Focalin XR to Vyvanse.

July 3, 2015 8:14 AM

Tips for switching from Focalin XR (dexmethylphenidate) to Vyvanse (lisdexamfetamine)?

I've been taking Focalin XR for years and it is great, but due to some issues between my insurance, it going generic and a bunch of other bullshit, I may need to switch medicines. I've spoken with my psychiatrist and with friends who are also taking stimulant medication for ADHD and Vyvanse seems like a good option, and my doctor is okay with me giving it a shot.

He will calculate the dosage (although we'll probably have to dial it in as per usual) but because the two drugs are in different families, I was just wondering if there's something I should watch out for or try to notice or be mindful of.

posted by a manly man person who is male and masculine to Health & Fitness (4 answers total)

Vyvanse is not for everyone. It is certainly more intense than Focalin or methylphenidates in general. But, in my experience, it has been the best way for me to achieve what feels like "neurotypical" levels of focus, concentration and task management. It is commonly described as feeling very "smooth" in comparison to something like Adderral IR or even XR, because it includes an amino acid that assists in regulating the drug's benefits over a longer period of time. I don't get the jerky "UP" feeling an hour after taking it. It's more like gradually ascending a hill, hitting a comfortable stride across a plateau for several hours, and then gradually descending back down the hill. After taking Adderall XR and experiencing crash after crash when the drug would wear off in the evening (we're talking tears, sobbing, headaches as soon as it left my system), I was thrilled to switch to Vyvanse and learn that it's possible to take a stimulant without feeling stimulated. Again, for me it's like feeling "neurotypical" (or what I assume neurotypical might feel like) as opposed to feeling jerked into overdrive.

One good thing about stimulants is that unlike an SSRI that needs to build up in your system over time before you learn its ultimate effects, you generally know whether or not a stimulant is working for you after just one or two doses.

If you have more specific questions about Vyvanse and other stimulants, now or in the future, feel free to PM me!
posted by nightrecordings at 8:39 AM on July 3, 2015

From the outside looking in: we've got a boy staying with us for the summer who takes Vynase. We've noticed that it kills his appetite, and that hunger is a trigger for Not Good Times, so we have to make sure that he eats a big, filling breakfast and follow it with the pill. The effects seem to last pretty well into the evening, coming down around bedtime. I'm not sure how that compares to Focalin, but I wanted to mention the appetite suppressing bit in case it's new. Dunno if that's a common effect of these sorts of things.
posted by jquinby at 9:31 AM on July 3, 2015

...and in terms of effect, again, my observation is that it takes about 30-45 minutes to kick in. Once it does, there's a very discernible quieting, maybe a single yawn, and then he's on an even keel for the rest of the day. Almost like a switch. He's a small dude and the dosage is ~20mg.
posted by jquinby at 9:33 AM on July 3, 2015

I had the opposite effect that nightrecordings mentions, for what it's worth—I started on Vyvanse and got little more than a total loss of appetite, and then stuck with Ritalin because it was stronger and more intense. (For whatever reason I need that slightly unpleasant "Hey! You're on something!" feeling as a call to action, but once I get going it feels great.)

I've never taken Focalin—I understand (as with Vyvanse vs. Adderall) it's supposed to be a little smoother—but have you tried Concerta? A switch to methylphenidate from dexmethylphenidate might be a little easier to sort out. I switched to it from IR methylphenidate last year and I've been really impressed with the steady extended release. (I get 10-12 hours out of it.)

Best of all, the generic, which is manufactured by the same company, is at the lowest copay tier for my insurance. (One of the other reasons I switched from Vyvanse, aside from its lack of effectiveness for me, is that at the time I couldn't really afford it.)
posted by Polycarp at 1:05 PM on July 3, 2015