View Full Version : Couple o' questions - low mood swing and cold!


willow129
03-09-17, 07:44 PM
Hi friends!
So I have a medication consultation with my doctor tomorrow,

I take Adderall 30mg XR, one a day in the morning...I've been at that dose for, oh I dunno, maybe a year now.

I am noticing a couple things and since there are so many people here who have a lot of experience with Adderall I'm just curious to hear what you think.

This is for anyone who is wondering about Adderall/meds in general:
Personally for me, overall it's good. I have a to-do list online that I use and it has a timer so I can see how much time I've spent on task and how many things I've gotten done, so from that website I have concrete evidence that I am getting more accomplished now. I am pretty used to how I am on meds, but I forgot to take it a couple days ago and oh my GOSH was I WIPED after work. Whew.

Negatives:
Low Mood:
I hear about this a lot from Adderall, At Work me is pretty different from Weekend me so it has a different feeling:

Weekdays: I'm pretty consistent, I take my pill at around 8:30 or 8:45 and I notice that around 12:45/1 I have a low mood, just, kind of unenthusiastic about life's demands, unenthusiastic about seeing my next group of students. It's not terrible but it's there, and it's not a thing I can shake off. I think my students (in their intuitive way) feel it from me because my classes at those times are not super enthusiastic either. I don't think that I'm like mean or anything, just...a little bleh, maybe a tad irritable. Now, that is after my lunch, but I don't think it's related to hunger/digestion. It IS the start of the 2nd half of the day, after I have a break, so that's why I think I would be a little out of it anyways but, it's at least partially artificial as well.

Weekends: the low is DEFINITELY Adderall related, and it's noticeable enough to me that I've sometimes considered not taking my meds because it's annoying to experience. Like I'll take the medication, a while later, it varies, but an hour or more later I am noticeably more clear headed and motivated, maybe even slightly better mood, not crazy just, I can face the world - and then a bit after that I'm overwhelmed and anxious about how much I have to do, agitated, fidgety, like if I'm out with friends I want to get home right away. I mean, I have so much I have to do on the weekends, a little anxiety to get it done is good, but I wish it didn't feel so depressing. I think in general if my work was more under control it might not be such a downer but, it's kind of annoying that it's happening at all, and the mood swings are like clockwork.

That being said, the extent of the mood swings do vary depending on sleep and probably also just general life stress too.

I was diagnosed with GAD as well. Bigger picture, Adderall seems to have helped with this and my panic attacks/agoraphobic tendencies.

Questions:
Is this something I just have to deal with as best I can do you think, or are there possible solutions? Does it sound like too much or too little, to any of you?
I guess what I've read here is that some people crash when the medication is wearing off, and they will take like an IR or something to ease that.
Do people also have a crash in the middle of the dose? Is that a thing?

I'm also not crazy about the artificial highs in mood I've had sometimes when changing dosing. I want calm, level, clear-headed. I dunno. I probably just worry too much, anyways, I'm going to present all of the above to my doctor. I guess the reason I wanted to post here is because I don't know how much my doc knows about Adderall actually. My psychiatrist left the practice and then the center I was going to couldn't find someone to replace her and so sometimes they had a substitute prescriber but sometimes not and I was randomly on and off meds, so getting my doctor to prescribe was kind of out of desperation. She's a nice lady and enthusiastic and I feel like she listens, but, I just don't know about this part of her expertise :)

Cold Temperature
The OTHER thing is that, mostly if I'm lacking in sleep, I get really cold in the afternoon! BRRR. My hands freeze!!! I do a lot of circle games and stuff with my little kids, and I see all of my little ones in the afternoon and my kindergarteners are always telling me how cold my hands are lol. It took me a while to realize but this is not that it's cold in my room in the afternoon, it doesn't matter where I am, and the timing is consistent.
Is THIS something to be worried about??? Is it doing things to my circulation???? Eek!

aeon
03-09-17, 08:04 PM
mood: I will get low mood from Dexedrine when my dose is too low, but not when the dose is correct.

cold: vasoconstriction is a known side-effect of psychostimulant medications for ADHD. If it isn’t progressing to tissue loss, it isn’t something to worry about, though you may have to take care to protect the extremities in cold weather and/or exposure to cold.

