adult Dad with ADHD who has tried stimulant meds for the last time!

[Chelseaguy76]

I recently after many years decided to try Vyvanse, after not using meds since my twenties due to terrible side effects, long enough ago were there was no Vyvanse. I’ve been in it for a week, and the anger, and irritability on only 30 mg’s is just too much to consider messing with it any longer. If you have to chase the dragon trying to squash anger, it’s just not worth it, I’ve had one good day in 7. I’ve tried all the usual suspects years ago, and the side effects didn’t out weigh the benefits, I’ll try a non stimulant or a nootropic instead. My son had genetic testing done and he can’t take all but one of the stimulants, and he tried Vyvanse, and struggled as well. Oh well, on too different pastures.

[STEM_Dad]

Welcome to the forum.

You're right, stimulants aren't for everyone. Only tried Adderall XR, and while it didn't affect my mood while it was working, once it wore off in the late afternoon/evening, in became irritable.

I've been on a non-stimulant called atomoxetine (the brand name is Strattera) for almost 2 years now, and it doesn't affect my mood, but it does treat my symptoms pretty well.

I've been hearing good things about Guanfacine (Intuniv), because it can help to improve mood management as well as treating ADHD symptoms. It's a non-stimulant, and sometimes is prescribed alongside other medications (e.g. stimulants, or Wellbutrin).

[Loutysonsmith]

Hey STEM_Dad

I'm 56 diagnosed with ADHD and Autism.

Vyvanse was good in some ways for me, but disastrous in other ways. I used it for 6 months a few years back but the irritability was so bad and it was giving me heart palpitations as well. I stopped straight away. I've asked to be considered for non-stimulants to try but not in the immediate future. So I'm back to managing things with exercise, food and sleep - which of course doesn't deal with anything other than the bare minimum functionality. It's such a tough balan e to keep isn't it?

[STEM_Dad in reply to Loutysonsmith]

I hope that your doctor is able to help you to get onto a medicine which is effective for you soon. The medication trials can be difficult to go through. (I think that I had it way easier than most...it only took 6 months, and only 1 month with side effects.)

I still had to ask my doctor a couple of times to try the non-stimulant that I'm now on. His reason for trying stimulants first were the following:

1. He said that most of his ADHD patients responded better to stimulants.

2. My non-stimulant (atomoxetine) can have very unpleasant and lasting side effects when ceasing treatment.

[Chelseaguy76 in reply to Loutysonsmith]

You are correct, I’ve been using natural remedies for along time, and I know I need to mitigate my symptoms better, but Vyvanse might have aggravated a auto immune issue that was healing as well, so stimulants are just not in the cards for me?!? I’m really interested in qelbree, I’ll have to check about coverage though?

[PinkPanda23]

I'm sorry to say I had similar outcomes. When I was first diagnosed at 54, I was prescribed Vyvanse and took to it like a duck to water. I felt energized and could concentrate at work. A year later, I was diagnosed with cancer and discontinued Vyvanse while undergoing chemo and radiation for a year.

When I tried to go back on Vyvanse when my chemo etc. were completed, I developed tardive dyskenesia, chewing up inside my cheeks and making weird movements with my face. They took me off Vyvanse, and we tried seven other meds with similar results - either I had TD or no discernible ADHD treatment effects from doses that were too low. I have been without meds for 8 years now. This year, we tried Bupronion and the side effects were crazy, so no more of that!

My ADHD symptoms have intensified since menopause. I firmly believe ADHD women are affected with hormonal changes. There is a webinar about that this week from ADDitude Magazine I will be watching. I realize that won't help you, but I wanted to weigh in and let you know you are not alone in the side effect department. Good luck!

[Loutysonsmith in reply to PinkPanda23]

Totally agree about menopause - it's horrendous with it's effects on ADHD. Glad you found the Additude Magazine webinar, it's great. They do some fabulous material x

[STEM_Dad in reply to PinkPanda23]

I know that any body change can change how a person can respond to a medication. (Typical examples are a child going through puberty or a teen becoming an adult. I've also heard about changes from metabolic changes, like gaining or losing weight or muscle mass, but also age related, and with menopause as you have experienced.)

I think this is the first time I've heard of such a change in ADHD medication response after cancer treatment, but both cancer and the treatments for it can make big changes in the body and brain... So I'm not at all surprised by that change.

I do think that more research needs to be done regarding the assessment and treatment of ADHD in women at all ages and stages of life, including during and after menopause. ADHD research has been so heavily focused on boys and adolescent males that the understanding of how to treat patients is very skewed.

[STEM_Dad]

My first ADHD medication was 10mg Adderall XR. According to a chart that I found, that it equivalent to 20mg Vyvanse.

So, you were started at a higher effective dose than I was. Ordinarily, doctors start at what they think might be the minimum effective dose, and then gradually increase the dosage to find the optimal therapeutic dosage. This helps to give the body time to adjust to the medication, and helps to minimize potential side effects. (This method of increasing the dosage gradually is called titration.*)

It sounds like your doctor started with a higher initial dose, instead of titrating to that level.

If my doctor had started me at 20mg Adderall XR (which was what gave me tachycardia), I might have been scared of any stimulation medications.

I'm very grateful that there are multiple options for ADHD medications now. I can only imagine what it must have been like for people whose only choice was Ritalin.

I haven't tried Ritalin or any of the related methylphenidate medications. I also haven't tried any other amphetamine medications besides Adderall XR (...except for the old formula of Sudafed, before they removed the pseudoephedrine from the OTC version, and I never liked the "medicine head" side effect that I got from it.)

*I think that some doctors just automatically start at a higher dosage that they have found to be effective for many of their ADHD patients, but because each patient's biochemistry is different, I think that doctors need to take their time to titrate from a lower dose.

[CMax3001]

I found vyvance too strong too. Different stimulants increase neurotransmitters in different mixes. You get different feelings with seratonin /dopermine/ norepinepherine increases, and each stimulant increases each to different ammounts and strengths. Its pure trial and error to get the right one.

Am currently on concerta 10mg twice a day, cause my system burns through concerta twice as fast and I get side effects after 3pm that were worse than the adhd to begin with. I have citalopram too, but have to be careful as both medicines increase seratonin, but at different levels. We found out that norepinepherine increase was my issue with vyanse (was on duloxetine at the time). So this combo after trying a few kinds was how it ended up. Its not perfect, but better than without anything.