View Full Version : According to my doctor, this is my last medication option


JFK4525
11-07-16, 11:08 PM
I apologize in advance as this may get pretty lengthy but i would greatly appreciate it if anyone had any helpful input.

A little background about my situation to start i guess:

I am 21 years old and I have ADHD. I was diagnosed at age 9. Tried stratera early on but apparently it didn't work. I don't really remember that time very well. No other medications until i was a freshman in high school, I didn't know i had ADHD yet at this point. As far as I know I was prescribed vyvanse and Adderall at different times in varying doses until I was about 16. I remember these terrible terrible crashes from the meds every day after school. I didn't know why it was happening but i felt really bad so I would just hide in my basement and play xbox until it passed. neglect my homework, responsibilities, and when my parents would try to tear me away from my hiding hole..... I remember having really unpleasant arguments and fights with them. They adjusted my dosage for a couple of years and eventually when they told me I had ADHD I was about 16 or so.

I ended up wanting to join the military and the recruiter told me I needed to be off the meds for 6 months and prove i could maintain normal life functions without it (basically I had to provide report cards to show my grades before and after the meds to show there was no effect) so I said fine, 6 months starts tomorrow. Well plot twist, they didn't take me anyways, dragged me along for a couple years until I found out the documentation from my original doctor in another state had been destroyed. but that little bit isn't terribly relevant to this. sorry for the tangent.

I was doing fine through my first semester of college... relatively. I was heavily reliant on caffeine but i had a 3.47 gpa. in the first month of my second semester i decided it was a terribly unhealthy habit to self-medicate with coffee and energy drinks and went to my doctor to try medication on my own. started off with adderall and everything was okay at first.

I need to clarify that I have always been responsible with my medication, never given it to anyone, never abused it, with a few exceptions of taking my second dose of the day a little too close to the first when I knew I had a big exam or stressful early part of the day, but no more than a dozen times in the last 3 years.

Since then, I have been on Vyvanse, Adderall, Ritalin, Stratera, dexadrine, and Welbutrin (combined with dexadrine). I always end up with the same crashes part way through my day.

My head goes into this fog like I have tunnel vision or horse blinders or something. often, though not always, accompanied by a headache.

lately, for the last year and a half i think, I've been on vyvanse 70mg per day split into 50 in the morning and a booster of 20 later on. most of the time i don't take the 20 because my class schedule doesn't really go too late in the day.

over the last 6 months or so I've noticed a "personality shift" for lack of a better term. I used to be goofy and fun loving and always happy about anything and everything, but I seem different. My friends and my roommate and my girlfriend have all noticed it. I'm more serious, less outgoing, and the crash i described is unavoidable even with diet, exercise, and anything else there is to try. Most recently I've noticed my face twitches when I smile. my muscles just don't want to stay like that for more than a few seconds.

My psychiatrist said the personality shift i described is normal, he said the goofy kid was likely a coping mechanism for the fact that I couldn't perform as well as i should. he said it was just the "cost of doing business." and I understand his meaning perfectly. We discussed the idea of me getting away from all medication and just trying to learn to deal with my ADHD on my own if this last one doesn't work because I've been on just about every medication that he is able/willing to prescribe (I'm not sure which of the two it is.)

I really want this to work. I'm a senior in college graduating early this december. I need to walk out of college happily and proud, not crawl out barely feeling like myself. If this medication doesn't work for me, I don't know if I'll be able to make it through the rest of this semester alone. It's been so long since I've been just me without the help of some sort of stimulant. There's no way that just nothing works for me. there has to be a reason, right? I still want to get off of this stuff when I'm done with school in december but I need to survive the next 2 months first. I know I'm a smart guy but I need a week or so to detox myself before I can function without medication normally, I don't have that Kind of time right now, I have way too much on my plate to take care of.

I refuse to just up my dosage until I feel fine all the time until I graduate. I don't want more drugs, I want drugs that actually work for me. My old psychiatrist before he moved away to a different state was a little too easy to up the dosage, my new one is very thorough and i respect him a lot. I remember resisting the old one telling him I would rather try a different med than take more of something that doesn't help.

Sorry again for the super long rant, if you couldnt tell my medication wore off a long time ago today. If anyone actually read that all the way through, thank you and I am open to any and all suggestions and input.

Thanks again

Pilgrim
11-07-16, 11:35 PM
This feeling you describe I think is fairly common and I think your doctor is exactly correct in the change.
I've gone through this and it's confronting, almost like your feeling really boxed in.