Also, vasoconstriction can interfere with perfusion of the genitalia during sexual activity. For men, this means erectile difficulty; for women, this means lack of engorgement of the vulva.


Cheers,
Ian

Postulate
03-09-17, 10:15 PM
Hey Willow, you say your mood is down at 12:45 every day. At what time do you have lunch?

willow129
03-09-17, 10:22 PM
hm it can kind of vary, my Monday schedule rotates around so I tend to snack on Mondays (preferred method of eating), but...like, 12ish Mondays and Tuesdays, 12:30 Wednesdays and Thursdays.

I have classes at 12:50 on Mondays and Tuesdays so I have to be done eating by then (I say this because Adderall definitely affects my appetite so I have to make sure I'm actually eating my lunch lol), and Wednesdays and Thursdays need to be done eating by 1:15ish

Postulate
03-09-17, 10:57 PM
Well, if we go back to the basics of Adderall pharmacokinetics:

http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/021303s005lbl.pdf

I'd like to bring your attention to a section of page 2:

https://s22.postimg.org/s0jpjhcz5/Untitled.jpg


As you can notice, a meal that is high in fat will reduce the rate of absorption because Tmax is increased by 2.5 hours. Tmax is the time when the Adderall blood levels reach a peak. And if you do a quick integral, given that the dose is the same, forcefully the absorption rate decreases. Pardon the author's French, by extent he meant how much of it will absorb at T infinity, naturally, that will not change, aka. bioavailability.

So, your first dose taken at 8:45 will increase fast because I assume you don't take a huge meal in the morning, and whatever increases fast also crashes fast, that, combined with the decrease in rate caused by your lunch may explain the temporary decrease in medication efficiency.

willow129
03-09-17, 11:18 PM
huh! Interesting. Sooo eating more in the morning may help me not crash so noticeably? (oof, I love breakfast, but I'm so sluggish in the morning lolol that is going to be a difficult adjustment for sure >.<)
I'll keep that in mind! Thanks for the info

Postulate
03-09-17, 11:51 PM
huh! Interesting. Sooo eating more in the morning may help me not crash so noticeably? (oof, I love breakfast, but I'm so sluggish in the morning lolol that is going to be a difficult adjustment for sure >.<)
I'll keep that in mind! Thanks for the info

Even better, you can get your doctor to prescribe a 5mg IR booster to take at 11am, and if dose wise you need to stay at 30mg/day, I think there is a 25mg XR, so in that case, 25mg XR in the morning with 5mg IR at 11am should do the deal.

There is also another method involving 2x XR. Say instead of taking 1x 30mg XR at 8:30am, you take 1x 15mg XR at 8:30am and another 15mg XR at 10:00am, what you did is you delayed the onset and concentrated more of it when you need it most (11-4), and also increased duration by 1 hour.

Vyvanse would sound like taking 5mg XR every hour. Have you tried Vyvanse?

cobain67
03-10-17, 01:20 AM
Pardon me for the stray in topic focus, but does anyone know how food delays absorption of IR meds, namely Dexedrine? Does it delay peak concentration as shown with Adderall XR? Just trying to keep stable blood levels as much as possible.. Thank you kindly.

willow129
03-10-17, 01:28 AM
Ok, ::nodnod:: Yeah that makes sense to me. I'll be curious to see what she recommends too but I would not be surprised if it ends up being some kind of XR + IR = 30 mg. I didn't know if XRs come in 5s, like 15 or 25... you know actually now I'm remembering, I did have a period where when psych was switching me to XR and we knew 20XR wasn't quite enough, there was a short period of 20XR & 10IR and I remember feeling like that was pretty good. And then he switched me to 30 XR...hm.

