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Vyvanse (lisdexamfetamine dimesylate)

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Old 12-12-12, 06:18 PM
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Is Vyvanse unpredictable at first? and closest dosage equivalents to other options?

First off, I just created my account and this is my first post... (also, please don't hate me if i go off on a bunch of tangents or use all the emoticons i use in internet speech like this *O;* ...) ok anyways...
I won't try to go into telling you my whole life story, but I'm 15 now, and got diagnosed a few months ago in the summer after going on a quest on the internet to find out what caused my insomnia, depressive episodes, and anxiety issues (I'll elaborate when they become more relevant in this post.)
Back to the topic though ._. ... In October, I started Adderall XR 10mg which I expected probably wouldn't work seeing as that I'm an overweight teenager ._.
The next month (November), I was put on Adderall XR 20mg. I don't know if this is really illegal or anything and I know it's generally bad, but once or twice with each prescription, I tried taking two and DID tell my mom and doctor about it (my mom is a NP - although in women's health - so I figured I didn't have to feel as guilty.) The doctor told me to call him if I need a dosage adjustment (again, this will become more relevant later in the post.) My experience when taking 40mg of the Adderall XR caps (which are the 'Actavis' generic kind, if that makes a difference although the 10mg ones weren't) was that if I ever got distracted, I got this feeling of being "unnatural" or that something wasn't right, but this went away when I got back to work on whatever I was doing. I figured this was just what it felt like when it was working/the correct dose or that I should've been more around 30mg since 20mg was only marginally effective for me. Earlier this month - 12.4.12 - I told my doctor about how I took the Adderall in the morning and it only lasted until the last two periods of my school day. Therefore, he figured Vyvanse would be a good option (I'm interested in pharmacology and lots of medical stuff so I had already known about it, but I tried not to blurt out too much information to not sound like a drug seeker or anything... :c) I did tell him that I've seen the generally true
"10 = 30
20 = 50
30 = 70"
for Adderall XR to Vyvanse (yes, the first number being the former and the second being the ladder - I'm just too lazy and have too much to say.)
His knowledge was that it was a 2x thing (a Vyvanse dose being 2x the equivalent of Adderall XR) so he decided that 40mg of Vyvanse should be good, but that I should call him if I need to change anything (medicine/dose/etc). Here's where the problem comes into the story. I (again, I know I shouldn't do this and that it's dangerous) tried two 40 mg capsules one day and honestly, it was a lot better. I'm usually irritable and prone to anger so it's hard to distinguish if it's just me or the Adderall possibly exacerbating it. The Vyvanse, on the other hand, didn't make me angry/irritable, and didn't make me feel like something was "not right" when I got distracted; I just didn't have any of the issues I usually have (both with and without Adderall). I tried just taking one capsule and hopefully waiting it out until my next appointment (In 30 days ) but I honestly can't. Today (and previous times this week), I was all spacey in all of my classes, I put homework off yesterday and had to turn in an incomplete assignment that counted a lot, and I forgot clothes for gym class even though I put them right next to my bag. [Here's where the anxiety and/or depression comes in:]. Before getting diagnosed, my set of coping skills that developed was anxiety. Honestly. I couldn't lose focus if I was busy in shock. I couldn't find time to fidget and pick at my skin if there was a surge of epinephrine running through my body. Actually, this backfired. I would get too stressed out (which made me move, pick, and scratch even more), suffer from panic attacks (I'm not diagnosed with an anxiety disorder, but I think I have a general idea of severe anxiety :|), and when the anxiety became to much, I'd hate myself and be driven into depression for almost a month at a time (again, no formal diagnosis, but the psychologist evaluating me said "Adjustment disorder w/ anxiety and depression" which I guess was probably on the basis that I hadn't described my previous 'episodes' as I call them and I had told them about my parent's recent divorce, which, wasn't the cause (it was frustration over my focus issues). This week, I've been trying to prevent that from happening, but it's too hard when my medication, which isn't even equivalent to the marginally effective dose of my previous medication, doesn't let me live normally. (Note: I am very sorry for writing my life story almost even though I said I didn't want to -.-) I guess my point is:
Has anyone else found a good dosage for Vyvanse that doesn't seem to work at first? I like it better than Adderall XR, but I'm honestly hoping that I can get my dose adjusted so I can live like a normal person. Also, if you've gone on titration paths for both meds (or even others - as long as they can be compared to Adderall XR or Vyvanse), what dose was equivalent?
*sigh* -i am very sorry for ranting :|-
IMO, when I find the correct dosage is when I don't need to consume >400mg of caffeine per day in addition to medication to not be called 'weird/crazy/etc'...
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Old 12-12-12, 07:45 PM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

You will get more replies if you use paragraph breaks, and think of ways to edit that down. A lot of us can't read blocks of text.

