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Old 05-15-10, 05:52 PM
Carth Carth is offline
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Huge dilemma (At least for me) What do I do? (Sorry, it's a long read)

Hello everyone! Hows everyone doing today? Hope everyone is well. Have a problem and need help please.

I've been an active bodybuilder for well over 14 years now. No longer don't ANY STEROIDS and haven't for well over 4 years now.

I consider myself to be in great shape. Physically I look great. I get compliments all the time. So this is how I know I look great. How do I feel? So-so. Not bad...but not great.

I sleep pretty decent. And wake up feeling ok. I think I have pretty good energy. If I didn't, I wouldn't be falling asleep or complaining (I'm sleepy..I need a nap). I wake up at 7:30am, eat, shower, get dressed and off to work. My job starts at 9am. Work is not stressful at all. In fact, I never complain, argue and the day doesn't seem to drag at all. I get home at 6pm, eat and then go to the gym to Train. By 9:30pm I'm yawning and feeling sleeping. 10pm is lights out for me!

So what's my problem? I have mildly low joy, pleasure in life. And slight ADD. Oh! And very low libido. Seems to me like a have a dopamine problem. Also, when I'm at the gym weight lifting. Even though I have energy, my strength and stamina are down. And I read that having low dopamine affects strength much more than stamina. I also tend to hold a little water around my mid-section. Again, I read that having low dopamine tends to cause an increase in water retention. Especially around the waist.

As a young kid I was put on Ritalin because of my mild case of ADD. Teachers always complained to my parents saying...."Smart kid (when he tries hard) but lacks focus, doesn't pay attention". So I was put on Ritalin.

This drug worked to help me become a better student. I Remember going from D's to B's and A's on this drug. But it seemed to me make me very irritable and extremely hostile if anyone distracted me from my studying. It made me a "All work and no play" type of kid. And this med caused me to become almost enemies with my parents. And friends started to dislike me. So I came off of that and never got back on.

I have gone to a few psychiatrists here and there throughout my life. Many told me (Endocrinologists as well) that I have ADD, low libido and low feelings of pleasure due to my steroid use. Remember, my steroid use was started when I was 20. I stopped when I was 30...I am now 34. But they were all wrong. If anything the steroid use (High levels of Testosterone along with anti-estrogens to keep my estrogen at normal healthy levels) made me a much better person! It increased my libido more (went from having NO libido to now having a slightly mildly low libido), increased my confidence, energy, strength, stamina, better sleep, MUCH BETTER MOOD (increased sense of well-being). And for sure without a doubt made a more productive and smarter person.

So why was it that I was still having a mild case of ADD, low libido, lack of focus, body aches from time to time (again...signs of low dopamine)???

Anyways, I went to a doctor that is located in Michigan. His website is allthingsmale.com He himself is an ex-bodybuilder/ex-steroid user. And is a MASTER of hormones. I went to him 4 years ago. I told him my problem and he did blood work on me. After he scolded me and made me feel like crap! LOL! Told me that steroid use should stop by the time I hit 30. That I came to him right on time. He told me that having super high levels of hormones in the long run causes Heart Disease. Also said that it IS the cause of mental problems...including libido issues,depression, anxiety etc etc. But since my DHT levels and Testosterone were high. Prolactin, progesterone, thyroid etc etc all at normal levels. And my estrogen at a normal level. That I shouldn't have ANY libido issues at all. The problems begins when estrogen (which most BLOATED bodybuilders have) is too high. And having high estrogen levels is what causes depression, anxiety, it also slows down the thyroid etc etc.And again, my estrogen levels was at normal levels due to me taking anti-estrogens.

After getting the blood work results back. He adjusted everything in my body to be that of a normal person that is in great shape. He adjusted my Testosterone levels, took me off the anti-estrogens (as they are no longer needed if testosterone levels were normal) and made a few other adjustments. He also adjusted my diet around a bit. Added in Omega fatty acids....the list goes on. Told me to go back to him 4 months later.

