What should I expect from Vyvanse?
August 26, 2010 5:09 PM   Subscribe

What should I expect from Vyvanse?

My doctor recently diagnosed me with ADD. I have trouble concentrating, etc.
Pretty much like what the person here described.

Except I am a 30 year old male.

As part of treatment she prescribed 30mg of Vyvanse, I didn't notice a difference, now I am on 40mg of Vyvanse, for about a week now.

I don't know what to expect, I'm going stir crazy, almost OCD like trying to figure out if I've changed. I'm not even sure I can focus because I'm constantly questioning am I focused or focusing better, I still fidget a lot and shake my leg whenever sitting still like always, and still very unproductive.

I've been trying to read 'Delivered from Distraction' and 'You mean I'm not Lazy, Crazy, or Stupid' along with 'The Skinny on Willpower', but not much is getting done so far.

Any input I would appreciate!
Sorry, this is anon so I can't really post a response back to any questions. But I weigh about 215 if someone wants to think it has to do with dosage vs. weight.
posted by anonymous to Health & Fitness (14 answers total) 5 users marked this as a favorite
My son takes Vyvanse, and he's said that he doesn't *feel* any different when he's taking it. However, his father and I can see that it works- he focuses longer, he fidgets less. I say give yourself some time to relax- another couple of weeks- into it and see if you're getting more accomplished during your day.
posted by headspace at 5:58 PM on August 26, 2010

I'm in the same boat. I'd been on Strattera for a while without any real effect (when I went off, though, I noticed I bounced more, so maybe there was a small one). I had had a bad experience with one day (just one day!) of Ritalin several years ago that had scared me off of fast-acting stimulants.

Now that I've been on 20 mg of Vyvanse for a week, I haven't noticed a thing. I suppose that's good, since it's easier to go up :) But Vyvanse really shouldn't have a break-in period, or "build up" in your body. It goes in and it goes out within a day. Now that you've been on it for a week, you might check in with your doctor to up it.

Also, I'm very familiar with the "is it working?" line of self-questioning. Get someone close to you that you trust to help monitor how you're doing more objectively. That was part of my diagnosis, actually; I had to bring someone else in to see how their assessment matched mine. Agree on a couple of things to look for: How's the fidgeting? Are you stopping in the middle of sentences? Can you do some math problems and then go back to what you're doing, or do you have to go back to Wikipedia and look up the Belgian royal family again?

Good luck! MeMail me if you want to go through this together; it'll be a barrel of monkeys.

P.S. You might want to ask a mod to put a throwaway Gmail address into your post so you can communicate with people.
posted by Madamina at 6:08 PM on August 26, 2010

44-year old female chiming in. I started Vyvanse about a year ago for a long-undiagnosed case of adult ADD. Also have very mild Tourette's as well (no meds taken for that).

Here's what I noticed in the first couple of days: Marked difference in attention. Ability to stay focused and get things done (whether they are miscellaneous tasks or big projects). Emphasis here is intentional: Marked difference. . This was noticed in the first two days of starting drug. Initial dosage was 20 mg for one week, then 30mg, then 50mg.

Immediate side effects: Hyper-awareness. Weird cold flashes that caused goosebumps (lasted about 5 seconds total for each occurrance). High level of emotion (not crying, just the feeling of being connected and engaged). Significant loss of appetite. I went from a size 12 to a size 8 in less than a month, and I'm 5'8". Honestly, when I took the drug the first day it gave me the same sensation of snorting a (big) rail of cocaine.

Dr. eased me back to 40 mg after about 6 months, which is the happy medium for me. Less side effects, but still have the benefit of the focus. I get shit done on this drug, but not in a fractious, nutso manner. I don't find that I stop in the middle of things and get distracted. I go from task to task, finishing each one, then starting new one. Believe me, that is NOT the way I was prior to this med.

I mentioned the high level of emotion because it is not typical of me when I am not on the drug.

Yes, there are side effects. But this drug has done wonders for me.

