Oh no! This parachute is a napsack!

September 26, 2008 9:32 PM

I'm having what I believe are awful side effects from Vyvanse, and I need some advice from adults with ADHD regarding other drugs to consider, and how to deal until I can see my doctor.

I'm a 37 year old man with a successful career, in good health, and a great family life. However, about a year ago, I was diagnosed with anxiety with depression, and began treatment with meds and therapy. It has been quite beneficial to mel; the first therapist I tried is quite talented, and it's good to know that negative-self talk isn't normal, and that day-to-day life can actually be much better than I thought.

The meds were kind of a rocky ride. My physician (not the therapist) first gave me Welbutrin, which was terrible. My heart would race, it would feel like I was spinning, I would have these feelings that the world was ending, feelings of great fear and anxiety, and an incredibly annoying tic where I always felt like I needed to open my throat in such a way that it pushed down my adam's apple.

The doctor switches me to Buxpar, which ten minutes after taking it gave me that momentary pleasant feeling one gets after a good, hard sneeze. Then it did nothing. Plus, you're not allowed to eat pineapple when you are on it.

So I switch doctors, and my new one tells me that she isn't surprised that the first two did not work. She puts me on Celexa, and after an initial battle with the throat tic, it works very well, except for making me sleepy during the day.

This past spring, I come to terms with the fact that each day at work, I get .5% of forty tasks done, but I'm not finishing anything. I read the symptoms of ADHD, and it was a near-perfect description of me. I had just about every symptom on the checklist. So I get tested, and I indeed, have ADHD.

So I start taking Vyvanse. I think the initial dosage was 35mg/day. At first it was awesome: I had amazing energy, a feeling of euphoria, and was getting stuff done at work. Looking back, I may have been a bit manic, because I could not stop working. I just felt this incredible drive to GO! GO GO!

Eventually, all the good seems to go away, and I feel like the medicine has quit, so my doctor ups the dosage to 70/mg a day, maybe three months ago.

Now, I feel like my ADHD is worse than it was before. The throat tic is back, and I have another, annoying, painful, tic: I cannot stop clenching my bowels. I have done it so much lately that I have a constant ache in my lower abdomen, presumably from all the clenching and releasing of the bowels.

Also, I am completely unable to focus on anything, and my procrastination is just terrible. I'm spending a bit more money than I should (on stupid stuff, like phone and iPod accessories), and I'm shirking basic responsibilities at home.

I feel depressed and and anxious so much of the time, which is a shame right now, because any day now, my wife is going to have our second child, and it should be a joyous time, but I just feel so out of sorts. It's like everything is painful, and it's just robbing me of all joy.

Before I got into all this mental health stuff, my anxiety was killing me. I was having trouble sleeping, breathing, I was irritable and even explosive. There were times I would just try to sleep during the day in order to shut off the negative self-talk.

Entering therapy was hard for me, but worth it. I have deep regrets that I didn't get tested for the anxiety/depression and ADHD sooner, and as I said before, getting the meds right was kind of traumatic for awhile. I know I don't want to give up and go back to the old life, but I don't want to live like this anymore.

Yes, YANMD, and I will talk to my doctor asap. I'm just the only one awake in the house, and I need some input to get me through the weekend (and maybe, beyond).

I'm looking for both advice and stories from people who have been in similar predicaments to mine. I apologize for the length of this post. Thanks for reading, and thanks in advance for your input.

posted by 4ster to health & fitness (6 comments total)

I was on adderall XR before I started on Vyvanse. So far Vyvanse has been better for me than adderall, but everyone's body/brain chemicals are different.

Finding the right dose and right medication is time consuming and can be expensive.

One thing I really found is that medications are not some super duper pills that will make you perfectly "normal". You need to work with you medications in order to experience the best results. When I first started adderall in college after being diagnosed, I could tell I was more focused and stuff and with the help of an academic counselor I was able to learn how study, focus, organize, etc. When you start a new med, use the initial honeymoon period to work on getting into better habits.

