View Full Version : No noticeable effects


deficit
05-01-16, 01:15 PM
Hello,

About six months ago, I was diagnosed with inattentive ADD and I was prescribed Ritalin shortly after. I started on Ritalin at 10mg twice a day, and worked my way up to 30mg twice a day in about two or three months. Due to lack of noticeable effects, my doctor decided to put me on Vyvanse, which I have been on since.

So I started on 30mg Vyvanse about three months ago, and my dose was increased to 50mg, and then 70mg about two months after the change from Ritalin. Again, I had no noticeable effects, just like my experience with Ritalin. My doctor added about 20mg Strattera last month, as he thought that there was a chance that it would work better.

The most noticeable effect that I have had has been random muscle twitching, which will occur at different places though mostly upper abdominal area. I am not quite sure whether this is caused by Vyvanse or Strattera, as it mostly became noticeable after I had taken Strattera for about a week or a little less. I am seeing my doctor again next week, and I am interested in hearing if any of you have any experience with these two medications or might have any recommendations.

Due to the lack of effects from either medicine, my doctors best suggestion is to take some time off and then try again in some time. Since that I have exams soon, I would really hate to quit everything as even a little help will be helpful even though I might not notice it. I will probably also end up convincing myself that the medicine was working and that I should try again, if I did decide to stop. Not that I am addicted, but I feel annoyed that Fail to have any noticeable effects on either medicine.

Any help or suggestions would be noticeable. I have heard about dexamfetamine, but as I am already on 70mg Vyvanse (lisdexamfetamine), my doctor feels that it would be a waste of time due to it being the "same" medicine.

Little Nut
05-01-16, 06:00 PM
Deficit, You in North America?

QuasarMind
05-01-16, 09:35 PM
I noticed that if I ear within 3 hours of taking Vyvanse, it completely crushes the effects.

I have had a lot of trouble with Strattera and it never really worked. You are on a low dose but the two medications on paper do contradict. You might try skipping the Strattera for a day or two to assess if it is causing problems.

I personally believe inattentive ADD is the hardest to treat. For me, it is like my brain is "sleeping" and needs a strong stimulant to wake it up. I have had more success with Adderall in two daily doses than Vyvanse but my new doctor has delusional ideations of Adderall being more addictive than Vyvanse.

deficit
05-02-16, 05:25 AM
Deficit, You in North America?

No, I live in Europe. Why?

I noticed that if I ear within 3 hours of taking Vyvanse, it completely crushes the effects.

I have had a lot of trouble with Strattera and it never really worked. You are on a low dose but the two medications on paper do contradict. You might try skipping the Strattera for a day or two to assess if it is causing problems.

I personally believe inattentive ADD is the hardest to treat. For me, it is like my brain is "sleeping" and needs a strong stimulant to wake it up. I have had more success with Adderall in two daily doses than Vyvanse but my new doctor has delusional ideations of Adderall being more addictive than Vyvanse.

I have heard good about Adderall as well, but we do not have Adderall in my country. However, I seem to have no noticeable effects on either Ritalin or Vyvanse. My main issues are procrastination and lack of focus when I am reading or attending classes, and neither medicine has not had any noticeable effects on these two. This annoys me as I am currently attending college and have to work on multiple exams and read a lot.


I might ask my doctor to try Dexamphetamine as a last shot, as it probably the closest thing to regular Adderall that is available in my country. I have also heard well about Dexamphetamine from people who switched from Vyvanse here on the forums.

sarahsweets
05-02-16, 08:37 AM
No, I live in Europe. Why?



I have heard good about Adderall as well, but we do not have Adderall in my country. However, I seem to have no noticeable effects on either Ritalin or Vyvanse. My main issues are procrastination and lack of focus when I am reading or attending classes, and neither medicine has not had any noticeable effects on these two. This annoys me as I am currently attending college and have to work on multiple exams and read a lot.


I might ask my doctor to try Dexamphetamine as a last shot, as it probably the closest thing to regular Adderall that is available in my country. I have also heard well about Dexamphetamine from people who switched from Vyvanse here on the forums.

