This is kind of long, so I apologize in advance! I recently started medication for ADD. I am on 30mg of Vyvanse (the lowest dose, I think) for the day and then between 4 and 8pm whenever I feel the Vyvanse start to wear off I am supposed to take a 20mg Adderall (the instant release kind) to cover me until I go to bed.

Yesterday was my first day on all the meds. The Vyvanse was very smooth and wonderful and did not cause me any problems. When I started to have difficulty concentrating and sitting still, I went ahead and took my Adderall around 7:30 pm or so. I had no adverse reactions to either of them and immediately upon taking them felt a MILLION times clearer, saner, etc. But by around 12:30am I began to crash in an epic way. I was sobbing and clutching my chest and every muscle in my body was aching. My hands were shaking.

But the worst part was the emotional reaction. I have NEVER felt that depressed and hopeless before. I had already had a somewhat emotionally stressful evening, but it was like all of my coping mechanisms had disappeared and I was completely and totally unable to handle my distress. I was also very "up" (high energy, irritability, etc.) which seemed to just exacerbate the problem. And I could NOT stop writing - I started a short email to one of my best friends around 2 am. It ended up taking me almost 8 hours to finish and was pages and pages long. I looked at it this morning and was totally blown away by the desperation and panic in the email. I don't even have a clear memory of feeling that bad, but judging by what I wrote it must have been even worse than I am remembering now.

Oh, and I also couldn't sleep, which just made me more distraught, because I have struggled with sleep issues since childhood. I ended up staying up all night and finally managed to fall asleep around 10 am but woke up 4 hours later exhausted but unable to keep sleeping. This is also after taking my sleep medicine (I take 50mg trazadone, a sedating anti-depressant, nightly), which has never failed me before.

In short, it was one of the most emotionally brutal experiences of my life. After suffering through that, I'm almost afraid to take the meds again today, but I don't think I have any choice. Having once experienced what it is like to have a clear and focused brain, I don't want to go back. I just need to know if the crash gets better or not as your body adapts. Am I going to have to deal with this every night? Is my "crash" reaction within the spectrum of normal reactions, or should I be concerned? Would it make a difference if I switched meds or is this pretty much just an unavoidable part of using stimulants? And is there anything I can change about the way I take the medication that might help ease the crash?

TOTALLY NORMAL! Each day it will get better, and after a week, it will be gone! Hang in there!

Thanks - that's a relief :)

I also have another question, if you or anyone else knows (I should probably make this a new thread, but oh well). My question is, how am I supposed to tell if my dosage is the best one? I definitely feel calmer, clearer-headed, and more patient during the day, but it is not really the dramatic change I thought it would be. I am not sure how to tell if I am getting the full effects.

The problem is I am terrified of running out before finals week starts at my university and not being able to get a refill. So I am worried about experimenting too much with the dosage on my own. (As I said before I am on 30mg Vyvanse in the morning and then 20 mg Adderall IR in the afternoon.)

For one thing, you might want to try each medication on its own first, to isolate the drug that is causing problems. You don't know if you're crashing because of the Vyvanse or the Adderall, or because of the combination.

I was on Vyvanse for awhile and I experienced those same horrid crashes. They never got better, so I switched to Dex. I've never taken Adderall. So it might seem like the Adderall caused the crash, but it actually might have been the Vyvanse. Rather than guessing, try just Vyvanse for a couple weeks, then just Adderall for a couple weeks. I think it's best to figure out how each of those drugs will affect you.

This is kind of long, so I apologize in advance! I recently started medication for ADD. I am on 30mg of Vyvanse (the lowest dose, I think) for the day and then between 4 and 8pm whenever I feel the Vyvanse start to wear off I am supposed to take a 20mg Adderall (the instant release kind) to cover me until I go to bed.

Yesterday was my first day on all the meds. The Vyvanse was very smooth and wonderful and did not cause me any problems. When I started to have difficulty concentrating and sitting still, I went ahead and took my Adderall around 7:30 pm or so. I had no adverse reactions to either of them and immediately upon taking them felt a MILLION times clearer, saner, etc. But by around 12:30am I began to crash in an epic way. I was sobbing and clutching my chest and every muscle in my body was aching. My hands were shaking.

But the worst part was the emotional reaction. I have NEVER felt that depressed and hopeless before. I had already had a somewhat emotionally stressful evening, but it was like all of my coping mechanisms had disappeared and I was completely and totally unable to handle my distress. I was also very "up" (high energy, irritability, etc.) which seemed to just exacerbate the problem. And I could NOT stop writing - I started a short email to one of my best friends around 2 am. It ended up taking me almost 8 hours to finish and was pages and pages long. I looked at it this morning and was totally blown away by the desperation and panic in the email. I don't even have a clear memory of feeling that bad, but judging by what I wrote it must have been even worse than I am remembering now.

Oh, and I also couldn't sleep, which just made me more distraught, because I have struggled with sleep issues since childhood. I ended up staying up all night and finally managed to fall asleep around 10 am but woke up 4 hours later exhausted but unable to keep sleeping. This is also after taking my sleep medicine (I take 50mg trazadone, a sedating anti-depressant, nightly), which has never failed me before.

In short, it was one of the most emotionally brutal experiences of my life. After suffering through that, I'm almost afraid to take the meds again today, but I don't think I have any choice. Having once experienced what it is like to have a clear and focused brain, I don't want to go back. I just need to know if the crash gets better or not as your body adapts. Am I going to have to deal with this every night? Is my "crash" reaction within the spectrum of normal reactions, or should I be concerned? Would it make a difference if I switched meds or is this pretty much just an unavoidable part of using stimulants? And is there anything I can change about the way I take the medication that might help ease the crash?