Went back to him 4 months later. Thought I was going to lose a lot of muscle and look and feel terrible. I went from 218lbs down to 195lbs but looking much leaner, vascular and much more healthier. I also looked younger. My skin got tighter, I had more pigment, semi-dark circles around my eyes went away. Everyone I know (parents, friends, relatives, wife, co-workers etc etc) keep saying to me that I looked amazing! One friend said..."You went from looking like a professional bodybuilder with a semi-unhealthy/miserable look to now of a greed god that looks super healthy and happy".

Ok, 4 years have passed. I get blood work done 3 times a year. Just got blood work done this past February . My doctor in Michigan, my personal endocrinologist, and primary doctor (all which have seen all my last 4 year blood works and this latest one in February) all were VERY impressed on how perfect my blood work came out. My primary doc (Dr.Brian Polner) said..."In all the years I've been a doctor, I have never seen such perfect blood work". No lie guys. But everything is OPTIMAL!

Testosterone, estrogen, SHBG, free Testosterone (the one that actually matters), DHT, IGF-1, ACTH, T4, T3, Prolactin, progesterone, cholesterol, triglycerides, HDL, LDL, etc etc etc. All came out at optimal levels. I achieved all of this by training hard at the gym, eating CORRECTLY, taking the right vitamins, minerals, aminos. And of course with the help of my doctor in Michigan. The God of Hormones!

Even though I am now looking better than I have EVER looked in my life. Sleep better. Think better and faster. (blah, blah, blah...you guys get the point). I still have ADD, low libido, low joy/pleasure and somewhat low motivation.

Still, this does not stop me from going to work. I go to work because if I don't work, I won't have money to survive. I go to the gym because if I don't I will look and feel like crap even more! I go out with friends at any chance I can get (but I don't drink, smoke or do drugs). But don't seem to enjoy the things/activities I do with my friends as much as they do. I do enjoy! Again...just not as much as they do.

I went to a shrink last year (guy doesn't listen, just writes and writes crap down for no reason at all and just starts offering me a bunch of meds and it's my choice to pick). Really?! Like is if I know anything about these meds. I know about hormones. NOT mental medications! What a moron!

So the ******* gives me Lexapro. This damn drug ruined my life! It made everything much, much worse! My ADD, low libido, low motivation, low joy/pleasure just got worse! I gained a ton of weight (even though I still maintained my diet). I went to the gym less. From 4-5 days a week down to 2-3 to sometimes only once a week. And I wouldn't even train hard. I went from doing heavy weights, high reps (all free form weight-lifting). Down to doing machines with very low weight and low reps. And always trying to catch my breath. Just getting too tired....too quickly! It made my prolactin go way up giving me headaches, muscle aches, RLS, galacotorhea and totally killed my libido. Did I mention it made my libido go from low to NOTHING? The little joy/pleasure I had was gone. And so it made me somewhat suicidal. What is the point of living if I can't feel joy or motivation to continue? I felt like was just surviving my life instead of actually living it.

I finally got myself a (what I think) is a better doctor than this last idiot. He told me to get off the Lexapro and to start taking Requip. Because my latest blood work (which I did again in early April) showed that I had a slightly depressed thyroid (T4 and T3). With somewhat high levels of prolactin (the dopamine killer). All due to the Lexapro.

Within 3 weeks of getting off the Lexapro (I stopped cold turkey and did not feel terrible or get brain zaps) and starting requip. My energy and mood began to get better. My RLS also went away. In other words...I was back to my old self BEFORE being put on the Lexapro. I got blood work done and everything AGAIN was back to optimal levels. So now this doc (and all my other docs) are sooooooo baffled and don't know what to do with me. They simply do NOT understand why I don't have a libido, better focus, motivation , joy etc etc (you get the picture).

So what he did was put me on Vyvanse. Told me that this will increase my dopamine and swore to me I would feel amazing on it. So I started on 30mgs per day. He also told me NOT to use if everyday. That for every time Vyvanse releases dopamine. A shot of prolactin at the end of vyvanse will be released. The more prolactin...the less dopamine. Hence why everyone builds a tolerance to amphetamines so quickly. It is due to the rise in prolactin.