I haven't tried vyvanse, the only other thing I've tried was Ritalin and that was WEEEEIRD. I felt reeeeaally strange on Ritalin. I think I tried like 5 days worth and that was definitely enough of that! Haha

dvdnvwls
03-10-17, 02:14 AM
The weekend thing...
I wonder if your dose is too much. It sounds to me like the amount in your system increases until it reaches perfect - and then just keeps on increasing, into anxiety/over-focus territory.

sarahsweets
03-10-17, 05:25 AM
I take adderall xr multiple times a day. Its mean to last about 6-8 hours but for me its more like 4-5. Ir and I do not get a long so I take the xr multiple times a day.

Fuzzy12
03-10-17, 06:02 AM
I used to crash as well everytime about 3h after my last dose. The prproblem disappeared when I dosed more frequently. Same daily dose but every 2h. It would last for almost the same time as well into yhr evening.

sarahsweets
03-10-17, 09:57 AM
Pardon me for the stray in topic focus, but does anyone know how food delays absorption of IR meds, namely Dexedrine? Does it delay peak concentration as shown with Adderall XR? Just trying to keep stable blood levels as much as possible.. Thank you kindly.

Are you talking about food in general or specific foods?

willow129
03-10-17, 10:01 AM
The weekend thing...
I wonder if your dose is too much. It sounds to me like the amount in your system increases until it reaches perfect - and then just keeps on increasing, into anxiety/over-focus territory.

Yeah, see, I was kind of wondering this too. OK so, I think when I was just taking 20 mg XR that it didn't feel like it was lasting very long....... so that's why we tried a 10IR after. And then psych boosted me to 30 mg and I remember wondering if the hyper focus was kind of too much , like I remember the change feeling drastic. But, I don't know if this sounds weird, but this was also towards the end of my 5 year relationship and ... I was trying to make things better with my partner and things weren't going so hot. It just, you know, things are good one day and you're like, everything's great! And then they're not so good and you're like everything sucks! I'm not sure I was in a place to really effectively compare different dosages, if that makes sense heh. It was also during the summer so I was on vacation too.

Anyways, since the 30 mg felt drastic, I asked to go back to the 20mg. Did that again for a month same issue as before, went /back/ on 30...and then I couldn't get another appt with psych - he was really filling in while they were trying to hire someone to be the psych at that branch, which wasn't going well, and then his schedule changed, my school year started, cue on and off meds sporadically, 30 mg XR was definitely better than nothing at all, and then there was another VERY short term fill in, and it was easiest to just say "this is what I need" rather than try to tweak dosages. (Tangent: This lady was vehemently opposed to IR for some reason and she was also like, suspicious, questioning how I got my diagnosis. I live in an area with VERY high amounts of drug abuse, it was in national news a few years ago, so, I believe she was on the lookout. There were many complaints about her.) Anyways, after that I talked to the previous guy and my therapist and they helped refer me to my doc, all this sort of forced me to at least act confident that I was taking the right dose so that people would feel comfortable prescribing to me at all, so I just really haven't had much of an opportunity to talk to anyone about how it's going.

God, you know, having ADHD isn't a walk in the park, without having to deal with this crazy stuff on top of it, PLUS in the middle of all that relationship officially ended, I really was just trying to keep my **** together as best I could. Haha hadn't really thought about all of this in a while but Ugh, I would NOT go back to that year.

Anywhoooooo I think I'm pretty close to the right thing for me, I hope doc will have some good thoughts :)

cobain67
03-10-17, 12:49 PM
Are you talking about food in general or specific foods?

Mostly food in general, and also fibrous/moderate fat foods.

willow129
03-10-17, 01:53 PM
Hooray! Doc super receptive and shared my concerns :) Yay! That is such a relief, I was quite anxious I realized. I'm nervous to be trying different doses, but I hope to find something that is helpful and it is nice to know that she's /actually/ around to support this, not in and out and substituting, etc.