Can you summarize your question for us?
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Old 12-12-12, 08:26 PM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

ok sorry >.< i digress a lot and wanted to just have any of the information that might or might not be helpful...
So it is::
Has anyone else on Vyvanse had weird ups and downs when starting on a new dose? Or was it pretty even every dose adjustment?
and
Comparing the medications (both Adderall XR and Vyvanse) :: what is the equivalent dosage to either the former or ladder or even compared to other groups like methylphenidates, dextroamphetamine (by itself)... at least in people's experience
ex: xx mg of methylphenidate = xx mg of Vyvanse
or just xx of Adderall XR = xx of Vyvanse -- which is more helpful if I'm staying with just the choice of those two medicines.
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Old 12-12-12, 08:31 PM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

Yeah, you're posting on a forum full of people who find it difficult to concentrate and group information together here. Walls of text don't exactly help
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Old 12-12-12, 09:45 PM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

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Originally Posted by Cenex22 View Post
Yeah, you're posting on a forum full of people who find it difficult to concentrate and group information together here. Walls of text don't exactly help
yeah, sorry... i posted a simpler reply, but i assume it's still going through the moderation thing since i'm new to the forum and what not... unless if i forgot to post it ._.
but on the flipside, i hope people (especially ADHD-I - which is my diagnosis) can relate to the fact that digressing happens really easily and everything seems relevant when there's only one, two, three, or more degrees of separation
... i have a hard time not going into paragraphs about one simple topic >.<
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Old 12-13-12, 12:22 AM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

Quote:
Originally Posted by dougpoop View Post
ok sorry >.< i digress a lot and wanted to just have any of the information that might or might not be helpful...
So it is::
Has anyone else on Vyvanse had weird ups and downs when starting on a new dose? Or was it pretty even every dose adjustment?
and
Comparing the medications (both Adderall XR and Vyvanse) :: what is the equivalent dosage to either the former or ladder or even compared to other groups like methylphenidates, dextroamphetamine (by itself)... at least in people's experience
ex: xx mg of methylphenidate = xx mg of Vyvanse
or just xx of Adderall XR = xx of Vyvanse -- which is more helpful if I'm staying with just the choice of those two medicines.
Yes, I found Vyvanse to be an unpredictable med because of the release mechanism. Lots of ups and down, and it seemed to be affected by what I ate.

Supposedly Vyvanse is about half as potent mg to mg as dexedrine/ adderall, because of the fillers, but I didn't find this to be true. I actually found vyvanse far more potent than it was supposed to be, most likely because of how my body metabolized it.

Some people are the opposite, and find vyvanse less potent. There's really no way to tell until you take it because of the unique release mechanism.

I personally would just start over with a new titration process when switching, but for myself I find 1 x 30 mg vyvanse equal to 2 x 10 mg dexedrine ERs
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Old 12-13-12, 03:16 AM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

Quote:
Originally Posted by dougpoop View Post
Comparing the medications (both Adderall XR and Vyvanse) :: what is the equivalent dosage to either the former or ladder or even compared to other groups like methylphenidates, dextroamphetamine (by itself)... at least in people's experience
ex: xx mg of methylphenidate = xx mg of Vyvanse
or just xx of Adderall XR = xx of Vyvanse -- which is more helpful if I'm staying with just the choice of those two medicines.
It is relatively easy to give precise numbers of what is in Vyvanse. The Wikipedia article on dextroamphetamine has this information:
Quote:
The conversion rate of lisdexamfetamine to dextroamphetamine base is 0.2948, thus a 30 mg-strength Vyvanse capsule is molecularly equivalent to 8.844 mg dextroamphetamine base.
The 0.2948 figure is credited thus: So, the drug content in 30 mg of Vyvanse is approximately equal to 9 mg of Adderall (Adderall is mostly dextroamphetamine with some levoamphetamine; Vyvanse is all dextroamphetamine). However, it's very important to note that this does not at all mean that Vyvanse is less than one-third as "strong" as Adderall - your body takes in the two drugs in a different way, making them hard to compare. It depends on what you eat, any other things you might be taking, when you take them, and so on.

