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General Medication Discussion This section is to be used for general medication discussion and other medications not broken out in their own respective forums.

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Old 03-20-18, 07:55 PM
JakeH99 JakeH99 is offline
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ADHD but with ULTRA RAPID METABOLIZING

If any of you have any idea what the CYP2D6 gene is, look it up if you have to; but it's making me metabolize stimulants insanely fast. I metabolize methylphenidates and amphetamines faster than 80-90% of the tested population. So, I could take a long-acting like Mydayis or Vyvanse and it would feel like a short-acting Adderall or Ritalin, at best. 70 mg of Vyvanse used to last me maybe 6 hours, on a good day. Now, I get maybe 3.5 hours of day of decent benefit, with maybe only 1-2 more hours of mild-moderate benefit. It's so blasted hard when I metabolize stimulants with my body metaphorically flooring the accelerator and using a tank of NOS like I'm in a drag race in a Ferrari, to put it very eloquently.
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Old 03-20-18, 07:59 PM
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Re: ADHD but with ULTRA RAPID METABOLIZING

By the way all, I don't take Vyvanse but I've tried it, Adderall, Ritalin, Concerta, Straterra, Wellbutrin, and now generic Dexedrine. Vyvanse made me have Raynaud's Phenomenon (again look if up if you're clueless what that is), Adderall made me feel damn near psychotic and anxiety was beyond words bad, Ritalin and Concerta made me pretty mellow and tired, but then left me with a sense of agitation and hopelessness intermixed with some symptoms of extreme OCD. Straterra made me have heart palpitations and absolute boatloads of fatigue, Wellbutrin made me nauseated to the point I wanted to puke, and now here I am on Dextroamp tablets. I truly can't explain how hard it is to deal with ADHD when my metabolism is abnormally high, and my response to so many medicines have been hard. I've tried a lot of tablets/capsules and tinkered with the timing of doses and taking it with/without food amongst other things, and nothing is substantially helpful.
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Old 03-21-18, 01:16 AM
CharlesH CharlesH is offline
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Re: ADHD but with ULTRA RAPID METABOLIZING

I'm no expert, but I don't think methylphenidate is metabolized through CYP2D6 (that's the amphetamines).

That's a rough situation you're in! The only piece of advice I have (and you've probably already tried it before anyway) is to try taking more frequent doses of the medicine. For instance, you say that 70 mg Vyvanse lasts you about 3-5 hours. Maybe your psychiatrist could consider allowing you to take 3X70mg Vyvanse per day. That dose would be higher than average, but you have genetic testing that justifies it. Maybe you could combine Vyvanse with IR dexedrine tablets for additional flexibility.
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Old 03-21-18, 01:19 PM
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Re: ADHD but with ULTRA RAPID METABOLIZING

I learned about this complexity in nursing school but never "met" anyone who actually dealt with it. What does your doctor and/or pharmacist think? A pharmacist is a goldmine with this kind of stuff, better than a lot of doctors, IMHO. Could you take a particular med more often?

Do you mind if I ask, how did you discover that you are a UM? In school they emphasized the pain management aspect and that it is often the biggest clue especially if someone is post op and in far more than "normal" amounts of pain quickly after being medicated. Also, they aren't in other situations like opioid abuse/previous abuse as these patients may need higher doses or more frequent doses due to tolerance.

Raynaud's due to Vyvanse is also very interesting.
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Old 03-21-18, 01:56 PM
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Re: ADHD but with ULTRA RAPID METABOLIZING

My youngest granddaughter has the testing to see which meds have the best
chance of helping instead of trialing med after med after med.

Her older sister has not had the testing, she's 20 now so by the time it was
available here she had aged out of the state health insurance program.

She took Concerta starting at age 11 and it worked very well, but only worked
for about 7 hours, nothing like the 10-12 hours the manufacturer boasts.
Over time, 1 to 2 years, the duration tapered off to maybe 5 hours.

I was hoping her doctor would give her a booster dose of Ritalin since this med
seems to work for her, but the doctor switched her to Vyvanse which became
a horror show.
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Old 03-21-18, 07:34 PM
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Re: ADHD but with ULTRA RAPID METABOLIZING

By reading the post I can see your metabolism burn through like a nuclear reactor. Anyways, from my work with medication, I would say you might want to use a depressant or something to calm you. All of your attempts to get the ADD under control have been stimulants. Maybe go the opposite direction and see how it works.....Also, I take Vyvanse and that particular medication isn't directly metabolized like other drugs. It gets used through the liver and slowly released....That particular medication worked for me for 10 hours at first....now it's like 6 hours or maybe on a rare occasion 8. But as I have said before try using something other than stimulants for now.
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Old 03-24-18, 02:30 AM
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Re: ADHD but with ULTRA RAPID METABOLIZING

Quote:
Originally Posted by JakeH99 View Post
If any of you have any idea what the CYP2D6 gene is, look it up if you have to; but it's making me metabolize stimulants insanely fast. I metabolize methylphenidates and amphetamines faster than 80-90% of the tested population. So, I could take a long-acting like Mydayis or Vyvanse and it would feel like a short-acting Adderall or Ritalin, at best. 70 mg of Vyvanse used to last me maybe 6 hours, on a good day. Now, I get maybe 3.5 hours of day of decent benefit, with maybe only 1-2 more hours of mild-moderate benefit. It's so blasted hard when I metabolize stimulants with my body metaphorically flooring the accelerator and using a tank of NOS like I'm in a drag race in a Ferrari, to put it very eloquently.
I am a fast metobolizer also due to nutritional/physical issues. I take adderall xr as if it was ir-so three times a day. I take dex ir as my booster dose.
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Old 05-17-18, 11:23 AM
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Re: ADHD but with ULTRA RAPID METABOLIZING

I am like this but with Ritalin and Concerta.

I was on 54mg Concerta and it would be effective for 2 hours before I needed another dose. I finally got my doc to prescribe me 2 Adderall XR spaced out in the morning and a couple IR spaced at after 12. My metabolism is crazy.


Quote:
Originally Posted by JakeH99 View Post
If any of you have any idea what the CYP2D6 gene is, look it up if you have to; but it's making me metabolize stimulants insanely fast. I metabolize methylphenidates and amphetamines faster than 80-90% of the tested population. So, I could take a long-acting like Mydayis or Vyvanse and it would feel like a short-acting Adderall or Ritalin, at best. 70 mg of Vyvanse used to last me maybe 6 hours, on a good day. Now, I get maybe 3.5 hours of day of decent benefit, with maybe only 1-2 more hours of mild-moderate benefit. It's so blasted hard when I metabolize stimulants with my body metaphorically flooring the accelerator and using a tank of NOS like I'm in a drag race in a Ferrari, to put it very eloquently.
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Old 05-17-18, 03:11 PM
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Re: ADHD but with ULTRA RAPID METABOLIZING

I have the MTHFR gene mutation, and I've dealt with identical issues from that. Haven't gone more in-depth to see if I have some of the other genetic variances that tend to accompany it, but I will say that having found out about the MTHFR mutation, I've had a lot of luck supplementing with methylated folate and avoiding folic acid. Getting far more duration off of my doses, and much better effect as well.

From what I've learned about these different genetic issues, the only truly successful way to treat them is through drastic lifestyle changes. There is no end-all-be-all answer, just lots of research and hard work. I personally have completely reworked my diet, cut out processed foods entirely and anything fortified with folic acid. That one's tough, folic acid is in everything. Thanks FDA! I will say though, I feel better than I ever have, my ADHD is much more managed than ever before, and my medication works a lot better than it ever did.
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