We decided to try going back to 20MG XR w 10MG IR in the afternoon.

Thanks for your replies and thoughts everyone!!! Hugs Hugs!

dvdnvwls
03-10-17, 02:50 PM
I hope it works well, or that if it doesn't then you and your doctor see other things that might.

willow129
03-18-17, 02:41 PM
So I went to 20 mg XR with 10 IR in the afternoon this week.

First couple of days, I feel pretty even, no mood swings that I'm noticing/feeling are because of the adderall. The 20 MG initial dose definitely feels like less than the 30, but I feel it's still effective.

HOWEVER today I went to have breakfast with some friends, and then we were walking around town looking in stores and I started to have some fight-or-flight panic type of anxiety (this was 2 hours after I took the 20 mg XR). I don't really know what triggered it, but then I was feeling kinda down and icky. This panic attack stuff is annoying, struggled with it for YEARS before I knew I had ADHD. Adderall really did seem to help with that - but could this be from the adderall?? Maybe only time will tell.

[It could also be that I've been pretty go go go the past 2.5 weeks...and then I kinda had a moment of undirected focus in the store, just waiting for my friends to find what they wanted, and maybe that was just a weird feeling and made me panic a little.]

I came home and I had ADDF blocked on my computer but I wanted to find out some more info on Adderall and anxiety - still feeling a little jittery, and also symptoms of too high doses verses too low doses. Oh my gosh, this place is such a haven from the rest of the internet!!! All these people who abuse their meds, ugh. Couldn't wait for the timer on the app to run out so I could read threads here/post here.
Anyway, that maybe wasn't a great idea, either. The rest of the internet + adderall is scary. I'm all worried now.

OK a couple more specific questions:
Yesterday I noticed a couple of times that I kept thinking I was seeing my cat out of the corner of my eye in my apartment, but when I looked it would be like my jacket or something. I've noticed this kind of thing very occasionally, and thinking about it now, it's definitely a side effect. Should I panic and run?! Lol. Help. Is this bad?? It was happening again this morning at the restaurant, kept thinking the door was a person >.< It's really not a super common experience but is it a bad sign??

O.o

Also, if the 30 mg is/was too much for me, I wonder if it's very bad that I was on it for almost a year. I don't know, I guess I can't do anything about it now, either way. But, I was wondering.

dvdnvwls
03-18-17, 03:39 PM
No, it's not bad to have been on it.

How has your sleep been lately? The things you just described sound like they could be related to it.

And are you staying well hydrated and eating good meals at every meal time?

willow129
03-18-17, 04:29 PM
Thanks for your questions DVD!! Good things for me to think about as factors....I appreciate that!!

It's true lack of sleep DEFINITELY makes like exponential increase in anxiety for me so I'm pretty attentive to how much sleep I'm getting. But, mm, I'm not sure this is totally sleep related. Wouldn't hurt to go to bed earlier tonight though...

Food and water I can be really bad about. I'm bad about organizing myself to drink and eat enough off of Adderall, and Adderall does help me be organized but it also makes drinking and eating more complicated!!! It's like a step ahead of what I can handle I feel like, cuz it makes me so dehydrated, and dampens my hunger, until I'm REALLY HUNGRY.

I was having some other stuff going on that I didn't think was med related and I mentioned it at the med consultation and my doc said it's that I'm not drinking enough. Which I know is definitely true.

[The past couple of months I've noticed that there are signs that I'm going to be getting hungry - it's like my brain will think about food, like hey Willow let's have a daydream about a burrito, even though my body's like, neh, burritos, **shrug**. But if I eat at that point, I'm better off haha.]