You can reliably say that a Vyvanse dose should be a somewhat larger number than an Adderall dose, maybe sort of about double. But that's about all you can say. You and the doctor have to figure it out. There is absolutely never going to be an exact match-up of dosages that works in the real world. Anybody who knows for sure, is wrong.


Note: There is a difference between latter and ladder. The former is not the same as the ladder, and you climb on the latter.
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Old 12-13-12, 06:01 AM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

I'd suggest you forget about those mg to mg comparisons. Vyvanse has a totally different release mechanism...then "pure" amps. It works great, however, once you get to the right dose. My doctor started me on 20mg and we increase the dose each month until I got to 70mg. Then I didn't need to drink energy drinks/coffee to stay alert/focused.

Start low and go slow..
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Old 12-13-12, 09:02 AM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

I've found that combining caffeine with vyvanse (or adderall) makes the medication extremely erratic.

I'd encourage you to quit caffeine and then work out the vyvanse dosage. Eliminate variables so you can get a better sense of what's going on.

This is what I had to do; I used to drink a ton of coffee along with the vyvanse, and it was pretty miserable. Anxiety attacks, mood swings, bouts of being completely over stimulated, etc.

Since you're interested in pharmacology, caffeine and amphetamines have a synergistic effect. Amphetamines make the dopamine stick around in your synaptic cleft longer, while caffeine will give you brief bursts where your brain dumps extra dopamine into your system. The combination of the two can be incredibly intense.

It's an oddly subtle but intense effect. Seems like very few people, and especially doctors, are aware of how strong this interaction can be.

I've found that I can tolerate decaf coffee as a small boost now that i'm at the proper dose of vyvanse. Decaf still has 5-15 mg of caffeine per cup. For me, personally, my brain chemistry makes me something like ten times more sensitive to caffeine while on vyvanse than normal.
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Old 12-13-12, 04:16 PM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

Quote:
Originally Posted by dvdnvwls View Post
It is relatively easy to give precise numbers of what is in Vyvanse. The Wikipedia article on dextroamphetamine has this information:
The 0.2948 figure is credited thus:

So, the drug content in 30 mg of Vyvanse is approximately equal to 9 mg of Adderall (Adderall is mostly dextroamphetamine with some levoamphetamine; Vyvanse is all dextroamphetamine). However, it's very important to note that this does not at all mean that Vyvanse is less than one-third as "strong" as Adderall - your body takes in the two drugs in a different way, making them hard to compare. It depends on what you eat, any other things you might be taking, when you take them, and so on.

You can reliably say that a Vyvanse dose should be a somewhat larger number than an Adderall dose, maybe sort of about double. But that's about all you can say. You and the doctor have to figure it out. There is absolutely never going to be an exact match-up of dosages that works in the real world. Anybody who knows for sure, is wrong.


Note: There is a difference between latter and ladder. The former is not the same as the ladder, and you climb on the latter.
oh darn just another homophone teachers have beaten wrongly into my head... I read enough about the Adderall salts mix and the comparison to lisdexamfetamine... i just wondered how people feel despite different "literature" saying slightly different conversion equations (at least what i've seen) and what not...

Quote:
Originally Posted by Plognark View Post
I've found that combining caffeine with vyvanse (or adderall) makes the medication extremely erratic.

I'd encourage you to quit caffeine and then work out the vyvanse dosage. Eliminate variables so you can get a better sense of what's going on.

This is what I had to do; I used to drink a ton of coffee along with the vyvanse, and it was pretty miserable. Anxiety attacks, mood swings, bouts of being completely over stimulated, etc.

Since you're interested in pharmacology, caffeine and amphetamines have a synergistic effect. Amphetamines make the dopamine stick around in your synaptic cleft longer, while caffeine will give you brief bursts where your brain dumps extra dopamine into your system. The combination of the two can be incredibly intense.