Basically, vyvanse contains dexedrine so you would be getting the best part of the vyvanse if you took dex. I have been on stimulants a really long time and had the best success with dexedrine.

deficit
05-02-16, 10:05 AM
You might try skipping the Strattera for a day or two to assess if it is causing problems.Vyvanse.

I decided not to take Strattera today, but I still seem to have some degree of muscle twitching. As far as I know, Strattera should be out of my system by now as it should last 24 hours. Not sure what is going on.

Basically, vyvanse contains dexedrine so you would be getting the best part of the vyvanse if you took dex. I have been on stimulants a really long time and had the best success with dexedrine.

Did you notice any large difference between the two? My doctor suggests that it is not worth trying Dex as Vyvanse is basically the prodrug version. I see his point, and I am also wondering why there should be a noticeable difference other than duration of effects.

Little Nut
05-02-16, 10:21 AM
Def, Some thoughts on areas to discuss with your doctor. I am "guessing you are at the point to either increase your dosage or try a different medication. (In fact you may have tried the max dosage for the EU.) In the states the on-label max dosage of dexedrine for adults is 40mg/d. The off-label max is 60 mg I remember reading and there are experienced physicians that go above this. In the states you could switch to dexedrine and try an increased dose and still stay on-label. (If I did the math right, 70 mg Vyvanse is equivalent to ~28mg dextroamphetamine sulfate (Dexedrine). So you can go up from there. The other reason I asked about your hom country is that I remember reading that in cases where Ritalin/Dexedrine show no benefit, that Desoxyn sometimes work, but I do not think that is available in the EU.

Again those are my thoughts on areas of discussion, but there are other alternatives to psychostimulants that would appropriately be presented by and discussed with your physician. GL and Let Me Know How It Turns Out, -LN

deficit
05-02-16, 11:15 AM
Def, Some thoughts on areas to discuss with your doctor. I am "guessing you are at the point to either increase your dosage or try a different medication. (In fact you may have tried the max dosage for the EU.) In the states the on-label max dosage of dexedrine for adults is 40mg/d. The off-label max is 60 mg I remember reading and there are experienced physicians that go above this. In the states you could switch to dexedrine and try an increased dose and still stay on-label. (If I did the math right, 70 mg Vyvanse is equivalent to ~28mg dextroamphetamine sulfate (Dexedrine). So you can go up from there. The other reason I asked about your hom country is that I remember reading that in cases where Ritalin/Dexedrine show no benefit, that Desoxyn sometimes work, but I do not think that is available in the EU.

Again those are my thoughts on areas of discussion, but there are other alternatives to psychostimulants that would appropriately be presented by and discussed with your physician. GL and Let Me Know How It Turns Out, -LN

Thank you for your reply.

The highest dose of Vyvanse is 70mg in my country, and it equals to about 20,8mg Dex according to the label. The highest dose for Dex is 20mg, which is almost equal to Vyvanse. These are the highest (standard) doses, and is probably what you call on-label (suggested by the medicine manufacturer I guess).

My doctor said that he did not feel good about increasing the dosage, as I am already on 70mg Vyvanse. I could probably try to change his mind since I have no noticeable effects, but I do not know if it is worth trying if 70mg has little to no effect. I had the same issue with Ritalin, and I am not quite sure what the issue is. Coffee has never done anything for me either, even though that it is not very comparable to Vyvanse/Ritalin.

I am considering asking my doctor to try 15-20mg Dex, mostly due to good experiences from users on this forum. However, I still cannot seem to understand the difference between Vyvanse and Dex. As I have understood it, it is basically just the prodrug version of Dex. I get that the duration is different and might differ from person to person, but are the effects not the same?

Little Nut
05-02-16, 11:37 AM
In the states max dose is normally 70 mg for Vyvanse. For Dexedrine it is 40 mg. In the EU the max dexedrine dose is normally 20mg?

As for Vyvanse my "understanding" is that as Vyvanse it is not psychoactive. As it is absorbed in the bloodstream an enzyme in the liver (???) breaks it down to lysine (iirc) and straight dextroamphetamine.