I would write more, but i can't concentrate. I ran out of my pills and they are $130 because I don't have health insurance and I am broke right now. You see, the down side of meds is that you can begin to rely on having them around and when you miss a dose, it really sucks.
posted by silkygreenbelly at 10:18 PM on September 26, 2008

If Celexa worked well for you but for the sleepiness, it might be worth asking about meds in the same pharmaceutical category.
posted by gnomeloaf at 8:14 AM on September 27, 2008

Wow -- those are definitely not good side effects. I imagine it's very difficult to go through the weekend feeling like that. Fortunately, remember -- one weekend is only 2 days -- so consider yourself 'halfway' through this. Look up the manufacturer's website and wikipedia article about your medicine. When you see your new doctor, give her your printed-out post and any other typed-out descriptions of how you are feeling right now. Cover these areas as applicable:
-sleep
-appetite
-exercise level if any
-energy-to-get-things-done level
-anxiety level
-ability to focus
-if you get unreasonably angry/any kind of anger levels
-tics and your other physical symptoms
I found it's easier to keep a little written summary than to try and remember everything.

As for the actual ADHD medicine talk: I know several people diagnosed with ADHD. I take Concerta and it works for me. One friend takes Adderall short-release; Ritalin and Concerta didn't do much for him. One friend takes Strattera; I know he went through several of the other medications. My point here is that you have plenty of options with the medicine -- they ARE different enough -- and, on the plus side, ADHD medicines don't tend to have a 4 to 8 week waiting period to see if they're helping you. They tend to have more immediate effects. It's (very!) normal to not have the very first medicine be exactly right.

And with all that being said, silkygreenbelly is absolutely right -- a drug won't reinvent your specific ways of working, but it'll help you do it yourself. The right medicine can help you be able to sit back and say "Hunh. I notice I have this tendency to do [whatever]. I wonder how I could change it." -- AND -- then -- that you can 1) concentrate on and 2) put forth effort to make those changes. That's the miracle-feeling part.
posted by oldtimey at 8:36 AM on September 27, 2008

I switched to Vyvanse 50 mg from Adderall XR 15. It seemed like too much. I felt speedy, with some of the things you talk about. I felt likt the top of my head was going to shoot off, it raised my blood pressure, and stress really affected me. Dropped down to 40 mg and it's just right. 10mg did make a big difference.

Going from 30 or 40 to 70 is a LOT, it seems to me. 70 is the highest dose available. But Vyvanse is a new drug and the doctors are still working out the "art" of getting prescriptions right.

Even once you get the dosage right, the ADHD drugs aren't magic. They give you the ability to focus, but only if you try. You still have to reinvent your working style and work out all the old bugs from your ADHD ways. That tangible feeling of "hey I feel awesome and am getting a million things done" isn't how they are supposed to work forever- that's just you taking speed. If you try to keep that up, that's how you end up with an abuse problem.

The way it was explained to me is that people with ADHD suffer from a deficiency of sorts, of stimulation. So the amphetamine (that's what adderall and vyvanse are) bumps this back up. Even though you get used to the "speedy" effects and don't feel them any more, the drug is still supplying the stimulation.

(Funny speed story- some old ball players were talking about the good old days when speed was something a lot of players used. They called them greenies. The one guy said the funniest thing he ever saw was Pete Rose's greenies kicking in during a rain delay.)
posted by gjc at 10:54 PM on September 27, 2008

Way later:

If you felt like you were a bit *too* manic on your 35mg, then you just might be quite sensitive to it, in which case, you might have been on too much, and burnt out a little - Too much Speed, equals adrenal burnout & tiredness.

The clenching etc sounds like a variation on standard amphetamine side-effects - tics, teeth grinding, compulsive behaviours (this includes the spending!), etc.

Whatever you're doing, you've probably done it already, but I really hope you went on *less* Vyvance. There'd be a bit of a hump, but it doesn't sound like the doses you were on were helping.

Go back to basics. The depression & anxiety are problems, therapy seems to have helped lots, celexa a bit. Explore looking at more depression meds, but I'd focus on the therapy, and complimentary methods of dealing with depression, exercise etc.

Also - as a new parent, you're going to be concentrating on getting *sleep* soon, and it may be irregular. There's good sides and bad sides to speed-like meds as a new parent - it may keep you up and keep you going, although the manic underslept-parent state seems kinda similar to that anyway, but many ADHD meds will make it harder to go to sleep, and go back to sleep after waking. but some depression meds will fuck with that too.

Gah. Try and find some little aspect of your life you have control over. Just... revel in the control you have there, it's an anti-dote to the 'I have no control over things' that often causes depression.
posted by Elysum at 7:21 PM on October 6, 2008

I just wanted to check in and report, for anyone who might read this in the future, that the problem turned out to be that my dosage of Vyvanse was too high. Once my physician lowered the dosage back to 35mg/day, things got much, much better.
posted by 4ster at 10:00 PM on November 14, 2008