Recently I saw this thing on U tube and at first I didn't pay much attention to it, I saw the number of views and it was low, one of these guys that in 4 minutes is going to change the way you look at the world.

It did, he talked about the thing with ADD when you just keep at it and at it, and he said you've got to see this and understand it's part of the condition. Just that rumination that begins and you can never get away from it. It's part of what we go through.

Just by hearing that I felt a weight off my shoulders.

dvdnvwls
11-08-16, 01:52 AM
You sound like a simple dosage reduction might fix everything. Try that first. For example, go to 40/20 (or 40/30?) instead of 50/20.

sarahsweets
11-08-16, 05:28 AM
I was doing fine through my first semester of college... relatively. I was heavily reliant on caffeine but i had a 3.47 gpa. in the first month of my second semester i decided it was a terribly unhealthy habit to self-medicate with coffee and energy drinks and went to my doctor to try medication on my own. started off with adderall and everything was okay at first.

I need to clarify that I have always been responsible with my medication, never given it to anyone, never abused it, with a few exceptions of taking my second dose of the day a little too close to the first when I knew I had a big exam or stressful early part of the day, but no more than a dozen times in the last 3 years.

Since then, I have been on Vyvanse, Adderall, Ritalin, Stratera, dexadrine, and Welbutrin (combined with dexadrine). I always end up with the same crashes part way through my day.

What about adderall was ok when it did work? What kind of symptom relief did you get? What dose were you on?



lately, for the last year and a half i think, I've been on vyvanse 70mg per day split into 50 in the morning and a booster of 20 later on. most of the time i don't take the 20 because my class schedule doesn't really go too late in the day.
over the last 6 months or so I've noticed a "personality shift" for lack of a better term. I used to be goofy and fun loving and always happy about anything and everything, but I seem different. My friends and my roommate and my girlfriend have all noticed it. I'm more serious, less outgoing, and the crash i described is unavoidable even with diet, exercise, and anything else there is to try. Most recently I've noticed my face twitches when I smile. my muscles just don't want to stay like that for more than a few seconds.

IME vyvanse caused those feelings for me too. Some of it could be that the dose is too high but in my case it seemed to be the delivery method.

My psychiatrist said the personality shift i described is normal, he said the goofy kid was likely a coping mechanism for the fact that I couldn't perform as well as i should. he said it was just the "cost of doing business." and I understand his meaning perfectly. We discussed the idea of me getting away from all medication and just trying to learn to deal with my ADHD on my own if this last one doesn't work because I've been on just about every medication that he is able/willing to prescribe (I'm not sure which of the two it is.)
I am not saying that medication is the only way to treat adhd but making the kind of lifestyle choices you are talking about works best most of the time with medication.


I really want this to work. I'm a senior in college graduating early this december. I need to walk out of college happily and proud, not crawl out barely feeling like myself. If this medication doesn't work for me, I don't know if I'll be able to make it through the rest of this semester alone. It's been so long since I've been just me without the help of some sort of stimulant. There's no way that just nothing works for me. there has to be a reason, right? I still want to get off of this stuff when I'm done with school in december but I need to survive the next 2 months first.
Why say "get off this stuff" when you are done with school?ADHD impairs your life in other areas then just school or work. Its a chronic, everyday disorder that would need consistent treatment and adhd never goes away and cant be cured. If it begins to work for you, wouldnt you want an improvement in your life beyond grades and studying?

I know I'm a smart guy but I need a week or so to detox myself before I can function without medication normally, I don't have that Kind of time right now, I have way too much on my plate to take care of.

Maybe I am misunderstanding you but I was under the impression that stimulants are not working for you now, so I am unsure of how you would need a week to 'detox' from something that isnt working?

I refuse to just up my dosage until I feel fine all the time until I graduate. I don't want more drugs, I want drugs that actually work for me. My old psychiatrist before he moved away to a different state was a little too easy to up the dosage, my new one is very thorough and i respect him a lot. I remember resisting the old one telling him I would rather try a different med than take more of something that doesn't help.

I get it but being 'easy' when it comes to upping the dose is a blessing when you think about how many people are denied treatment, or dose increases from doctor's that dont know their stuff or are constantly in cover-your-as* mode.