This morning I got delayed to meet my friends for breakfast by a litterbox emergency (bad kitty) so I was PRETTY hungry by the time I got to the restaurant. Gotta look at that earlier post from Postulate but maybe something about the really hungry, eating a lot, made some Adderall anxiety. Hm.

dvdnvwls
03-18-17, 07:46 PM
I'd go so far as to say if you aren't going to eat well and aren't going to drink water continually all day, you might as well not take your meds.

Habits are the only way I can handle this myself. I keep a water bottle with me all the time - if I don't, I won't get enough water. Develop the habits that will allow you to succeed at this, whatever those may be in your case.

willow129
03-18-17, 08:14 PM
Yeah, I see what you're saying...I lose everything including water bottles >.< [seem to have misplaced my guitar...don't know if it's at my friends' or at school but it's not at home!!] Sigh. OK. I'll figure this out.

(I know it's not good for your body to not drink, but does that really cause anxiety? The Adderall is still *working*........well, anyways, I will work on my hydration.)

dvdnvwls
03-18-17, 08:17 PM
Yeah, I see what you're saying...I lose everything including water bottles >.< [seem to have misplaced my guitar...don't know if it's at my friends' or at school but it's not at home!!] Sigh. OK. I'll figure this out.

(I know it's not good for your body to not drink, but does that really cause anxiety? The Adderall is still *working*........well, anyways, I will work on my hydration.)
Yes, that really does cause anxiety. It's happened to me too.

willow129
04-02-17, 03:09 PM
Med consultation in a week - posting observations so far...

Went from 1 30mg XR a day for almost a year, kind of on and off to 20mgXR with 10mg IR in afternoon

No more mood swings! YAY

However, definitely more spacey :( and I think more struggle initiating tasks, getting organized... I think the drop to 20mg XR in the morning was kind of a big drop. Not that it's not helping at all, it is, but less...

I know I didn't sleep well last week, but I've been through this before, being/feeling unorganized and spacey, not getting as much done as I need to, then I don't get to bed on time because I'm still trying to finish my work, then I don't get enough sleep, then I'm even more spacey, then I don't sleep well cuz I'm stressed. Ack. It's so sad how much I've been through this in my life, ADHD affects so much.

I am also noticing being less attentive while driving (which is making me marvel that I was ever able to get my license off meds in the first place!!! Lol!! Teaching me to drive was unpleasant for EVERYONE involved, and there were multiple people who tried. So much tears and frustration.)

Also having a kind of funny mystery...so I used to worry about whether or not I took my meds in the morning on 30mg, and that was only 1 pill a day. Now that I have to take 2, I'm writing in my little planner how many pills I should have left if I've taken both of them that day, for every day. (I put all my pills in the same container, small enough to keep in my purse, if I don't keep them there I will forget them when traveling for SURE.) When I switched to the 2 pills, in the first week of course I immediately had a day of forgetting to take 2nd pill. But I adjusted my little numbers, cuz now I've got one extra IR in the bottle and I don't want to get confused.

This morning I took my XR, but I was soooo unusually tired. Like just tripping over myself tired, and I have so much I need to do and it's a glorious sunny day but I gave up and went back to bed. I used to get tired like this pre-meds. I usually am not able to nap on Adderall unless I'm really sleep deprived, like had to take a red eye flight or something. Maybe I'm just still catching up on sleep, but, I just woke up from my nap and I was like god I am zonked, did I actually take my XR this morning?!
Check pills: Not only did I take the XR, but I have one fewer XR than I'm supposed to, and another extra IR! **scratches head** I mean, that suggests that I accidentally at some point took an XR instead of an IR...but what the heck?! The 2 pills look nothing alike, I really had to have been not paying attention at ALL. I mean it's possible. But I also don't remember a day of feeling particularly jazzed from the meds either, 40mgXR is more than I've ever taken in a day.
Anywho it's mysterious, I may never know the answer! But I honestly feel like an old granny, mixing up my medication, cutting people off driving, getting all befuddled and tired. **eyeroll** **sigh**

Maybe should try 25mgXR instead of 20 in morning?