As for the equivalence of Vyvanse I bet your package label is talking about 20 mg of Dextroamphetamine and I was referring to Dextroamphetamine SULFATE.

GL and let me know how it turns out.

deficit
05-02-16, 05:49 PM
In the states max dose is normally 70 mg for Vyvanse. For Dexedrine it is 40 mg. In the EU the max dexedrine dose is normally 20mg?


It says that the highest dose is 20mg but that it can be up to 40mg "in rare cases where it may be necessary". Not sure what that is supposed to mean. Perhaps people with extremely bad ADHD?


As for Vyvanse my "understanding" is that as Vyvanse it is not psychoactive. As it is absorbed in the bloodstream an enzyme in the liver (???) breaks it down to lysine (iirc) and straight dextroamphetamine.


I still do not understand the difference. If Vyvanse breaks down to Lysine and Dexamfetamine, how is this different compared to straight Dexamfetamine? Even if the delivery is different, should the effects not be very similar?


As for the equivalence of Vyvanse I bet your package label is talking about 20 mg of Dextroamphetamine and I was referring to Dextroamphetamine SULFATE.


I thought that these two were the same? It says that the equivalent of 70mg is "20,8 mg dexamfetamine". When I look at the online leaflet of straight Dexamfetamine which is available in my country, it says "5 mg tablets contain the active substance dexamfetamine sulfate".

GL and let me know how it turns out.

Thanks, and I will :)

I might ask him if it could be possible to try straight Dexamfetamine, even though that he suggests that it is not worth it as Vyvanse fails to work.

Little Nut
05-02-16, 08:11 PM
The effects of Vyvanse should be about the same. I always guessed that the Vyvanse an dexedrine have different uptake rates and on top of that your have a secondary rxn to decompose the Vyvanse, so overall the Vyvanse should take longer to show effects and will be in your system a lil longer.

Not the same. one is the amphetamine and the other is the sulfate salt of the amphetamine with a higher MW. Therefore in say 10 gram of sample, the pure dextroamphetamine would have more dextroamphetamine in it than the Dextroamphetamine sulfate. Sorry if still not clear, but simplest I can do. Past this point we get into general Chem and first term organic. Maybe someone else can do a better job if you're still interested.

Just remember 70mg of Vyvanse is ~28mg of the dextroamphetamine sulfate. So if you were able to take 40 mg of Dextroamphetamine sulfate, it would be ~ like a higher dose of Vyvanse which may make a difference.

sarahsweets
05-03-16, 11:24 AM
Did you notice any large difference between the two? My doctor suggests that it is not worth trying Dex as Vyvanse is basically the prodrug version. I see his point, and I am also wondering why there should be a noticeable difference other than duration of effects.
No offense but your doctor is a wee bit off base in the sense that yes, dex is part of vyvanse. But mg for mg, vyvanse contains a lot less dex then taking the actual dexedrine. A member here Aeon knows the conversion.
And of course its worth trying if you are satisfied with vyvanse. Its worth trying different drugs.
There is for me, a large difference in the duration and consistency in the way it works.

deficit
05-03-16, 01:47 PM
No offense but your doctor is a wee bit off base in the sense that yes, dex is part of vyvanse. But mg for mg, vyvanse contains a lot less dex then taking the actual dexedrine. A member here Aeon knows the conversion.
And of course its worth trying if you are satisfied with vyvanse. Its worth trying different drugs.
There is for me, a large difference in the duration and consistency in the way it works.

He meant that it is not worth it because it is essentially the same drug. It says on my bottle that 70mg is equal to 20,8 mg Dexamfetamine. The maximum dose for the straight Dexamfetamine (sulfate?) is 20mg. His point is that if 70mg Vyvanse has no effect, 0-20mg Dexamfetamine will no have no effect as well as it is the same drug when Vyvanse breaks down (plus Lysine).

I was not very statisfied with Vyvanse, as I did not have any noticeable effects when on it. I know that the doses are therapeutic doses and that you are not supposed to get high, but I felt no noticeable changes on procrastination or lack of focus.