Meds often take many tries with type and dosages to get it right. Do you mean you tried many kinds of meds and dosages? Upping the dose shouldnt be avoided because of a fear of tolerance (not as common a people say it is) or because of some invisible line that will be crossed. There are many here who have dosages of medication that people who dont know any better who would say the doses are "too high" or not safe.
There are also many who have great luck with meds at doses that some people would say are "too low".
I totally want to help you, and I am not trying to sound preachy or something, I am just trying to get a better grasp on what you are saying.

C15H25N3O
11-08-16, 06:01 AM
You sound like a simple dosage reduction might fix everything. Try that first. For example, go to 40/20 (or 40/30?) instead of 50/20.

I think so too. 40/10 works great for me as a booster. If I need a power-booster I
take 40/15. I would check out decreasing the dosage after one or two days break.
A small break gives a better taste for reductions.

I rarely boost with 1/4 to 1/3.

JFK4525
11-08-16, 12:51 PM
What about adderall was ok when it did work? What kind of symptom relief did you get? What dose were you on?
With adderall it's been a while, i think the highest i got was 60 mg xr at most. I'm not 100% sure but that sounds right to me. i think it was a 40/20 split on adderall for the dosage schedule. after the initial week or two it was just like everything else, some symptom relief early in the day and then the rest of my day with headaches and brain fog and no attention span. I remember that i hated adderall but not nearly as much as i hated ritalin.
Why say "get off this stuff" when you are done with school?ADHD impairs your life in other areas then just school or work. Its a chronic, everyday disorder that would need consistent treatment and adhd never goes away and cant be cured. If it begins to work for you, wouldnt you want an improvement in your life beyond grades and studying?
I never really liked the way the medications made me feel. they may have given some symptom relief and make school easier for a fraction of my day but I spend the rest of my day feeling like garbage. I'm sick of that. Once I graduate if I don't find a solution I'm planning on tapering down and getting off the vyvanse for who knows how long.
Maybe I am misunderstanding you but I was under the impression that stimulants are not working for you now, so I am unsure of how you would need a week to 'detox' from something that isnt working?
I use the term detox loosely. What I mean is that even though the meds don't give me positive side effects all of the time, I frequently have negative ones. And I sometimes have an open enough schedule that I can not take medication for a day during the weekend and I still feel worse without it than with it. every summer and christmas break i stop cold turkey and it takes about a week to stop feeling the withdrawal of not having the medication. I don't have that week of free time between now and december.
Meds often take many tries with type and dosages to get it right. Do you mean you tried many kinds of meds and dosages? Upping the dose shouldnt be avoided because of a fear of tolerance (not as common a people say it is) or because of some invisible line that will be crossed. There are many here who have dosages of medication that people who dont know any better who would say the doses are "too high" or not safe.
There are also many who have great luck with meds at doses that some people would say are "too low".
With Adderall, Vyvanse, Dexadrine, and stratera I was on a variety of dosages over several months. The only one that I did not try to adjust the dosage with was Ritalin. Ritalin just made me feel jittery and "jacked up" like i'd drunk a gallon of coffee in a few minutes. In my experience and my own personal opinion, Ritalin is the devil in little orange bottle.

Overall, I guess I would say that I felt increasing the dosage would only increase the negative side effects from the medication even if there was a more euphoric effect for the first few days being on the higher dose. That's what happened every time my dosage went up on every stimulant and non stimulant drug I've been on. Felt great for a few days and then back to the same old sh*tty feeling all day long.

Pilgrim
11-10-16, 12:50 AM
I think I didn't explain myself that well.

In regards to medication, ' if it helps take it ', if you tolerate side effects,

The other thing, just recognise when your going down, have a default mode,

go skydiving all weekend, cave diving, roller skating. IMO, when you start to feel this way

you need to be able to detach for a bit, even a weekend. I might have your situation wrong..

dvdnvwls
11-10-16, 03:10 AM
Feeling like garbage a lot of the time from ADHD medication is another clear signal that a lower dose is needed right away.

JFK4525
11-10-16, 10:28 AM
I think I didn't explain myself that well.

In regards to medication, ' if it helps take it ', if you tolerate side effects,

The other thing, just recognise when your going down, have a default mode,

go skydiving all weekend, cave diving, roller skating. IMO, when you start to feel this way

you need to be able to detach for a bit, even a weekend. I might have your situation wrong..

I understand your meaning. I should have a backup plan in the back of my mind at all times for when i start coming down by doing something i enjoy for a while. I try to as much as i can but I dorm at my university so money is tight since i try to not work while I'm here. It's easier to focus on school if my only distractions are school, clubs, and friends.