Hope this helps.
posted by sundrop at 6:50 PM on August 26, 2010

I've been on Adderall for two months now, and I thought that it wasn't working. It was only after talking to a friend about what I'd done over the past two months that the "big picture" clicked into focus. I'm getting things done that I've sincerely wanted and intended to get done for a long time. When I try to do the right thing and work hard, I can actually DO it.

I expected that I'd immediately be able to tell if the Adderall was working. It would feel like a magical pill that fixed my brain and turned me into a motivated go-getter. That isn't the case; if I don't put the effort into being responsible, I'll still sit around reading Metafilter when I should be working. I'll just be really focused on Mefi. In another ADD meds related question, someone said that their meds made their attention like a laser beam, but they're still responsible for focusing that laser beam on the things they want to pay attention to. Reading that also helped me to answer the question of whether the meds were working or not.
posted by freshwater_pr0n at 7:04 PM on August 26, 2010 [1 favorite]

I just started on Focalin two days ago, and I had the same coked up feeling the first day. Beyond that, I have noticed a difference in my behavior, and that difference is that when I decide to do something, I can follow through and complete it. As for those things that I knew I wanted to do but could never seem to get started on, I've been systematically completing those tasks one by one in an orderly fashion. Amazing. Today I had to tell myself, "you've spent enough time cleaning. It's time to relax." Trust me, THAT has never happened before.

For me to pay attention to something, I still have to decide that I want to pay attention to it. It doesn't make me a better worker or help with my cleanliness unless I decide that I want to be more efficient or more clean. But now I have the ability to make those decisions and follow through with them.
posted by TrialByMedia at 7:14 PM on August 26, 2010 [1 favorite]

Honestly, when I took the drug the first day it gave me the same sensation of snorting a (big) rail of cocaine.

I'm glad I wasn't the only one... First day going from adderall xr to vyvanse and the inside of my head was melting around 11am. After that first day, nothing.

Vyvanse positives: lasts longer than Adderall XR. Seems "cleaner".

Vyvanse negatives: where Adderall XR seems very even in its effectiveness throughout the day, vyvanse seems to be more peaky around the middle of the day. This also means it tapers off more slowly for me. If I don't take it early enough in the day, I have trouble getting to sleep. And I've come to believe that I am a "slow metabolizer" of amphetamine, which was exacerbated greatly by taking zoloft at the same time. The amphetamine was building up in my system, and I was only "sleeping" when I would crash from exhaustion. I knocked the dosage down (to the confusion of my doctor) and got off the zoloft, and I'm fine now. But look out for that effect.

My reactions in general to amphetamines (adderall or vyvanse, not illicit): I don't "like" it, like some people like speed. But I don't dislike it either. I really don't notice it, except that when I don't take it, I am back to my tired, unfocused self.

I first started on Adderall, and I knew it was working when I sat down for my usual evening reading with the TV on routine. I read for an hour, and had NO idea what was on the TV. My focus was 100% on whatever I was reading, which was completely unusual for me.
posted by gjc at 7:30 PM on August 26, 2010 [1 favorite]

I'm on mixed amphetamine salts (MAS, generic Adderall). It increases my heart rate, has a stimulant effect that makes me feel less tired and more energetic, and makes me much more focused mentally, sometimes to the point of elevating my OCD symptoms. I tend to take less notice of time passing when I'm on it. I tried Vyvanse for a little while but I found its effect to be muted compared to the MAS in a way I can't quite explain. It still had a noticeable effect although my MAS dose translated into more than twice what you're taking in Vyvanse.
posted by XMLicious at 7:38 PM on August 26, 2010

Also, I feel no need for coffee in the morning because the MAS has an even better effect on wakefulness for me.
posted by XMLicious at 7:39 PM on August 26, 2010

On further thought, I realized that I forgot to mention a big side effect: elevated blood pressure. I started tracking my BP, and found that it was hitting as high as 160/110 at around hour 3. Scary.

