Great mornings, Ordinary afternoons.

[WestieHighlander]

Hi All. Recently diagnosed adult, working my way through my experiences with Vyvanse. Started on 20mgs, then 30, now 40. Increased over a period of roughly 3-4 months. I'm 179cm and 82kgs.

Firstly, it's been life changing. The calm and "organised" thoughts I get when the Vyvanse kicks in is amazing and potentially life-changing. If nothing improved from here, I'd still be pretty happy.

But it's definitely obvious that if I take my dose at about 8.30, it's pretty much worn off by 1pm. And my ADHD symptoms seem more obvious to me now when it wears off. Basically, I'm having great mornings, and pretty ordinary afternoons. (well, no worse than I used to, but by comparison). I'm not really looking to boost the effect of the medication, just the duration.

I also see a psychologist. She mentioned that many of her clients use a short acting medication to "cover" them for the afternoon. I mentioned this to my prescribing doctor, but he seems to prefer to up my dose of Vyvanse instead. He seems to be fairly cautious generally, which is fine.

I guess my questions are as follows (I'm aware my doctor is the best one to ask about this, but am looking for others experiences in my situation).

- does upping the dose of Vyvanse generally make it last longer?

- is there any way to prolong the effects of my current dose?

- would there be any reason my doctor would be reluctant to prescribe the short acting medication?

- would splitting my dose of Vyvanse actually work better? As in 20mgs in the morning, 20mgs in the afternoon, if this can be done?

- any other ideas/experiences!?

Thanks so much. This group has been really helpful so far

[STEM_Dad]

Vyvanse can be made less effective by vitamin C. (The general advice is not to take Vyvanse within an hour before or after ingesting food, drinks, or supplements containing vitamin C.) I don't have experience taking Vyvanse, but I did take Adderall for a while, which has the same warning about vitamin C.

Since Vyvanse is an extended release formulation, it ought to last for several hours. Definitely talk to your doctor or pharmacist (or get a message to your doctor) about how short the duration seems to be. However, each person's biochemistry is different, so experience will vary from person to person.

* It may be that eating or drinking something with significant levels of vitamin C later in the morning or in the afternoon may be affecting absorption of the Vyvanse (but I'm not a medical or pharmaceutical expert, so I don't know).

An increase in dosage might help, or taking smaller a booster dose...but again, check with your doctor

[Emsil21]

i feel I can relate I find that vyanase at the right dose is great but I mentioned to my doctor it isn’t all day, so they prescribed quick acting amfexa for this afternoon which helped . But if I’m being completely honest I’m after that intense focus feeling where you can’t bare to pull away from your work laptop to even get a glass of water - I know this isn’t healthy yet that’s what I crave - I suppose that means I’m craving that dopamine.

In reality ‘normal people’ are not 100% focused so it might be ok to not feel on it. I don’t know if it’s the adhd or just me but I have a all or nothing mentality - make me Bradley cooper out of limitless or don’t bother affecting me at all and it just doesn’t seem enough!

That’s not exactly helpful to you in terms of next steps but it’s what Iv come to realise about myself - unless I ‘feel’ vyanase all the time what is the point 🤔

[Hominid711 in reply to Emsil21]

Haha I'm the same. Just love reading, thinking, any mental cognitive emotional processing and being creative in my head on Vyvanse. And no worries about that glass of water. It's not THAT unhealthy to miss it.

[Hominid711 in reply to Emsil21]

Again, try upping Vyvanse instead

[Emsil21 in reply to Hominid711]

I’m glad it’s not just me! Iv asked up to up my dose It take two weeks to get a response and seeming I pay for this service it’s really not great, what dose are you on? I’m also upping my b vits and magnesium - feel like I want concentrate on boosting me energy levels and general health - which is not like me at all 🤣

[Hominid711 in reply to Emsil21]

70mg.

