How can I have a fun night out on ADD meds?
March 13, 2015 7:41 AM   Subscribe

I have ADD, and have been taking Vyvanse for the past year. It works well when I take it around 6:30 AM, but by 8 PM I have little energy to do things with friends, even on Fridays/Saturdays. When I do go out, I have a hard time enjoying myself since my brain is basically shut off. My friend's bachelor party is coming up, and we'll be out late. I want to be there to celebrate with him until the end, and not be snoring on the table. How can I accomplish this?

We'll be riding on a party bus for the bachelor party, so I'd have a hard time bowing out early. Also, he's a good friend and I'd like to stay with him until the end.

The thing is... the last time I went out with friends, I couldn't wait to get home - I was just so incredibly tired. I kind of just sat there towards the end, and couldn't follow conversations very well at all. We were only out until 10 PM, so it's not like I was pulling an all-nighter at a club, which would have explained my lethargy a bit better. My friends sometimes joke about me having turned into a homebody; a lot of them don't know that I'm taking ADD meds, and I'd like to keep it that way.

I used to have more energy before taking Vyvanse, and was usually able to stay out with friends with few issues; on it, I'm able to focus better in the morning/afternoon, but just want to laze about after it's worn off. It's a trade-off that I'm willing to make most days, but on big nights out I want to be "all there." So far I've thought of:

1. Not taking the Vyvanse that day. That probably wouldn't work, since there's a chance I'd become even more of a zombie than usual. I've tried skipping days before and had withdrawals, even though I'm on the therapeutic dose. If I ever quit Vyvanse, I think I'd have to do a slow taper.

2. Taking the dose later than usual, maybe around 2 or 3 PM. I'd get terrible sleep, but maybe it'd be worth it for a day.

3. Not riding on the party bus. I'm not sure how I feel about that.

I'm also planning on: Getting a good night's sleep the night before, eating a lot, staying hydrated, etc. Is there anything else I could try in order to not be the guy falling asleep at the table, while everyone else is having a good time? I'd like to be able to apply this advice to future nights out as well. Thanks!
posted by CottonCandyCapers to Health & Fitness (15 answers total) 1 user marked this as a favorite
2, all the way. You're not going to sleep much anyway, I'm sure.
posted by Oktober at 7:43 AM on March 13, 2015 [3 favorites]

Another vote for the second option. If the party is on a Saturday, take the following Monday off if you can to give yourself an extra recovery day. You may not need it, but a random day off isn't a bad thing.
posted by rtha at 7:47 AM on March 13, 2015 [2 favorites]

My non-medical-professional understanding is that Vyvanse and similar medications are extended-release formulations of immediate-release amphetamines like (non-XR) Adderall / mixed amphetamine salts.

Depending on my schedule I've switched back and forth between extended-release ones and immediate-release, and during some periods would be prescribed both with explicit instructions to take the extended-release in the morning and immediate-release in the afternoon as needed. So if you'll be seeing your doctor soon enough you could ask if that's an option.
posted by XMLicious at 7:56 AM on March 13, 2015 [2 favorites]

Another vote for #2. No one expects you to get a full night's sleep (or even any sleep) on the night of such an event.
posted by ocherdraco at 7:56 AM on March 13, 2015

Second option for the short term solution. Long term: have you talked to your doctor about this? Perhaps you could have your dose adjusted to twice/day?

(I've taken Adderall 4/day for years. It would make me crazy if my body/mind started shutting down earlier than normal.)
posted by she's not there at 8:01 AM on March 13, 2015 [1 favorite]

I'm on Concerta and I work Saturday nights - I usually take my dose by 2 p.m. or so. Usually during the workweek I take it around 10 a.m. Works just fine, for sure.
posted by sutel at 8:39 AM on March 13, 2015 [1 favorite]

My non-medical-professional understanding is that Vyvanse and similar medications are extended-release formulations of immediate-release amphetamines like (non-XR) Adderall / mixed amphetamine salts.