I also take Lexapro (20mg), and found that, with some experimentation, if I stagger the Lexapro 3-4 hours after taking Vyvanse (taken upon awakening), the crash at end of day is lessened. I was experiencing a depressive, anxiety-filled crash starting at around 6pm.

If I take the Vyvanse after 11am, I have much trouble falling asleep before 1am. However, if I don't take the Vyvanse at all, I am sluggish and lethargic.

For me to pay attention to something, I still have to decide that I want to pay attention to it. It doesn't make me a better worker or help with my cleanliness unless I decide that I want to be more efficient or more clean. But now I have the ability to make those decisions and follow through with them.

TBM is spot on with this. Was previously unable to put that into words. Thanks, TBM!
posted by sundrop at 6:34 AM on August 27, 2010

The really big thing that I saw when I started on Adderall was that I suddenly found whole passages in books that I had no idea were there. I read for enjoyment, and re-read books I like; but on Adderall, books I'd read several times suddenly had a lot more in them. Yes, I was able to focus on other things, accomplish tasks of importance, stay on task longer, etc etc etc. But I just hadn't realized how much of *life* (not work) I was missing by not being able to focus, either.

My husband finds that when he's forgotten to take his Vyvanse, his attention drifts at work; he doesn't stay focused, but gets distracted frequently. He doesn't really *feel* a difference, but after a few hours at work it's really obvious to him if he's accidentally forgotten it (and keeps some in his work bag just in case he does forget).

Maybe if you want to see a difference, after you've been taking it a couple of months, try not taking it for a day and see if there's a difference. It'll probably help to wait a couple of months, though, because the adjustment to taking ADD meds is not exactly instant. Let your body settle into it before expecting noticeable change.
posted by galadriel at 9:35 AM on August 27, 2010

My answer in that AskMe you linked to was about Vyvanse. For me it was really, really obvious that it was working the first time I took it, which makes me think that either it's not the right drug for you or you need a higher dose.

My understanding is that weight isn't relevant when figuring out what your dosage should be, because it's metabolized in your liver (note: I could be entirely wrong about this). I know people much lighter than me who take the same dose that I do.
posted by The corpse in the library at 12:18 PM on August 27, 2010

You can go much higher, dosage-wise, than 40mgs.

If you don't know whether you're focused, you probably aren't.

A good test I use is trying to read something that I usually get distracted from or find difficult to motivate myself to read even though I want to read it.

Whether or not you can sit still is a good test, too. I twitch even when well-medicated but I CAN sit still if I want/need to.
posted by the young rope-rider at 1:03 PM on August 27, 2010

By the way, is there any chance that you do have OCD?

If so, it's worth it to get screened for that, too. The two conditions can co-exist and in my experience stimulants can make OCD more uncomfortable.
posted by the young rope-rider at 1:05 PM on August 27, 2010

40mg is a fairly small dose of Vyvanse.

Here's the thing about Vyvanse, though: It's brand new (yes, Vyvanse is just extended-release Dexedrine, and Dexedrine is crazy old-school, but still), and due to the kids-first nature of ADD drugs, it hasn't been widely tested on adults. Hence the careful toe-in-the-water dosage.

IANAD, but given the above, it seems to me that if Vyvanse is the first line of medication your doctor has prescribed for your adult ADHD, she's doing it wrong. There are plenty of other options whose effects on adults are much better known. Is she a specialist? You want a specialist. Really. See a specialist.

Do you remember signing any forms re: medical trials? (If you don't want a placebo, don't!)

Anyway. I'm on Vyvanse now, after exhausting all the other pharmaceutical options. Milligram-for-milligram, Vyvanse is (for me, anyway) way, way, way weaker than similar extended release stimulants like Adderall XR and Concerta, which actually WORKED! HOLY SHIT! but my stupid heart is stupid so I can't take those anymore. And those drugs were a hell of a lot cheaper than Vyvanse, too. Frankly, in my experience, Vyvanse is a couple of notches below a Venti Americano in terms of effectiveness. YM-will-certainly-V, but, yeah.
posted by Sys Rq at 10:07 PM on September 8, 2010

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