[Underbite234]

I'm having a similar experience with Vyvanse. Like you, I was diagnosed and started taking meds as an adult, and it has been completely life changing. However, I have noticed that the therapeutic benefits of Vyvanse tend to wane in the early afternoon. My doc has prescribed me 5mg of Adderall IR to give me a boost which helps, but it definitely doesn't work as well as the Vyvance in the morning.

I'm thinking about actually trying to shift my work schedule to focus on tasks that need my greatest attention and focus in the morning and maybe shifting tasks that don't tax my executive functioning system as much to the afternoon.

That is probably going to be easier said than done, but it's worth a try.

[STEM_Dad in reply to Underbite234]

The work schedule that you described is one that is supposed to work well for many people (both neurodivergent and neurotypical).

According to what I've heard and read by scientists (including Dr. Andrew Huberman, on the Huberman Lab podcast), it's common for people to have more energy and motivation in the morning, then to have lower energy and less executive functioning capability in the afternoon. I believe they say that this pattern is due to the circadian rhythm.

I hope it works well for you.

[Underbite234 in reply to STEM_Dad]

Thanks for the information! It's always nice when science matches up nicely with lived experience.

The biggest barriers to making a shift like this relate to the shame around "I should be able to function like everyone else" stuff and unhelpful thoughts like, "People are going to think that I am being demanding, self-centered." It's so hard to drop the mask...

[Hominid711 in reply to Underbite234]

Science matches up unless a scientific element is missing. Or an unscientific one intruding such as a belief. Except one that has a placebo effect.Be proud you've made it so far so well! Enjoy the relief it brings to have an explanation now. Imagine the coping strategies you've developed and consolidated and be aware of the leeway to give yourself to now take it easy, give a flyingfuck, for the fun of it be consciously here and there a bit "mad". Sorry people, my ADHD again.

Having said that I recently drank a bit much during an animated dinner and perfectly innocently, subconsciously, subjectively calm, illuminated, feeling good, but objectively logorhoeic and infuriating to him, argued a friend into a rage. So, alcohol can be an issue potentiating the stimulant effect and extroverts should probably keep a certain awareness of their personal blend of social interactions

[Hominid711 in reply to Underbite234]

Try upping Vyvanse if there is scope. Any issues with your GP being reluctant, it doesn't turn you into an addict on a higher dose. What carries that addictive risk are short-acting or fast-release stimulants or possibly having different stimulants or too many hours out of 24h on them but that I don't know. Just recall no statistically significant development of addiction, tolerance, dependence, craving on Vyvanse including the maximum licensed dose

[WestieHighlander]

Thanks so much for all the replies and great info. I see my doctor in a month or so. After thinking about it, I really hope he can add a short acting med to the afternoon. Mainly because I'm very happy with the effects. I'm not looking to strengthen the effects, or get a more intense reaction if that makes sense. I just want it to last a bit longer so I don't have to pick a 4 hr window based on my day. I'd even be very happy with two, 4 hour windows. But I suspect he'll up me to 50mgs. Guess we'll wait and see.

[Hominid711 in reply to WestieHighlander]

Upping Vyvanse does not necessarily increase the intensity of the effect but it lifts up the later reduced effect. Check if your GP knows what they are doing.

[Underbite234 in reply to Hominid711]

That is great information. I have also been a little afraid that increasing my dose (I'm on 30mg, tends to peter out mid afternoon) might make me jittery/manic.

[Boss_barbie]

I’m currently on 60mg.

I’m now finding that it’s working amazing for me. My sr said he may want to up it to 70mg which is the max, to have it last longer.

He also said that if I’m getting it wearing off too quick that he can get it prescribed so that I’d take half dose in the morning and the other half in the afternoon.

Hope this helps!

[Mamamichl in reply to Boss_barbie]

for my partner, he takes dextroemphetamine mid day that has a slower up and down and it works well for him.

[breadandcircuses in reply to Mamamichl]

I take dextroamphetamine - 15mg in the morning and another 5 around 11am. It help extend the dosage, but I still feel as if it's worn off a lot by 2pm and, sadly, I need to be really functional for work from 2-5pm, so I don't know.

