View Full Version : Report on Vyvanse experience


chronological
03-24-17, 09:05 PM
Thought I'd report in on my recent experience with Vyvanse in case it's of any use to anyone.

I'm male, 50+ and was diagnosed with ADHD about five years ago. Initial attempts to treat it were with adderall, ritalin, and concerta. All failed to make the slightest dent in my symptoms, to the extent that I pretty much gave up. More than that, I was never really convinced that ADHD was a real thing -- it always sounded like a bit of a "first world problem" if you know what I mean. And so the lack of response to meds did nothing to disavow me of that notion.

Then about a year ago, working with a psychiatrist (rather than my primary physician) on some peculiar fatigue symptoms that turned out to be stress I gave Vyvanse another try, on the theory that the ADHD may be behind the stress. But again, no response whatsoever, even up to the FDA max approved dose of 70mg. I felt like I was eating Tic-Tacs. However, because this guy is a specialist (i.e. psychiatrist and working in ADHD with adults), he asked me if I wanted to keep pushing the dose up. I am 5'8" but almost 300lbs in weight, so it seemed plausible that my excess weight was working against the meds. I was happy to go up further and so, after some arguing with my insurance to get them to pay, I began titrating up beyond 70mg. 80, 90 not much and then ...

...140mg (that's 2x70mg tablets in the morning), it was like someone had turned on the lights! Absobloodylutely incredible. Those of you who have experienced the meds working as they're supposed to will know what I mean, but to me it was like being in the movie Limitless. My concentration ability went through the roof; I forgot to eat; and I was completely immune to distractions like email, facebook pings, etc, etc.

Thing is, it was *so* effective, I didn't realize what was happening until I looked up from desk that first day and everyone else had gone home. There were no other "feelings" that told me the meds were working; no euphoria, nor dizziness; nothing. If instead of me taking the meds, someone had slipped them into my morning coffee, I would have found myself utterly amazed at my vastly increased focus but without the slightest clue as to why it had happened.
The best way I can describe it is that I simply became fully "me" -- I was the guy I always knew I was, able to point my brain at whatever I wanted to and work on stuff.

Now from there I then discovered the wondrous monster that is hyperfocus -- that is, I realized that I was going to have to learn how to control this new superpower. I felt a bit like Cyclops in the X-Men; if I wasn't careful, I'd blow things up! That wasn't *remotely* easy, and in fact I'm still figuring that out but I'm improving.

Or at least, I was until I hit the old Flowers for Algernon effect, and saw a rapid onset of tolerance after about 8 months of daily use (which my psych says was a pretty good run). I wasn't sure at the time; at first I thought I was just getting more used to the new me. But eventually old habits of distraction drifted in, and one day I found myself staring blankly at a jillion emails unable to choose which one to get moving on. Finally, a full year after finding the 140mg level, I was back to where I'd started with a whirl of thoughts in my head and little or no ability to bring them to order.

So we've suspended use of Vyvanse for now. We gave Adderall -- at a decent dose this time -- a try, but it looks like the cross tolerance with Vyvanse is sufficiently strong that I'm effectively immune to that too for the time being. And even although I've heard of Vyvanse doses going up as high as over 200mg a day, we're not going to go that route. It's then just an arms race, and eventually the meds win.

So I'm now moving to Desoxyn, and am in the process of doing a rapid titration up to see if I can hit therapeutic effect with a decent, albeit probably higher than normal dose. 25mg today was certainly not there yet. If we get that working I'm aware that it's only a matter of time before I hit tolerance there too. But we may then find we can cycle back and forth with Vyvanse, or perhaps some methylphenidate will be useful. Longer term I'm pinning my hopes on meditation, and also weight loss, but for now, All Hail The Meds!

So there you go. Vyvanse was a miracle for me, and I guess I can offer a few lessons learned:

1. Stimulant meds work fast -- like within hours, less if you're not tolerant. So if you are titrating up, don't be afraid to call "fail" if you don't see the effect. Don't let anyone tell you you have to give them days or weeks to take effect. Stims are not SSRIs.