I'm starting to lower my dose on my own a bit. Last week I had a slip up where I made the mistake of taking a pill (50mg) when my alarm went off, and hitting snooze. Then when the alarm rang again, I was too drowsy to remember the first pill i had already taken and took another 50mg. not the end of the world but it kinda messed with my head the rest of the week. taking just 50 and sometimes the extra 20 in the afternoon felt like not enough but the past few days this week I've been at just 50 and today I feel fine. probably because i was able to sleep a regular amount.

I have a terrifying physics exam tomorrow (friday) morning and then hopefully I'm going to start lowering my dose to 40 per day and who knows how much lower from there. I also need to get an appointment with my psychiatrist that's sooner than mid-January about this.

Thanks for the insight guys, it's greatly appreciated.

Oh! I almost forgot to mention but for a few months (july to early october) i was having some issues with not being able to relax my jaw. Saw a dentist, he said there was nothing mechanically (my words not his) wrong with my jaw as far as like teeth shifting or muscle/joint problems. saw my regular doctor and he said it could be stress induced but I wasnt stressed at all when this started or really very much between the start and when I saw my doctor. the only thing i can think of would be vyvanse all of a sudden after a year causing me to clench my jaw all the time but I wouldve seen that sooner since i hadnt changed my dose in a year or more?

It's mostly resolved now but still comes back from time to time. not really that important i guess. who knows.

thanks again guys and/or girls whoever had input on my problems haha

JFK4525
02-13-17, 06:48 PM
Update since I have not posted anything in a while.

I graduated with little to no trouble at all, not even from physics (which I got a B in!!) I've been working full time at a local company my brother works for as a forklift operator which is nice because I'm constantly thinking and planning so I'm not bored to tears with repetitive actions like the temps working on the assembly line.

I think I have identified the cause of the "crashes" I've been experiencing for the last few years that I always assumed was a timing issue with my medication. I was driving to visit my girlfriend who is still in college and as it got dark, I noticed the same "crash" symptoms starting to come on and I realized that the headlights of the other cars on the thruway were hurting my eyes. I did a very brief google search later to confirm suspicions I was having for a little while and found out that light sensitivity is a symptom of migraines. I suspected this to be the cause for my feeling this way a couple of months ago but came to a finalized conclusion just this weekend.

My best friend in high school used to describe the tunnel vision and very distinct headaches and it clicked with me recently. If I'm just having migraines late in the day after work then hopefully my psychiatrist can confirm or deny my hypothesis and recommend what to do if I'm right about this.

I'm still on Vyvanse at 70mg per day, usually I only take 50mg per day but I have the extra 20mg if I know I'm going to have a long day and need a boost. Does/can Vyvanse cause migraines? The literature that comes from the pharmacy says to notify your doctor if you experience headaches, should I be concerned? I'm not supposed to go back until May but I'm going to call tomorrow and get a sooner appointment to get this figured out.

As always, any and all input is appreciated. Thanks internet people.

dvdnvwls
02-13-17, 07:46 PM
High doses of Vyvanse can cause that.

PLEASE, LOWER YOUR DOSE. Analyzing can wait, at least till you try a lower dose and can confirm that the migraine-ish symptoms are still there.

For a start, how about a dose of 30 + 10, and see if those symptoms go away.

Taking a too-high dose is not doing yourself any kind of favour.

Oh... Just in case, make sure you're eating three healthy meals a day and drinking a lot of water all day. It really helps.

JFK4525
02-15-17, 06:39 PM
I've gotten these headaches and exact same symptoms from every variation of medication and dosage I've tried over the span of 3 years now. My doctor still has my blood tested once a year to make sure that I didn't inherit the thyroid problems that my dad currently deals with (he only has half a thyroid thanks to tumors and such). I was better about water in college when I could have a bottle on my person at all times but I still make sure to eat and drink regularly.

The longevity of the Vyvanse is fine, but I get a headache that starts in my temples followed by sensitivity to lights which makes the headaches worse and tunnel vision such I always described in my posts as feeling foggy-brained. During the day my medication does exactly what I need but around 3 or so all of that and probably more that I can't identify or verbalize too.

I'm gonna move my appointment closer than may during my lunch break tomorrow and see what happens. I'll bring up the high dosage thing too but he always starts me out low and he's very careful and thorough so I do respect and trust his judgement more than my last doctor who would up my dosage as much as I asked him to (I never did of course, I said no to his higher doses more than I ever said yes)

Thanks for the advice, internet, and I'll update when things happen or don't happen