I had tons of issues getting dosage increased to where I needed it by a former provider. I see my new provider for the "nuts and bolts" medication conversation on Tuesday. I'm planning to ask her how to deal with this.

The drop is pretty precipitous and I have the kind of job where meetings that need me to think happen all day starting at 7:30am and sometimes after 5pm and then I'm trying to get actual work done in between. I block time on my calendar in the morning to give myself a fighting chance.

[WestieHighlander in reply to Boss_barbie]

Thanks heaps Barbie. That's good to know, because I wasn't sure if you could take the Vyvanse over two doses.

[Hominid711 in reply to Boss_barbie]

Halfing long acting formulae doesn't make scientific sense!

[Hominid711 in reply to Hominid711]

On the other hand it does no harm so go for it by all means

[StanleyThyroid]

Before taking Elvanse I always needed to sleep in the afternoon and drank lots of coffee in the morning to get going. When I started taking a few months ago I had the same effects as you but the afternoon crash was often severe. I avoided taking amfexa and over time the effects have moderated so I can now go the whole day without sleeping but can have sleep issues. Its not prescribed but I have split a slightly higher dose on occasions to go a longer day which worked fine. I did this by diluting the Elvanse in water. My learning is that when you push the body further you are going to need recovery time so I often take days off when I can afford to be less busy.

Overall the medication has been good but it doesn't fix adhd and in some cases amplifies the symptoms eg my brain comes up with more random ideas that I need to manage but I like the increase in productivity that goes with it.

[Hominid711 in reply to StanleyThyroid]

Same here with your last paragraph

[Mamamichl]

my partner got a gene test and they said for him to do 50mg of vyvanse. He also takes 10mg of dextroemphetamine mid day so that it boosts the effects without a quick stop mid day. He just weighed himself at 202 pounds.

[Hominid711]

I'm not a psychiatrist but a GP. My first thought before reading what your GP advises was the same. Up the dose of Vyvanse (10mg every 5-7days or so. No need to be slower than that) until it works for the 13-14h that it should. It's a slow release formula made to last that long. If you take it at an hour within 13-14h prior to the start of your desired sleeping period you may risk insomnia (dropping off or staying asleep). Tired or not but unable to sleep/completely drift off. Generally you take the dose that works for those 13-14h or at least 10-11h. When exactly you take it is completely up to you and depends on your lifestyle, work, activities. You can take it 1.5-2h before you want it to work - even before getting up if you want it to work straight from getting up if you manage to wake yourself up, take the tablet and roll over for another hour to two snoozing - because it takes that long to kick in which you already know. The level of it in your blood as well as how it makes you feel reaches its peak at 4-5h from taking it and from then onwards the effect very slowly reduces over the next 7-10h or so. Imagine this as a graph with time the horizontal or X axis, effectivity/blood level of Vyvanse the vertical or Y axis (school maths). I myself am on 70mg because I wanted to see what the maximum would make me feel like, but because of the minor but odd side effect of involuntary muscle spasms around the mouth (this is called a tic, mostly known as lid spasms which most people have had as a result of muscle fatigue on occasion) I've decided to reduce the dose to 60 and if necessary 50 or lower.

[WestieHighlander in reply to Hominid711]

Thanks for that. I'll absolutely follow my GPs advice. I think the increase from 30 to 40 has helped a little. So maybe going from 40 to 50 is a good idea.

[Hominid711 in reply to WestieHighlander]

Absolutely! I also read an article recommending as the best dose the highest you can take without intolerable or other significant side effects. I'll send it if I find it again. So for example, the side effect constipation is common but usually tolerable and not in itself a problem for most people so even if you have that already you can still increase.

[Miloishungry in reply to Hominid711]

I’ve never heard or been told why my mouth makes weird spasms around my mouth. Thank you!!!!Finally someone who gave me an answer and can relate!!! Unfortunately, for me to function because of Narcolepsy, 70mg is what I need to be able to minimally function.