View Full Version : Tried Adderall IR, Adderall XR, Vyvanse, and Methylphenidate. What should I do next?


PhilipL
02-28-17, 03:50 AM
I am a 24-year-old male. Very athletic, and a very fast metabolism as indicated by my thyroid activity + a resting metabolic rate test.

First, I'll start with the useless. Methylphenidate in all forms does not work very well for me. Leaves me feeling high and hyper focused for an hour, then does nothing for the rest of the day.

Adderall IR also leaves me feeling a bit high at a 10 mg dose. Has to be taken every few hrs to sustain effectiveness throughout the day.

Adderall XR definitely provides me with the most focus, at a 20 mg dose lasting until the middle of the day.

On both forms of Adderall, I notice increases to cardiovascular activity/fight or flight response.

Didn't realize how pronounced this effect was until I switch back to Vyvanse after trying it two years ago. After trying a few doses, I am currently on 50 mg Vyvanse, and the cardiovascular effects are nearly nonexistent when compared to Adderall (which I understand could be related to the absence of levoamphetamine.)

With that being said, I have noticed that even on 70 mg of Vyvanse, the amount of focus I have is no where near the level of focus I have on Adderall XR at even a 20 mg dose.

I'm wondering if there is some combination of medications that might benefit me more than the options I have tried, or if a stronger, lower dose amphetamine might provide better results than Vyvanse in increasing my focus to the levels I see on Adderall without pronounced impacts on my cardiovascular activity.

aeon
02-28-17, 11:25 AM
That’s because Vyvanse is so much weaker than Adderall for the same milligram dose.


Cheers,
Ian

PhilipL
02-28-17, 12:51 PM
Thatís because Vyvanse is so much weaker than Adderall for the same milligram dose.


Cheers,
Ian
Thanks for the quick response. I guess my question was more geared toward why I would need 50+ mg of Vyvanse to get a lower affect on my attention than I get on both forms of Adderall. Either the l-amphetamine is a gift and a curse that helps my attention and messes with my heart, or my body is not able to do whatever chemically needs to be done to cleave the d-amphetamine in vyvanse.

Fraser_0762
02-28-17, 01:41 PM
If stimulants are causing you high blood pressure and palputations. It's perhaps worth trying an SSRI such as Strattera or Wellbutrin. They take longer to come into effect (usually several weeks) but are considerably easier on the body.

aeon
02-28-17, 01:45 PM
If stimulants are causing you high blood pressure and palputations. It's perhaps worth trying an SSRI such as Strattera or Wellbutrin.

Neither Strattera nor Wellbutrin are SSRIs.


Cheers,
Ian

aeon
02-28-17, 01:46 PM
Thanks for the quick response. I guess my question was more geared toward why I would need 50+ mg of Vyvanse to get a lower affect on my attention than I get on both forms of Adderall. Either the l-amphetamine is a gift and a curse that helps my attention and messes with my heart, or my body is not able to do whatever chemically needs to be done to cleave the d-amphetamine in vyvanse.

Or, as I said, Vyvanse is simply a weaker drug at the usual clinical doses, because it has less dextroamphetamine base to begin with.


Cheers,
Ian

elite242lbs
02-28-17, 02:46 PM
I lift heavy weights and nutrition is very important to me so I had to find a med that wouldn't interfere with my lifestyle. Vyvanse made me euphoric and energetic for a few hours but with a scatter brain. Couldn't focus very well. Adderall XR had the worst sides for me and when I would go to the gym I just didn't feel good. I tried to move to Dexedrine particularly bc of my health insurance bc I thought that Adderall XR would be my med of choice but instead my doc let me try Desoxyn. My heart rate is unnaffected, I get my meals in and I have had some great lifting sessions being able to turn it on when needing to get in the zone. My dose now is 15mg with a breakfast shake and 10mg with another meal. I tried three doses per day but the third dose no matter what brings the most sides. So I stick to those two doses and that provides better coverage/duration than other meds I have tried. It's not for anyone and you will need to mail order to avoid problems the hassle of getting it filled conventionally but it's all worth it for me at least. Even Dexedrine I was told by pharmacies that they don't stock or offer it. The bad side is that it tends to be thought of as more neurotoxic than other meds that are commonly prescribed.

Fraser_0762
02-28-17, 03:05 PM
Neither Strattera nor Wellbutrin are SSRIs.


Cheers,
Ian

Ok, if you want to be more specific. Strattera blocks the reuptake of Serotonin and Norepinephrine. Wellbutrin blocks the reuptake of Dopamine and Norepinephrine.