He told me to think of sex. We have sex because dopamine tells us to have sex. When we have an orgasm..that is the HIGHEST amount of dopamine the body releases then followed by a HUGE blast of prolactin. Prolactin is what tells us..."Ok, you reached an orgasm....now stop and get away from this person". LOL!!!! Which is why when most men reach orgasm, we relax, tension is relieved. And some men fall asleep (no dopamine means sleepy time...again due to the high prolactin). And now we have to wait minutes, sometimes hours or even days (depending on the person and their health) for prolactin to go down in order to get the that DESIRE to have sex again.

So, he didn't want me to use vyvanse everyday. Only on days were I feel I needed it the most. Which for me I would say weekends because that is where I want to feel the most joy and happiness. Especially since I'm going to be around my wife and friends more. And I use it on Tuesdays and Thursdays at work. Where these days are the most hectic and I need to feel good while on these days.

30mgs didn't do anything. Bumped up to 40mgs. Still I felt nothing. Bumped up to 50mgs. Again! Still nothing. Finally 60mgs is where I feel this euphoric feeling. I feel super motivated, super focused, libido goes up (well, desire to look at women more), I feel more happier, more joy in the things I LIKE to do. And my strength and stamina in the gym are back to normal.

However!!! Here is the HUGE DILEMMA i have with taking 60mgs of Vyvanse. Again, I CANNOT take a lower dose as anything below 60mgs doesn't do NOTHING for me.

Here it is.....

I get what I strongly believe is anxiety! I think its anxiety. I know a couple of people that suffer from anxiety. And all they do is sweat, complain that their heart is going to explode out of their chest, feel that everything is wrong (what they say is...is everything OK? I feel things are not right! Something is wrong. And of course I have to hear all their problems that is going on in their life. Like money issues, health problems etc etc). They also cry for no reason at all. Seem to be more sensitive. Complain of feeling weak and sleepy and become immobile. Yet they can't fall asleep. Don't want to talk to anyone. And get irritated at almost everything! Like....The TV is too loud, that lawn mower I hear is annoying me, its too bright in here etc etc.

When I take Vyvanse, I feel more energy. More of a wanting to do things. Accomplish things that have to be done. Like errands for example. Fixing things that have to be fixed. Cleaning things that have to be cleaned. I find myself more concerned about how I look. I tend to dress better, go tanning often, and keep myself more groomed.

However! I feel a constant battle within me. A struggle within. Between happiness and being annoyed/irritated. I feel colder at certain points when everyone else is fine. I feel hot and sweaty when everyone else is fine. I tend to talk to people with more energy. And they notice it. Some say that I'm talking too loud. Too fast. Some say I sound very irritable. Sometimes I feel that am ABLE to cry very easily even though I do NOT cry. And I DON'T know why I feel like a could cry. No sad thoughts are running through my head. If someone looks a tiny bit upset at me....that is when a tear comes down my eye. When at other times I could just easily ask the person..."what did I do wrong? please let me make it up to you".

My dog (a bulldog) irritates the living hell out of me. She's the type of dog that always wants to be hugged and kissed. And taken out of the house at ANY time she says. When not on the vyvanse, and she asks to go out (its a non-stop thing....does it like 4 times an hour for NO REASON and then comes running back in the house) I take her out. It doesn't bother me because all she does is pee quickly or just look around and comes right back inside the house. But on Vyvanse? Omg! I'm like...."WTF dog!? You just went out! I'm not going out again! She wants to be hugged, touched, kissed and play all the time. When not on the Vyvanse I can put up with it this OVER-affectionate dog for a limited time before I just start ignoring her. But on ON the Vyvanse. Man! It's like I can only put up with her so much before I just totally ignore her or end up yelling at her (which I feel bad doing).

As for sex. It's weird. I have a strong urge to just look at porn and masturbate. Which of course on Vyvanse its NOT going to go well. I can't get erection worth my life! And achieving an orgasm takes me a LOOOOOOONG time. You would think I would want to have sex, but I actually don't. It's like I don't want to be touched or touch her back. I don't feel lovey dovey. I just want an orgasm. That's it!