Never take your booster of Adderall that late in the evening unless you plan on being up all night. Also, you are experiencing stimulant rebound and that can be depressing at first but in a short time you will develop a tolerance to the amphetamines and will not feel so many of the side-effects as the meds peak and then start to wear off. I suggest giving your body some time to adjust before adjusting your meds.
If the anxiety is too great and your Vyvanse actually lasts till 8PM you may not even need the Adderall in the evenings.
Trust me, the Vyvanse honeymoon does'nt last and you will eventually need the PM Adderall booster.
Hang in there ok!

20mg of IR adderall is very large vs 30mg vyvanse.

30mg of vyvansee is ~15mg of D-ampetamine over ~8-12 hours.
20mg IR adderall is around 15mg of d-amphetamine over ~ 3-4 hours.

The adderall is around 3 times as much per hour as your vyvanse dose.

You might check with your doctor about trying 1/4 the 20mg adderall tablet next time and see how it goes.

BobC

when i first started taking adderall, i had HORRIBLE crashes. for about a month. to the point where i couldn't get out of bed for the rest of the day. once, i drove to the gym and sat in the parking lot, scared to get out of my car and had a panic attack when i first started taking it. it DOES go away, for sure. but if you still experience REALLY BAD side effects, then your dose is either too high, or this is not the drug for you. i NEVER liked vyvanese. it always made me in a numb-bitter state and i never felt good, mentally or physically. it always made me want to throw up and feel dizzy and horrible. What I did was take 30mg of adderall xr in the morning and then 20mg of IR adderall about 6 hours later. after that i take 1mg of ativan, which zaps away anxiety and those annoying freak out sessions in about 5 minutes after you take it. also, it helps you sleep and it's a really nice sedated feeling, but still lets you function. this might help:
8:00AM take 30 mg of your vyvanese
1:30PM take 20mg of your IR adderall
and around 4-5:00PM take 1mg of ativan
Your doctor might be able to prescribe it to you if you just call in and tell them what you've been experiencing.

If you absolutely need the add meds in such high doses, a benzo (like ativan) will be of great help to you! You must call your doctor though! Maybe you also need some kind of stabilizer too, and not so high of the add meds. I think with us, we tend to have multiple "disorders" like anxiety, depression, manic-episodes, etc. it's so hard, i have been there! ahhh i HATE THAT CRASH! oh and MAKE SURE YOU EAT BREAD! The bread and big meals always helped me with those stupid crashes. and SLEEP 6-8 HOURS. Whenever I don't get enough sleep, I get anxiety so bad that I am bed-ridden the rest of the day. Good luck to you, you'll figure out something!

You probably already have your answer by now, but your side effects, albeit pretty..drastic, will more than likely go away after about a week. Like I said, you probably already know this, since this post was made about a week ago.

I'll have to respectfully disagree with the poster above me (no offense) in regards to asking your doctor for an RX for Ativan (lorazepam). It should be a goal to minimize the number of different drugs a person has to take. If your symptoms are still there, and you're still a nervous wreck, I'd suggest asking your doctor for a different stimulant. If all else fails, a combined treatment of stimulant + antianxiety could be done, yes. :)

Thanks everyone! I've noticed that the crash is starting to get better, possibly because I've been adjusting how I take the meds to reflect the fact that my Vyvanse and Adderall IR dosages are so different (I've started taking 10mg IR in the late afternoon instead of 20). I am going to see a different psychiatrist next week (since I go to college in a different state and need someone to write my monthly prescriptions). Hopefully he can help me figure out if any more changes need to be made.

I also have another question, if you or anyone else knows (I should probably make this a new thread, but oh well). My question is, how am I supposed to tell if my dosage is the best one?

This is just my experience. I wouldn't really advise adjusting dosage without your doctor knowing. My doctor is pretty liberal and I did it at my own risk. But I was on 30mg of vyvanse and it was great the first 2 days, I got ALOT done with a clear mind. The problem was I couldn't eat at all, I would either be preoccupied or just didn't feel like eating. After about 5 days on it it got to the point that I couldn't even look at food without getting nauseous. I was about to just give up on it. I figured since it was the losest dose I would just try for a day or two taking two pills at once(60mg) and see how I felt. Would have figured the negative effect would be twice as bad, but it was a significant improvement. I've been taking 70mg for awhile and my apetite is fine, and still feeling clear headed, but it doesn't seem to last as long. When it wears off its very gradual still worth taking.

My doc gave me a boost to take in the evening which is meant to be Adderall IR, but the pharmacy gave me some generic stuff and I feel HORRIBLE on that. Extremely irritatble and negative thoughts along with some confusion and a heavy fatigue after about 2 hours. I don't think I'll be doubling up on that because those are mainly mental issues.

Hi, I was on Concerta 54mg for about 3 months and it was working well - no side effects - no crash, llasted pretty long, and didn't interfere with my running at all, but it wasn't helping with organization much and I felt a little zombie-like sometimes. I just started 25mg of Adderall XR about a week ago, and It is fantastic for the very short time it works, I feel more flexible and organizing is actually easy and not paralyzing for the first time ever. The downside is the short duration - I start waning at 3 or 4 pm and at night every day the crash has been progressively worse - anxiety, can't think about anything but food, like I need to fill the void or something and the mornings are kind of spastic too until I take it - I was a drug counselor for 3 years out of college (never even tried anything other than alcohol until this) but I feel like this must be what they would describe as a physical craving/drug seeking.... Does this get better or is this a really bad sign and should I just take what I can get with the Concerta? It's really frustrating because the Adderall helps with decision making, focus, motivation, all of it, but these side effects really freak me out. Thanks in advance for the help!