The main point of the post is that they act somewhat differently than stimulants and are often used as an alternative.

sarahsweets
02-28-17, 03:16 PM
My instinct is to tell you that your adderall xr dose is too high. Not as in daily total but all at once. I have absorption issues so I have higher than normal dosages but I break them up over the course of the day. Now, my day starts really early (because I like it that way) so my three main doses are at 4am, 8am and 2pm. My booster doses are at 11 and 3. This helps everything run smoothly for me with no peaks or valleys. It could be that 20mg xr is either too high in general or too high all at once.

PhilipL
02-28-17, 04:35 PM
Thanks everyone for input so far. I guess I forgot to mention that before resuming treatment for adhd when I moved to college we had tried various SSRI and SNRI medications and the general consensus was that these were causing more anxiety, indicating that my problem was likely related to dopamine. I have the perfect focus/attention/motivation on Adderall XR 20, but the heart side effects are sometimes anxiety-inducing. I am a 5'10" 135 lb male very healthy and active. I notice it's much harder to exercise on Adderall XR than Vyvanse and believe that it "may" be related to the PNS effects and more specifically the CNS effect of a higher affinity for L-amph to the NE receptors. Vyvanse has the exact effects I am looking for, but even at the maximum dose of 70mg I find that by the time the medication kicks in and has a chance to build up in my system, it starts filtering out and never reaches a blood level high enough to optimally maintain my focus. I may ask about splitting up the Adderall dose, it's just frustrating that XR 20 works so well in the morning and not in the afternoon, and affects my heart moreso than Vyvanse which ultimately does not help alleviate the focus problems as much as it does the hyperactivity problem.

Sorry for the physio/pharmacology lingo... I'm a physiology graduate and take graduate level coursework in physiology/pharmacology so naturally I want to hypothesize what is going on here.

Main concern with Straterra is that Adderall XR also effects NE receptors and I'm seeing a more desirable but less profound result on the more selectively dopaminergic amphetamine, Vyvanse.

PhilipL
02-28-17, 04:39 PM
Sorry for the double post I was awaiting moderator approval and my attention is split between this and my job...

I would also like to add that Adderall XR at 10 and 15 mg still affects my CV system while providing a less effective treatment for my attention deficit. I am combined type, but more attention-deficit than hyperactive. It's just frustrating because I felt like Adderall XR 20 was perfect (minus the CV effects and not working after lunch time) until I tried Vyvanse. Then I realized that both have traits I want from a treatment, and both have different effects that kind of sway me back and forth between the two. I'm almost at that point where I am so frustrated with both medications that I just want to stop treatment and let my life spiral out of control. The absence of amphetamine has caused great disaster at previous points in my life, but the limbo between Adderall and Vyvanse is causing enough dissatisfaction that I can't simply get over it and choose one over the other.

Last edit while I'm on break. Vyvanse dose was not kept above 50 mg due to no increase in focus and increase in anorectic side effects. My BMI is already very low and doctor did not see benefit to an increase in appetite suppression with no increase in focus.

aeon
02-28-17, 05:26 PM
Ok, if you want to be more specific. Strattera blocks the reuptake of Serotonin and Norepinephrine. Wellbutrin blocks the reuptake of Dopamine and Norepinephrine.

The main point of the post is that they act somewhat differently than stimulants and are often used as an alternative.

Indeed true about Strattera, and the picture with Wellbutrin is a little more complex:

The third paragraph, in particular, is interesting. (Wikipedia) (https://en.wikipedia.org/wiki/Bupropion)


Cheers,
Ian

PhilipL
02-28-17, 07:38 PM
Indeed true about Strattera, and the picture with Wellbutrin is a little more complex:

The third paragraph, in particular, is interesting. (Wikipedia) (https://en.wikipedia.org/wiki/Bupropion)


Cheers,
Ian
My doctor seemed to believe that most people who require moderately high doses of amphetamine do not tend to respond to Wellbutrin very well. It would only be used for someone like me if every amphetamine option were causing cardiovascular problems or if a low dose of Adderall was working but not necessary to maintain a relatively "normal" quality of life. Also more beneficial in people who have been diagnosed with depression and ADHD together. I guess my question here is there any amphetamine option that has the level of efficacy as Adderall but the lack of adverse cardiovascular side effects that are more closely related to norepinephrine stimulation. Sorry for the complexity of my questions. Just trying to educate myself so I can possibly understand what treatments might be more effective than others.

cobain67
03-01-17, 02:26 AM
Dexedrine ER or IR:)