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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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  #1  
Old 05-17-10, 09:12 AM
Calm & focused Calm & focused is offline
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Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

hi there,

some know my basic story by now. I'm ADD but not really hyperactive (at least not physically). My main issues have always been a lack of continued attentiveness and clarity, as well as lethargy. I describe it to my pdoc as an unshakable "fog" that is there some days. This is not a minor issue. It has caused me to lose a couple of jobs that i otherwise really enjoyed (and would like to have kept!) because on certain days i just couldn't produce.

Back in the day, adderall worked pretty darn well for me, even at relatively low doses (10mg XR). I used to know that if i took adderall, i would get stuff done, period. Now, even with 40mg/day it's "helpful" but much less so. I'd say it helps with mental "energy" but it doesn't draw my focus to the task at hand like it used to.

All my enquiries thus far since joining this forum have focused on issues that may be causing my adderall to lose its effectiveness. It seems as though i've exhausted that exploration though, and i don't want to increase my daily dose much more (i've set my mental limit at a scrip of 60mg/day, which i don't think would be a revolutionary change for more than a week or so).

SOOO, should i think about switching? As i see it, my main options are Vyvanse and Concerta, or their instant release counterparts; dexedrine and ritalin. I know the chemistry stuff pretty well at this point. My curiosity is how the rubber meets the road so to speak. I "like" the physical/motivational kick of the Adderall (particularly prior to the "reformulation") but it seems that, at doses which are sufficient for mental clarity, the side effects may not be conducive to long-term health and happiness. More often than not, it brightens my mood and makes me more outgoing, quick-witted, more interested in what people have to say, etc...but other times i'm more easily agitated. Back in the day, it used to give me anxiety, but (probably because i'm on zoloft now) i don't get nervous anymore, i just get somewhat agitated.

My thoughts on the alternative medications from gathered wisdom are as follows….

Vyvanse / Dexedrine:

Pros: Reduced physical side effects, and perhaps less mental agitation compared to Adderall.

Cons: Could just be a weaker version of Adderall without the kick, since Adderall is 75% d-amp already and removing the L-amp may take away the motivation. I've also heard Vyvanse has the same issue with not lasting nearly as long as Shire claims and it seems that doctors may be less willing to give a daily dose of Vyvanse that is equipotent to, say, 60mg of Adderall.

Discussion: Switching to Vyvanse may be healthier than staying on 40-60mg of adderall. On the other hand, i worry about losing the motivational kick i get from adderall (or used to get). Maybe the fact that Shire is making Vyvanse with quality d-amp ingredients will more than make for the lack of L-amp?

Concerta / Ritalin:

Pros: May help me "hone-in" on the task at hand better than Adderall. I've heard that methylphenidate is less damaging to the brain than amphetamine. It seems like Concerta might actually last 12 hours (or at least 8?) as opposed to Adderall "XR" which lasts 4.

Cons: Might make me feel more tweeked out.

Discussion: From what i gather, Ritalin is generally found to be more "edgy" or "speed-like" than Adderall, so i'd be wary that it might give me anxiety or make me too socially awkward for an interactive professional setting (as opposed to cranking out papers in school). On the other hand, I have heard some people say that Concerta, more so than Adderall, gives them "tunnel vision" around the task at hand. This has been cast in both a positive and a negative light. For me, one issue with the Adderall is that it doesn't help me zero in on the project in front of me the way it used to. Although I will have an "interactive" role at my next job, my role will still largely consist of cranking out spreadsheet models for financial/economic projections. And right now for instance (still in school), I'm on my adderall and I feel "alert" but I'm doing this instead of studying what I should be studying, and when I have been studying, I haven't had the greatest clarity. In the professional realm, the social aspects were always a strength for me (all of my reviews listed "interpersonal skills" as a strength). My problem was that when it was time to go sit at my desk and produce something, I was a waste of space. A little tunnel vision might actually be nice if it allows me to produce at a rate where I don't get fired.
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Old 05-17-10, 03:02 PM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

Avoid Concerta please. Look into Focalin if anything. Dexedrine has no motivation (for me). Write a list and get it done, otherwise you will just focus on things that don't matter.
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Old 07-16-10, 03:21 PM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

I tried Ritalin ER after 6 years on Adderall XR 30mg and Ritalin was terrible. Complete opposite of "tweak" ... it made me want to sleep all the time. I felt like a drooling mental patient. It blocked EVERYTHING out... not just the distraction. So I wasn't distracted at all but I also couldn't focus on anything to save my life. Major hole in the head feeling all the time. Plus I got really bad headaches from it. I'm considering a switch to Vyvanse because of money and they offer financial assistance for it through Shire. I'm nervous though. Adderall, even the worse version still seems to be the best of all the meds. I hated Ritalin and Concerta both though. It was just terrible.
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Old 07-17-10, 05:53 PM
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Lightbulb Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

What worked for me was spreading my dosing out. I take 45mg of.XR a day but its spread out as 3 15mg capsules. If you are not doing it like that try it and see how it works for you Calm and Focused. I wouldn't take your last does after 5p or 6p. Might keep u awake.
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Old 12-13-10, 08:49 PM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

I take 60mg's but find myself needing more.

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Old 12-14-10, 01:34 PM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

what source are you referencing when you talk of 'damaging; to the brain???
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Old 12-15-10, 02:47 PM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

Quote:
Originally Posted by aarondev View Post
what source are you referencing when you talk of 'damaging; to the brain???
I have seen and heard people talking about amphetamine (Adderall) causing accumulated damage to the brain (albeit, over time) but have not found any scientific papers that exclusively discuss therapeutic amphetamine in this context.

