combination therapy for ADHD

[starsallover]

Does anyone have experience using combination therapy of a stimulant plus a non-stimulant? From what I understand, you take the stimulant in the morning and the non-stimulant in the late afternoon or evening.

I recently started using Adderall ir. Having a lot of trouble in the evening and at night though. I read about combination therapy and I'm going to ask my doctor about it tomorrow.

[STEM_Dad]

I haven't heard of it called "combination therapy", but I have heard of people who have been on both stimulants and non-stimulants together.

The stim+nonstim combination that I've heard of most is a stimulant plus Guanfacine (Intuniv).

~~~

I take generic Strattera, and it works 24x7 because it builds up in the system in order to be effective.

When I first started on it, I had to take it in the evening because it made me feel sleepy within the first few hours. After the first few weeks, I was able to take it in the morning when I take my vitamins. That was important to me, because I was worried that I might miss a dose if I didn't attach my meds to a routine (i.e. Habit Stacking).

I am considering asking my doctor for an IR stimulant to help me get out of bed in the morning and start moving with my day. Mornings are the hardest time for me to get anything done.

[Ratio]

Hi. Although it was before I was formally diagnosed with ADHD, a psychopharmacologist prescribed lexapro and ritalin to be taken together. He was treating me for debilitating depression. As it turns out, it was a misdiagnosis but the treatment was incredibly effective. Years later, when I was diagnosed with ADHD, the psychiatrist affirmed the treatment. After some years, it was less effective but it was a miracle when I began the two drug treatment.

[crossfitter15]

I am on vyvanse (stimulant) and guanfacine (non stimulant) and I take both at the same time per docs recommendation. I fell like it helps for the most part. It does (at least for me) take some getting used to.

[samami in reply to crossfitter15]

I was on Guanfacine and then Vyvanse separately. Thinking of taking both together. They do such different things for me. The guanfacine helps with anxiety and the Vyvanse with motivation and concentration.

[Alm751]

I was on Adderall for several years but then developed some twitches so my dr took me off and started me on Strattera. Adderall was great. Strattera did nothing for my ADHD so I asked her to take me off. Don't want to put meds in my body if they don't work.

[STEM_Dad in reply to Alm751]

Very understandable.

Since Adderall is amphetamine based, your doctor probably wants to keep you off of any related medications.

Has your doctor considered the other types of stimulants, based on methylphenidate? (Those would include Ritalin and Concerta.)

Also, some people with ADHD respond well to Wellbutrin (bupropion), a non-stimulant which treats both dopamine and norepinephrine deficiency. It has also been used in combination with Guanfacine.

[Alm751 in reply to STEM_Dad]

I’m actually on Wellbutrin! Thank you for your response.

[Slmndrs]

I take Wellbutrin together with generic vyvanse, both in the morning.

Vyvanse is the longest acting for me and generally gets me through the day, but when I was on concerta, it also helped to take a small dose of immediate release Ritalin in the afternoons (before the concerta completely wore off). The problem was remembering to actually take that pill. My doctor was concerned about the sleep impact but I found that it actually helped me have the executive function to put myself to bed and a quieter mind to fall asleep. But actually with all the stimulants I do sometimes need to give myself a day off and/or take sleep aids.

[Alm751]

thank you for your response. I’m on Wellbutrin. I have sleep apnea - just diagnosed- and bc I’m so tired my focus is really off.