I tried having sex before. And it never goes well. I have to use a full dose of Viagra. And this only SLIGHTLY helps in getting an erection. Its a weak erection and it doesn't last long. And requires constant oral sex to get it back up again. Which again....doesn't last long.
And like I said, it's like I don't want to have sex. I just rather masturbate with my flaccid penis just to get the orgasm (which I almost never achieve and when i do get it....its a weak orgasm, in which I feel I can go again and again and again).

I'm tired of feeling like this on Vyvanse. A constant happy, euphoric, motivated, high libido feeling. But with slight irritability (anxiety I think) and not feeling lovey dovey with my sex partner. And this desire to leave the house to go do errands. But with a feeling of NOT wanting to leave the house. I don't know why I get this.

Just yesterday I took a Xanax (no vyvanse). It was my day off of work. First time taking it in a year. I only take it when I can't sleep at all. I found myself more relaxed and not sleepy at all. Even though it did not effect my energy levels. I found that ADD got worse. I had a list of things to be done. and I didn't even know where to begin. Had 10 things to do. All of which I had prioritized on Thursday night (when I was on vyvanse)

The next day comes and I did nothing on that list! Was too busy on the computer looking up useless info! All I got to do was go to the supermarket. And at the end of the day! Wow! So productive! LOL (being sarcastic)

While on the xanax, going to the supermarket (walmart actually) was no problem at all. I felt at peace with everything. Like everything was ok and I shouldn't have any worries at all. When my wife got home, she said I looked and sounded more happier and calm. And the xanax did not stop me from going to the gym. My strength was not affected. Only my stamina. At night, my wife wanted to have sex. But I simply was not in the mood. I wish I can feel like the way I did on the xanax. But of course with more motivation, drive, focus and urge for sex.

I asked my shrink if taking a benzo with vyvanse was ok? He said that benzos work with GABA. And GABA job is to shut down dopamine. If I take a benzo with vyvanse...I will just cancel out the vyvanse.

I tried this once with only a .25mgs of xanax and he was right. It was like my vyvanse was wiped out of my body. And I was back to normal (not being on the vyvanse).

So after all I just said. What is wrong with me guys?

Am I getting anxiety on the vyvanse?
Whats the solution?
Dropping it down to 50mgs is not an option. To me its like taking an empty capsule.

Taking Magnesium, Taurine etc etc (all that stuff) lets me have my energy. But totally stops dopamine. At least for me. I can feel the drive, motivation, urge to have sex all go away.

My god! What is wrong with me? What do I do????
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Old 05-16-10, 01:31 AM
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Re: Huge dilemma (At least for me) What do I do? (Sorry, it's a long read)

Aaaah, the first thing to do is take a deep breath -- you're not crazy, there's nothing wrong with you! It can all be perfectly explained by the pharmacology of dextroamphetamine (what Vyvanse becomes after the lysine of lisdexamfetamine comes off in the intestines).. d-amp not only affects dopamine (DA), but it also affects norepinephrine (NE). And actually, the effect on NE is stronger, about 5x stronger than the effect on dopamine. So for you my friend, by the time the Vyv starts acting on DA (60mg for you), the norepi becomes too much for you.

This perfectly explains why you feel great, more pleasurable (the dopamine effect) but at the same time irrtable/anxious. NE is the brain chemical that controls fear, and is high in people with anxiety disorders. When you have NE, you focus too hard (can't let go of negative thoughts), which is why all you ever hear from anxiety sufferers is their problems, they just can't let it go due to the high NE.. High NE is physically uncomfortable too, makes your muscles tense, makes the heart jumpy, AND NE also constricts the blood vessels, making erections really difficult or near impossible! Pseudoephedrine, which acts by increasing NE, is considered the gold standard for priapism (an erection that won't go down).