It's an oddly subtle but intense effect. Seems like very few people, and especially doctors, are aware of how strong this interaction can be.

I've found that I can tolerate decaf coffee as a small boost now that i'm at the proper dose of vyvanse. Decaf still has 5-15 mg of caffeine per cup. For me, personally, my brain chemistry makes me something like ten times more sensitive to caffeine while on vyvanse than normal.
haha I know what you mean with the overstimulation and what not :\ except that was more caffeine than usual for me... I think it's generally still helpful if I stay under 200mg of caffeine because I haven't found Vyvanse to take effect for about 2 and a half hours, and after that, it's pretty smooth. So I've found in this past week and still with the Adderall previously, if I have my caffeine (which I think has approximately a 5 hour half-life) early enough in the time window before the medicine hits me, it gives me a nice kick until the meds take effect.
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Old 12-14-12, 02:00 AM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

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Originally Posted by dougpoop View Post
oh darn just another homophone teachers have beaten wrongly into my head... I read enough about the Adderall salts mix and the comparison to lisdexamfetamine... i just wondered how people feel despite different "literature" saying slightly different conversion equations (at least what i've seen) and what not...
The answer to how people feel is... "differently". There is approximate agreement that what your doctor told you is more-or-less correct. Beyond that, every person has to find the right balance.
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Old 12-14-12, 11:45 AM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

I tend to think of Vyvanse as being more like an in-between IR and XR version of amphetamine (dexedrine or adderall...take your pick). Adderall XR takes longer to peak by an hour or two. Vyvanse peaks rapidly but not quite as fast as normal IR amphetamine.

Even though 70mg of Vyvanse is supposed to equal 30mg of amphetamine I would say 40mg is closer to being correct. The reason is that Vyvanse gives a consistent and almost perfect absorption pattern.
Regular amphetamines absorb very poorly. Depending on conditions you might only get 50-60% of the dose and the rest gets eliminated in urine.

From my experience comparing methylphenidate to amphetamine is difficult. Apples to oranges. I've found with methylphendiate there is a very fine line between it working well vs. crap side effects.
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Old 12-14-12, 11:56 AM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

Quote:
Originally Posted by dougpoop View Post
haha I know what you mean with the overstimulation and what not :\ except that was more caffeine than usual for me... I think it's generally still helpful if I stay under 200mg of caffeine because I haven't found Vyvanse to take effect for about 2 and a half hours, and after that, it's pretty smooth. So I've found in this past week and still with the Adderall previously, if I have my caffeine (which I think has approximately a 5 hour half-life) early enough in the time window before the medicine hits me, it gives me a nice kick until the meds take effect.
Well, best of luck sorting it out

I still can't stress enough how little caffeine it takes to completely skew the effects of vyvanse. My advice is still to quit caffeine completely and then slowly re-introduce it once you get to a stable point with the vyvanse.
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Old 12-14-12, 02:05 PM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

Just a thought - some people say that they can't "feel" Vyvanse working, even though it is. Something like "no buzz, just a calm focus". Measure by your results, not by whether you feel it working.
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Old 12-15-12, 06:34 PM
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Re: Is Vyvanse unpredictable at first? and closest dosage equivalents to other option

vyvanse is pretty predictable to me, but i've been on it a little so i'm used to it. The day they release a generic form of the medication will both be a blessing and a disguise.


I didn't start experiencing bad downs with adderall xr until I started increasing my dose for higher effectiveness. Regardless if it was adderall or vyvanse though, the downs would hit when the medication wore off and I hated it. However, once I started eating a balanced diet, exercised on a regular basis, and gave up coffee or anything with caffine in it, the down effect was very small (I could feel myself lose some focus, but that was about it). MUCH more manageable at that time.

Also, I was able to find this, let me know if it helps:

70mg of Vyvanse is roughly equivilant to 30mg Adderall XR (According to Shire). 30mg of Adderall XR is roughly 22.50mg Dextro-amphetamine (75%).

30mg Vyvanse = 7.50mg D-Amphetamine
50mg Vyvanse = 15.00mg D-Amphetamine
70mg Vyvanse = 22.50mg D-Amphetamine
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