2. Dose is everything. Just because it doesn't work at some dose does not mean it won't work at all. I went from zero effect to OMG!!!! simply by titrating up

3. The effect for me was *unmistakeable* -- well, that is when I even took time to consider (in other words, it is *so* effective that you may not notice because you are so engrossed in your work). So don't be bullied into trying to imagine its working if its not. As I say, don't be afraid to call "fail" if the dose isn't working. Your doc needs to know and only you can tell him/her

4. The notion that the meds are only part of the solution and that you still have to do the work is not entirely wrong, but it's misleading. In terms of attention, for me the meds were 100% of the solution. However, they do then present a new challenge: instead of having to use sheer willpower and determination to stay focused, I moved to having to use organizational tactics and tools to target this new attention-laser I'd found. For example, I learned that I must not start dabbling in busy-work in the time between taking the meds and when they kicked in (as quick as 30 minutes). If I did that, and the meds kicked in while I was on busy work, then I'd be doing busy-work for the entire day. I would, of course, rip that busy work to shreds and get through a *ton* of it. But in general I have more important things to do with my time, so I had to learn that lesson.

5. Although I've developed strong tolerance to 140mg Vyvanse, I had almost no problem stopping it even though I'd been using it daily for a year. I tapered down, but fairly fast. I did have a bit of daytime sleepiness for a few days, and some intense brain fog too -- at one point I wondered if maybe I was seeing the beginnings of Alzheimers!, but then I remembered I was stopping a stim med and that explained it. Within a week all of those discontinuation symptoms had gone, and as I say none were too serious.

c

DonPearson
04-11-17, 01:37 PM
Thanks for your insights. I'll discuss them with my doctor, as I'm not sure I'm getting the proper benefit of my medication.

sarahsweets
04-20-17, 01:43 AM
...140mg (that's 2x70mg tablets in the morning), it was like someone had turned on the lights! Absobloodylutely incredible. Those of you who have experienced the meds working as they're supposed to will know what I mean, but to me it was like being in the movie Limitless. My concentration ability went through the roof; I forgot to eat; and I was completely immune to distractions like email, facebook pings, etc, etc.


Now from there I then discovered the wondrous monster that is hyperfocus -- that is, I realized that I was going to have to learn how to control this new superpower. I felt a bit like Cyclops in the X-Men; if I wasn't careful, I'd blow things up! That wasn't *remotely* easy, and in fact I'm still figuring that out but I'm improving.

Dont take this the wrong way and I am not trying to pick on you but stimulants are not there for you to feel like a superhero or the guy from limitless. Neither of those two are normal or likely or realistic. The idea is to get up to baseline, or to be up to where a normal peer would be, not to exceed all others and be superman.

Or at least, I was until I hit the old Flowers for Algernon effect, and saw a rapid onset of tolerance after about 8 months of daily use (which my psych says was a pretty good run). I wasn't sure at the time; at first I thought I was just getting more used to the new me. But eventually old habits of distraction drifted in, and one day I found myself staring blankly at a jillion emails unable to choose which one to get moving on. Finally, a full year after finding the 140mg level, I was back to where I'd started with a whirl of thoughts in my head and little or no ability to bring them to order.

I am fortunate to have not experienced tolerance per se. But I can say that I have heard of people becoming more tolerant on higher doses of meds. There is also something about being a fast metabolizer. I have absorption issues due to my gastric bypass. Before the bypass I was on 30 then 60mg of amphetamines a day. Post bypass its 60mg of adderall and 20 of dexedrine.



4. The notion that the meds are only part of the solution and that you still have to do the work is not entirely wrong, but it's misleading. In terms of attention, for me the meds were 100% of the solution. However, they do then present a new challenge: instead of having to use sheer willpower and determination to stay focused, I moved to having to use organizational tactics and tools to target this new attention-laser I'd found. For example, I learned that I must not start dabbling in busy-work in the time between taking the meds and when they kicked in (as quick as 30 minutes). If I did that, and the meds kicked in while I was on busy work, then I'd be doing busy-work for the entire day. I would, of course, rip that busy work to shreds and get through a *ton* of it. But in general I have more important things to do with my time, so I had to learn that lesson.

I disagree that that the meds being part of the solution are a notion or misleading. They are a BIG part of things but the motivation and task initiation must come from you. I was told that "pills dont teach skills" and I have found that to be very true.