I do notice it seems to "wear off" by the afternoon. I take it before work (around 7:00 am) and it keeps me pretty focused until about 2:00, which works for me. I think 20 mg is pretty low so you may need the higher dosage. I find after a few months, it is not quite as effective so I take "breaks" when I can. When I am on vacation or sometimes on weekends when I don't have to be productive or multi-task, I skip my pill. On those days I need a little extra coffee otherwise I feel pretty crummy for a day or two. But then when I start up again, I find the Vyvanse is more effective.

Glad to hear your psychiatrist was able to give you some advice about this. I am currently taking Dexadrine, which makes me calm, but mostly not sleepy. I took Adderall briefly and one of the side effects for me was extreme fatigue. I could literally lie down on the couch and sleep for 4 hours - seemed really nuts. I've also read that the unexpected calm can make you tired. I've also learned that the stimulant won't do a thing for me if I'm already physically tired. I've always had trouble with insomnia, but practicing good sleep hygeine has been very effective (still is) - I let the knowledge that if I'm tired I'll be worthless the next day to keep to my bedtime routine.

As with any psychiatric medication, it can take many tries to get to the correct medication at the correct dosage - also know that what works for one person may not work for another or may work differently. Keep at it, keep tracking (good for you for doing that), and be honest with your doctor about what you're experiencing and honest with yourself about what you're willing to tolerate.

IversonK profile image
IversonK

I have been on Vyvanse for 2 weeks 40 mg. I have been feeling more relaxed which is very nice because my mind seems to be calm. I am also very tired and Lack motivation. I can focus better but I always tired. I will be talking to my Dr about an increase.

in reply toIversonK

i was like that after two weeks. But now i never have a noticeable crash or feel tired ca of it as such so keep at it. 2 weeks is very early still for the body adjusting to this new regualr intake. Make sure you keep well hydrated with water ALL THE TIME. Stretching or a quick 10 swauts or push ups (sounds weird yes) works wonders I promise. It isn’t supposed to make you motivated but give a better ability of clarity to focus on what you motivate yourself for. Its a tool to assist you, not make you remember. Little steps and keep going! 👍

Hi. I’ve been on Vyvanse (Elvanse in the UK), for around a year. I haven’t read all the responses so sorry if I repeat anything…

First off, the forst couple of weeks may wildly vary due to your body adjusting. Try not to over analyse throughout the day and monitor every few to week - time, what you eat/drank before it or soon after - THIS is very important for me because if I don’t do things like I nornally would the effects vary or even don’t work sometimes. Do not drink caffiene or vitamin C before or after am hour each way! The caffiene will make you more jittery combined with it and you wont be able to monitor if its purely the meds or not. Vit C hampers absorption efficacy so just take thwt later in the day. In the first couple weeks I had slight highs and some minor side effects - the thing with vyvanse is when its optimal, and after a while, you shouldn’t be getting a high, just an increased sense of focus, its weird, like a noticeable ability to focus but not quite yourself. Cleared anxiety up for me really well too. Just don’t over think it at first as it will vary and do not think you should be feeling a high so you dont make the mistake of continually chasing that dragon and increase in dosage

Twal profile image
Twal

Hi, I asked the same thing as my husband is exactly the same as you are describing, I had been told your diet can have a lot to do with it as vyvanse is a stimulant if you add caffeine, sugar you will become over stimulated and feel tiered, brain fog as well.. maybe the dose is two high.. hope this helps in some way ☺️

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