Yep - dexedrine is the immediate-form version of Vyvanse. If you have time to see your doctor and ask to try it out before the bachelor party, I'd definitely suggest doing that. The doses don't translate directly from the Vyvanse dose though since it's metabolized differently, even though the active ingredient is the same. So some trial and error will be needed, and it might not work as well for you (or might work better!).
posted by randomnity at 9:00 AM on March 13, 2015

#2 and don't start drinking right away. Have coffee or a Coke or something else with caffeine before you meet them, and have another Coke (or energy drink) for the first round. Eat more protein than carbs, too.
posted by Ideefixe at 9:04 AM on March 13, 2015 [2 favorites]

PS you probably already know this since you've been on it for a year, but just in case, alcohol can interact dangerously with amphetamines, so be careful. My doctor told me it was OK to drink but to be cautious at first because e.g. some people will get wasted after one drink while on ADD meds. So you might want to ask your doctor about it, and keep in mind again that dexedrine might not behave exactly the same way as vyvanse.
posted by randomnity at 9:05 AM on March 13, 2015

Suggestion: take half a pill at the usual time. Take half a pill at 3.
posted by bq at 1:53 PM on March 13, 2015

Note to others: you can't split a Vyvanse pill, it's in a time release capsule.

I usually take Vyvanse at 7 to 7:30am, before work, and by 3pm I'm done and blargh to the point where all my energy is used up on work. So then I go home and I unravel into an ADHD mess who can't keep things organized at home.

As a solution, my p-doc put me on a low dose of Adderall to take in the evenings as needed. Yes, another option is to wait to take your Vyvanse later in the day, but then I find that my mornings suck. And when I don't start off on the right foot in the morning, it's a slog to do anything at all. That's just me. YMMV.

I wholeheartedly endorse the concept of "evening Adderall" to buoy the waning Vyvanse. See what your doctor says, but it's not an unreasonable request and if it's right for you, I think you'll find it beneficial.
posted by nightrecordings at 2:51 PM on March 13, 2015 [1 favorite]

Do you take one pill for the whole day, or two successive doses? Because if the former, I personally can't really imagine going into the office and working until 2pm unmedicated without it being kind of a disaster. But maybe I'm extra low-functioning.

I would recommend asking your doctor to try other stimulants with you. People definitely react differently to different drugs, even ones that are in theory very similar. For me, every XR drug I've been prescribed for ADD gave me crazy crashes and side effects compared to my level of stability with normal ol' Adderall.

Here's a huge one that nobody's mentioned-- exercise!! I do still crash a little every day even though Adderall works best for me, but if I can get in a workout just around when my meds are wearing off, everything is like 200% better for the rest of the evening. And it will help you sleep better. Seriously, if there's any way at all that you can exercise in between work time and fun time, I highly recommend it. I'm not at all someone naturally inclined to enjoy exertion, I just do it because it's like taking a free magic pill.
posted by threeants at 5:14 PM on March 13, 2015

Note to others: you can't split a Vyvanse pill, it's in a time release capsule.

The time release mechanism in vyvanse isn't actually in the capsule. It would be trivially easy to open a capsule and split the contents roughly in half.
posted by a box and a stick and a string and a bear at 5:16 PM on March 13, 2015

Depending on how much time you've got before the party, this seems like something you could ask your doctor about. The last time I saw my psych, she mentioned that she could give me small, immediate-release pills in addition to my normal time-release to use if I find myself flagging in the afternoon/evening. I haven't taken her up on it, so can't speak to how it actually works in practice, but it's definitely an option that exists.
posted by duien at 5:36 PM on March 13, 2015

> joke about me having turned into a homebody

I'm not an MD, but have you considered that, on top of your ADD, you might be a bit agoraphobic?

The timing may not work out on the event you describe above, but you may want to ask your doctor about a trial month or two of Wellbutrin, which is very effective against social anxiety (and is not an SSRI and so lacks the gnarly side-effects of SSRI drugs).
posted by doctor tough love at 6:46 AM on March 14, 2015

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