Vyvanse side effects, "withdrawal", and dosing questions (adult male)

[ruggermc]

Hi everyone, this is my first time posting here and am glad to have found a place to ask questions and get insight on my experiences.

A little background on me. When I was in college I was diagnosed with depression/anxiety and tried a few different meds for a few years until I stuck with a low dose of Paxil a few years back. Just recently a new doc I have been with said a lot of my behavior as a youth and young adult could be explained by ADHD, it was really quite a revelation for me but supposedly teachers had told my parents about it early on but they declined to seek medical help for it, instead trying to work through it naturally.

So with that, about 4 months ago in October, I was diagnosed with ADHD as an adult(29yo). My doc started me on 30mg Vyvanse to see if it would help me at work and WOW I could not believe how much it helped me stay on task, get work done, be sociable with coworkers/clients, etc. (I still take the Paxil btw) I was not taking it on the weekends and having no side effects at all. After a month of that the doc decided to up my dosage to 40mg. Again, great effects no side effects and again I would not take it on the weekends. After 2 months of that we decided to up the dosage again to 50mg. I have been at this dose for about 3 weeks now. The effects are still there, but I feel very 'out of it' and 'nervous'. It is sort of hard to visually focus on what is in front of me. It is difficult for me to fall asleep at night and I just feel sort of strung out and depressed in the evenings. On top of that I still try to not take it on the weekends and last Saturday(did not take Vyvanse this day) I had a very strange episode where I was having the sudden emotional urge to cry all day. My mind would sort of fester on all these guilt emotions and I would just well up. Luckily I have a very supportive family so they helped me through the day. I decided to take my Vyvanse on Sunday and didnt have any of the emotional fits of the previous day.

I don't know if this is a sort of 'withdrawal' symptom from not taking it, a dosing issue, or what, but i'd definitely like to avoid days like that in the future! I have a call in to my doc but he has yet to get back with me. I am continuing to take my current dose(50mg) until I can talk with him.

Has anyone had similar effects as this? Thanks for listening!

[Vickie]

You and the doc can sort out the issues and adjust your med for your needs. You might want to keep a journal so you can talk to the doc without forgetting things that may be important for your med management.

The new dose may be too high or you may need time to adjust. Vyvanse has one blood peak at about 3.5 hours (absorbed and converted to the active dex form- http://www.adhdinfocentre.com/vyvans...nformation.PDF) and then it tapers off over several hours. Watch when you have the side effects. Are they at the peak or as the med is tapering off? Also with too low of a dose, the tapering period can be a bit abrupt for some and not as smooth or as long as a higher dose.

In stress periods, my stress indicators are worse while my vyvanse is wearing off, especially when I was at a lower dose. When the med is wearing off or has worn off, some people have rebound where symptoms come back worse than pre-medication.

Stimulants can increase anxiety for some people and for some, proper treatment of ADHD can decrease anxiety. Some people cannot sleep until the med is out of their system and some (me for one) actually sleep better when there is still med in their system. The rebound period (if this occurs) can really interfere with sleep if it comes at bedtime. So timing is important.

My doc prefers his patients to take meds daily to avoid the ups and downs that can come with breaks. As you are titrating the dose to your effective dose, if you have side effects with a new higher dose that settles down as your body adjusts, then if you skip a day or so, these side effects can come back when you first start up again.

My daughter currently does not take her concerta on weekends so she can eat more, and on Mondays she has more side effects (severe lack of appetite and headaches as the med is wearing off) but these settle down by Tuesday. We plan on trying vyvanse for her soon, because she needs more med duration in high school and wants to try something that may have less appetite effects so she can take the med daily (for many people the appetite issues are less or they settle down in a few months with this med).

[ruggermc]

Little update:
Talked with doctor, am going back down to 40mg vyvanse and taking it every day rather than just during the work week.

Am still a little concerned with my last Saturday and why i got so emotional/weepy. Definitely dont want a replay of that. Anyone else had an episode like that after missing a daily dose?

[jman05]

I have had similar experiences as you. I can tell you that I think it was because your dose was too high and not because of taking weekends off. Your body needs a break from stimulats or you will build a tolerance to them. Just like if you take sleeping pills everyday. Your body will adapt. Especially with amphetamines. I mean these drugs are simmilar to speed! And methheads need more and more over time to keep it working. Plus it is very common for stimulats to eventually stop working years later. If you at lease skip weekends I think this will help so you might as well skip weekends.

Right now the same thing is happening to me. I increased the dosage and later in the week I started to feel out of it and depressed. I think its because it kept building up in my body. It was even worse on adderall. I also got that urge to cry after it wore off so I backed off this week.

Either your body just gives you bad side effects with this drug like it does with some or your dose is to high. But since it worked at 30mg it must be because of too high a dose.

Also every doctor will tell you somethig different so you need to rely on yourself more than your doc.

[kibbled_bits]

I'm not taking weekends off for many reasons: 1) I like having productivity so I can actually get stuff done on the weekends, 2) yes I have less patience with people & a short fuse

There is one school of thought where you stay on your meds most of the time to stay on course mentally & emotionally.

There is another option besides meds or no meds if you can get your doc to give you an instant release version of your medicine for weekends or even evenings (if you had to work evenings). My son is on Focalin XR but Focalin IR (generic) on the weekends which means I can let him sleep in and have it last just long enough and it doesn't effect his appetite as much. For Vyvanse you would be looking at a Dexedrine which is the active ingredient in Vyvanse (since it's basically an extended release Dexedrine).

[ruggermc]

Another little update:

Have been back on 40mg and have been doing much better with the 'nervous' and 'out of it' feelings during the day. I still get a bit of a depressive crash in the evenings but it seems much more manageable. I will probably take the regular dose this weekend just to keep an even level. Depending on how well that goes I will talk to my doc about other options for the weekends later. I have also noticed that having an afternoon snack helps with controlling the crash later in the evening as I have been eating much less for lunch and dinner doesnt come at my house until 8 or so. Maybe its a blood sugar thing? I dont know.

[ruggermc]

Another little update:
Took 40mg each day this weekend. Did not get any of the emotional, depressive episodes that I did when I skipped the weekend doses.

I am still having issues with very cold hands/feet. I have found myself having to wear two pairs of socks now otherwise my toes go numb and ache all day. Anyone else get this? I wonder if it has to do with high blood pressure. I had issues with blood pressure being too high before but was managing it with a mix of meds, diet, and exercise. I know that Vyvanse as a stimulant can increase blood pressure. Put it on the list of things to ask the doc...

[adhdPEteacher]

I have cold hands...i am on 40mg of vy....Its been almost 2 months on it, and I have a feeling I might have to be bumped up. I am a big dude, almost 250...so I think that has some of it. I do also have issues of high bp.....
so far my blood pressure has maintained control. Even though I am shovling slow like a mad man outside....keep up the good work....