I get the same thing with my dog!!!! He's the cutest overweight golden ever, normally I just wanna hug him all day, run around with him hoping he'll drop some pounds... but when I take a lil extra Vyvanse (I'm on 20mg but have 5mg capsules compounded for me), I find myself getting impatient and irritable with him for no reason, and I too feel really bad about it, but I just can't stop myself from feeling that way even though I know it's not right. That's NE!!

Also, when I take that extra 5mg, I get more motivation to get work done, but physically I feel pretty ****ty... I also feel more pleasurable, but at the same time more cranky and tense. High NE can make you feel emotionally cold or detached (explains why you can't get cozy with your girl).. That detatchedness with the DA-related increased pleasure is such a weird feeling, I know.

Benzodiazepines such as xanax lower norephinephrine, but like your psych said, the GABA also lowers dopamine, which brings you back to square one.

Intuniv is a medication that works by lowering norepinephrine, and that's all it does. It makes you very tired at first, but once you get used to it that shouldn't be too much of a problem, especially on a stimulant (the DA will keep you awake). Talk to your doc about combining it with the Vyvanse... I've never been on it but theoretically it should help!

Hope you're feeling relieved after reading this!
Best of luck,
Tom
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Old 05-16-10, 08:05 AM
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Re: Huge dilemma (At least for me) What do I do? (Sorry, it's a long read)

How long has it been since you have had a total heart work up? I mainly ask because you mentioned erection issues and that is often a sign of a heart problem of some kind. It could potentially account for some other symptoms you mentioned as well.
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Old 05-16-10, 02:12 PM
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Re: Huge dilemma (At least for me) What do I do? (Sorry, it's a long read)

Tom! I feel like a thousand pounds have been lifted off my chest! Yes! I do feel a bit better. Thank you sooooooo much for taking the time to read my very lengthy post. The med you are talking about is called Guanfacine.

Not sure how to bring this up to my doc. He is that type of doctor that is VERY weary of everything!

Any suggestions on how I should bring it up / suggest it?

As for Krys. You may have a point. Might be a good idea for me to see a cardiologist. What do you think?

Tom...again. Thank you brother! Thank you very much! I owe you! Take care brother!
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Old 05-17-10, 01:03 AM
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Re: Huge dilemma (At least for me) What do I do? (Sorry, it's a long read)

I started on 30mg and 50mg. At 50mg I was very irritable and edgy, but was bumped up to 80mg because the 50 wasn't lasting more than 7 or 8 hours.

On 80mg I was surprisingly far less irritable, though I was still having ADD distractability issues.

I was bumped up again to 100mg where I've been for just shy of a month now and it's really been the sweet spot so far - very limited irritability, good focus, lots of energy. I just wish my insurance covered it.
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Old 05-17-10, 06:28 AM
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Re: Huge dilemma (At least for me) What do I do? (Sorry, it's a long read)

Quote:
Originally Posted by Carth View Post

As for Krys. You may have a point. Might be a good idea for me to see a cardiologist. What do you think?
I think a cardiologist would be a great idea... especially if you haven't seen one before now. Like I said already, the erection issues are often a sign of an underlying heart problem. I've read/heard that heart issues have also been linked to low libido, and mood issues as well. If you do go that route, be sure to tell who ever you see about your symptoms and your past steroid use as it might affect what things they check. Good Luck to you no matter what.
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Old 05-17-10, 11:10 PM
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Re: Huge dilemma (At least for me) What do I do? (Sorry, it's a long read)

Quote:
Originally Posted by ParkBench View Post
I started on 30mg and 50mg. At 50mg I was very irritable and edgy, but was bumped up to 80mg because the 50 wasn't lasting more than 7 or 8 hours.

On 80mg I was surprisingly far less irritable, though I was still having ADD distractability issues.

I was bumped up again to 100mg where I've been for just shy of a month now and it's really been the sweet spot so far - very limited irritability, good focus, lots of energy. I just wish my insurance covered it.
I wish that would be the issue with me. But I've tried it before. I've taken more than 60mgs. Double sometimes triple that. Just makes things worse for me. 50mgs...I don't feel nothing! No euphoria, no joy, no pleasure. Nothing! Feels like I'm just on Wellbutrin (hated that drug...all that energy with no motivation at all).