I talked with my doctor today, and he agreed to let me try Dexamfetamine as I have had no luck with everything else. 10mg twice a day, so about the same amount of Dexamfetamine in dose compared to Vyvanse. The label says Dexamfetamine, but when I look at the leaflet with extra information it says "Dexamfetamine Sulfate". As I understand it there is Saccharate and Sulfate, but on my Elvanse (European Vyvanse) it just says "Dexamfetamine".

I will try my first dose tomorrow or the day after, depending on when I get it as his system was down and had trouble creating prescriptions.

I still to have some muscle twitching to some degree, even though that my last intake of Strattera was two days ago and it says that it should last for about 24 hours. Could it still be in my system, or could muscle twitching be caused by something else? It did start only a few days after starting Strattera on top of 70mg Vyvanse, which I had taken for one month prior at the same dose with no such side effects.

Little Nut
05-03-16, 02:18 PM
Deficit, great. If you see obvious improvements in your adhd symptoms, even if just partial improvements, be sure to jot them down and let your Dr. know next time you speak. -LN

deficit
05-10-16, 02:21 PM
I have taken Dex for about a week now, and thought that I would reply to this thread with an update.

The effects have not been much different from everything else that I have already tried, such as Ritalin, Vyvanse, and Strattera. I did feel something the first dose on the first day and perhaps the second dose but less noticeable, and since then it has been barely noticeable that I am taking medication just as previous medications. I am well aware that I am not supposed to hunt the euphoria, but I do however expect some noticeable effects that make me aware that I took Dex and not vitamin pills or a cup of coffee. My procrastination can be extremely bad, which is I am expecting some effects to get me started. I did however notice that it made me a little tired after about 3-4 hours of taking the medicine, but this has somewhat disappeared and only lasted the first 2-3 days.

I still seem to have annoying muscle twitches in the abdominal area throughout the day, but the twitching everywhere else has vanished after I stopped taking Strattera. I did not have any symptoms of any tic/twitch disorders before starting Strattera, and it has almost been a whole week since I stopped taking it. Could it be caused by something else, or could it be that the Strattera has not yet left my body completely? My psychiatrist told me that it takes 2-4 weeks for Strattera to start working, perhaps it takes a while to leave the body as well? The muscle twitching began only 1-3 days after starting on Strattera.

My Dex dose is 10mg twice daily. I have asked my psychiatrist if it would be possible to try a larger dose due to lack of effects.

Little Nut
05-10-16, 03:26 PM
Deficit, I am pretty sure I have this right, that 20 mg of dextroamphetamine SULFATE is equal in amphetamine base to ~50 mg Vyvanse.

In any event you had a little bit of a reaction at first. Was it ~ an hour after you took the tablet? If it was me I would at least want to work the dosage up to either the max dose your doc and you feel comfortable with or you had a really positive effects before having to switch drugs. GL and Let Me Know How it is Going, -LN

deficit
05-10-16, 03:55 PM
Deficit, I am pretty sure I have this right, that 20 mg of dextroamphetamine SULFATE is equal in amphetamine base to ~50 mg Vyvanse.

This should be about right as far as I have heard.


In any event you had a little bit of a reaction at first. Was it ~ an hour after you took the tablet? If it was me I would at least want to work the dosage up to either the max dose your doc and you feel comfortable with or you had a really positive effects before having to switch drugs. GL and Let Me Know How it is Going, -LN

Not sure if it was an hour, it might have been a little less or more, but it did disappear after about 3-4 hours.

I have already tried Ritalin, Vyvanse, and Strattera, and since that no other medicines are available I have no option but to try higher doses with Dex. If this does not work, I might ask my psychiatrist to try higher doses with Ritalin. My end dose with Ritalin was 30mg twice daily, so 60mg daily, which I tried for a month before switching to Vyvanse due to lack of effects. He did not feel comfortable about trying higher dose and would rather have me try other medicines.

I am still unsure about my muscle twitching which occurs in my upper abdomen, close to celiac plexus/solar plexus. I might call my doctor tomorrow and make an appointment to get it checked. It started just after starting on Strattera, but has still been bothering me even though I stopped taking it about a week ago. It might be caused by something else, but worries me as it started just a few days only after starting on Strattera.