Most of the studies that prove neurotoxicity/damage involve methamphetamine and more importantly, STREET methamphetamine (which is not pure, and whose doses vary tremendously). Meth does not work exactly the same way its sister "regular amphetamine" does. But I feel like people blur the difference between (METH)amphetamine and just simple DL-amphetamine that is in Adderall (or D-amp in Vyvanse).

With that said, if anybody does have a scientific journal/paper discussing therapeutic amphetamine and neurotoxicity, please share it with me.

---------

To the OP:

I started my ADD treatment on Vyvanse 30mg which eventually required a move to 40mg. 30mg is equivalent to 10mg XR according to shire. Due to a variety of concerns, one of which being the cost of 30-day vyvanse (twice as expensive as adderall XR)... my doctor switched me to 20mg XR and I have been happy with that since.

I felt the Vyvanse was less potent at keeping me focused on the task at hand but it did give me more motivation to do what needed to be done. I felt the subjective effects did not last very long at all, not nearly as long as advertised. A dose taken at 9am would no longer be "felt" by 2-3pm. Though, my appetite would still be suppressed until 7-8pm pretty strongly. Very weird. The Vyvanse also took much longer to take effect than Adderall when I switched.

I notice that Adderall XR (Shire) keeps me more focused on the task at hand while also providing the motivation to get it done. However, it also tends to make me very moody or edgy, and sometimes anxious as well. I also feel sped up or "activated" on it whereas I didn't get that same feeling on Vyvanse after awhile. I also felt I developed tolerance to Vyvanse quickly but not as much Adderall.

I took Ritalin (clandestinely) a few times to study in earlier years in college, (Focalin XR I believe, and Concerta) and I also felt a mellowed out attentiveness but overall the attentiveness/motivation was not nearly the extent at which I felt on Adderall or Vyvanse. The mellowed out feeling I suppose could be good for people who are really prone to freakouts or speediness on Adderall/Vyvanse but I didn't like methylphenidate at all.

Everybody's body chemistry is different though, so what works for me one way may not work for you the same or at all. Moral of the story, I guess tell your doctor you want to try a few to see which suits you best.
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Old 01-09-11, 12:09 PM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

I use to take Adderall XR 30mg once a day, until they jacked the price up on me ($180.00/per month). I work and go to college, and don't have insurance. So I ended up trying Vyvanse and that was a mistake, it made me feel like I was tweeked out and I couldn't concentrate on anything. So I ended up going to the regular Adderall taking 10mg 3 times a day, and that still isn't working for me. I can say that the regular Adderall is worthless, and every month the company send's my pharmacy a different pill. The pharmacy still gets there order from the same people as before, but just in the past 3 months they started getting different pills.
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Old 01-09-11, 12:51 PM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

Try Concerta.
Vyvanse is almost the same thing as Adderall, except it's only Dextro-Amphetamine (Dexedrine) with some "pro-drug" technology.

I'm on Ritalin and it's the best medication I've taken.
It keeps me calm and helps me get work done. I've never been jittery on Ritalin.
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Old 10-19-12, 01:34 AM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

Calm and Focused, I really appreciate your post. I am going through a very similar quest for knowledge and understanding of add medication and dosing. I have only lost one job because of my ADD, but it was the position that was supposed to start my career as a permanent state employee. I had studied two years and earn a degree for the position (working at a fish hatchery) and then lost it because just like you described I was in a constant fog. I am now miserable and trapped at my current position until I can get the correct medication and dosage. I am on 10mg adderall ir and I am still not functioning at a high enough level. So scared that it will always be like this.
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Old 10-21-12, 11:37 AM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

I noticed that the all pink XR's are 1/2 as effective as the ones I take now. I thought generics were the same but after reading on here I guess I wasn't "imagining stuff".

The all pink 30m/g's are awful , for some reason the "global" XR's and "MFG-Teva" 30's are much better then the pink brand ... I didn't know what was going on with me !

I was perscribed 90m/g XR P/D but two months ago I had to switch one of the XR's for an IR.

So pretty much , the most effective (as the "brand" was -- I always get brand but they don't exist anymore) "version" is definetly the Global XR and the mfg-Teva ir . (at least for me)

It's insane how one "version" can be so drastically different from another ...
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Old 10-21-12, 11:00 PM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

Some of you adderall pro boners are full of it. Ritalin is proven and works very well , so well that it was and had been the most tested drug for adhd. So aside from the lack of buzzy ness I guess it works ! Not everything is supposed to tweak you .
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Old 10-22-12, 06:42 AM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

With the exception of the new generic (actavis?) The other generics and brand adderall xr are all made by shire so you may want to switch.
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Old 02-01-13, 02:14 PM
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Smile Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

Quote:
Originally Posted by aarondev View Post
what source are you referencing when you talk of 'damaging; to the brain???
I have read that it can have a 'swiss cheese' effect on CT scans. I cannot remember where I read it, I was researching the interaction of prozac with vyvanse. Ultimately this particular patient 'swiss cheese' CT scan was due to prozac (and equivilants) in combination with large doses of amphetamines. He had a psychotic episode and either inexperienced or unknowledgable psychiatrists did not catch the connection of the medication interactions. He ended up on the same ADHD medication (dont remember which one) and D/C'd the antidepressant. Oh and the 'swiss cheese' CT scan lessened. I have also read that long term use or moreover abuse of amphetamines can damage cognitive function. It is less pronounced in methamphetamines. This in turn also coincides with medication tolerance/interactions/missuse etc. So yes it can damage your brain. But, if you educate yourself as with forums like this,advocating for yourself with prescribers and professionals thus taking control 'damaging' your brain is not likely. Hope someone finds that helpful
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Old 02-02-13, 06:15 PM
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Re: Even "Brand" Adderall XR isn't great anymore; switch to Concerta? Vyvanse?

I switched from Dexedrine to Concerta and it's been a great change for me.
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