60mgs....joy! Life is worth living. But constant battle of irritability and joy. Anything past just increases the irritability. To the point where I don't even get irritable. I just get weak and sad and want to cry. I become a little sensitive baby girl! LOL
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Old 05-17-10, 11:12 PM
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Re: Huge dilemma (At least for me) What do I do? (Sorry, it's a long read)

If you know about it Tom. Why are you NOT on this drug to reduce this nasty side effect?
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Old 05-20-10, 12:52 AM
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Re: Huge dilemma (At least for me) What do I do? (Sorry, it's a long read)

Quote:
Originally Posted by Carth View Post
Tom! I feel like a thousand pounds have been lifted off my chest! Yes! I do feel a bit better. Thank you sooooooo much for taking the time to read my very lengthy post. The med you are talking about is called Guanfacine.

Not sure how to bring this up to my doc. He is that type of doctor that is VERY weary of everything!

Any suggestions on how I should bring it up / suggest it?

As for Krys. You may have a point. Might be a good idea for me to see a cardiologist. What do you think?

Tom...again. Thank you brother! Thank you very much! I owe you! Take care brother!
You're very welcome! so glad i've been of help to you, does a lot for me as Im thinking I might wanna be an ADHD specialist in my future! nice to see i can make a difference already.

hmm, well you could explain to him your issues and how they might be related to high norepinephrine, and say you've read about a medication (guanfacine aka Intuniv) that lowers norepinephrine, ask his opinion and if he says no don't walk out of that door without some kind of other option. this is your life bud not some docs, but also def dont be demanding !

also my other suggestion would be to start taking the vyvanse daily. side-effects of amp medications are worse when starting it and even out once you get used to it.. but if youre only taking it a few days a week, each day is like starting it. when i started it the high NE effects were a lot worse than they are now.


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If you know about it Tom. Why are you NOT on this drug to reduce this nasty side effect?
haha, good question, a couple reasons.

i only started taking the extra 5mgs recently, like a week ago, so the side-effects were more pronounced, they're quite ok now, and never were that bad. this med works great for me i dont really want to mess with it.

also i have a narrow therapeutic window to stimulants.. 30mg is too much for me but on the 20/25mg im on now, i notice the dopamine effect wear down after a while and i rely on mostly NE to carry my focus for the rest of the dosage.. so if i lower NE then i'll chop several hours off the med and will have to tweak my doses, dose more frequently.. trying to keep things as simple as possible as im on 3 meds. thats the whole point of vyvanse for me, i love how it lasts allll day. im bipolar so naturally my mood is swingy, i can't add anymore ups and downs to that. IR was terrible in this respect.

also, i just added a new med this past thurs (lamictal), so id hate to complicate things any further..
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Old 05-20-10, 01:34 PM
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Re: Huge dilemma (At least for me) What do I do? (Sorry, it's a long read)

Reason why I don't take it everyday is because I notice the dopamine effects not working after a while. I can take the stuff everday for weeks (have done this for 2 months straight). And I ALWAYS have the NE flowing. Never a problem there. But I noticed the more I use it...the less dopamine I feel.

That is why I am now only using it 3-4 days of the week. It's the dopamine I need more! Not so much of the NE. Again, no matter how many days of the week or how long I stay on. The NE never dies out out on me. Its the dopamine effects that go away.

And for those whole 2 months I was on the vyvanse (daily use), my irritability didn't change at all! If anything it got worse due to the fact that I wasnt' feeling the dopamine anymore.

Know what I mean?
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Old 05-20-10, 01:37 PM
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Re: Huge dilemma (At least for me) What do I do? (Sorry, it's a long read)

BTW...a friend of mine gave me 3 pills of Tenex. Each pill being 1mg.

Questions.....

Do I take the Tenex at the same time as my Vyvanse?

How much should I take? Should I start with half a pill?

How long does the Tenex last?

How long for it to kick in?

What if I switch from Vyvanse to Dexedrine? Anything I need to know?
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