3 meds....super-high drug tolerance?? | ADHD Information
See, I've been pushing for vyvanse for a long time because I want something longer-lasting. I'm not even noticing much with Adderall XR now (30 mg.), although I did feel lethargic for a few days that I took it (I took effexor xr a few hours later today and didn't feel so lethargic). I also noticed that my focus actually seems to improve at night, when all the meds are pretty much out of my system (Effexor XR isn't a 24-hour med like most antidepressents). I'm wondering if maybe my focus would actually be better without the effexor. I also still want to see if I can try vyvanse. I had an rx for it, but I couldn't find a pharm. that had it and by my next visit, when I told my doc that, that's when he switched me to AXR. soberxinsanity39399.8781365741[QUOTE=ShawnB]
Hi Shawn!
I don't know why your Dr. tried comparing Concerta with Vyvanse when Vyvanse is more comparable to Adderall XR than anything else. My Dr was going to prescribe Adderall XR to me, but because I had an issue with Focalin XR not lasting long enough he thought the Adderall XR would do the same thing length wise... so he chose to try the Vyvanse since it's supposed to last 12 hours. (and it does for me).
Since I upped my Focalin XR dose to 20mg, I noticed that it works great for about 4-5 hours and then seems to wear off. No rebound per se, but it loses some effect and I get a little tired and pretty hungry.... I might just need a higher dose or to take it twice during the day. Nothing keeps me awake at night if I want to sleep......at least nothing YET.
My insurance changed and my p-doc doesn't accept the new insurance so he is allowing me to just call in with how I am doing after Thanksgiving. We'll adjust accordingly and once I have it figured out he will mail me my prescriptions (he is an hour away). I'll only need to come see him every 6 months.
That's great that Vyvanse is working so well for you!
[/QUOTE]
[QUOTE=soberxinsanity]See, I've been pushing for vyvanse for a long time because I want something longer-lasting. I'm not even noticing much with Adderall XR now (30 mg.), although I did feel lethargic for a few days that I took it (I took effexor xr a few hours later today and didn't feel so lethargic). I also noticed that my focus actually seems to improve at night, when all the meds are pretty much out of my system (Effexor XR isn't a 24-hour med like most antidepressents). I'm wondering if maybe my focus would actually be better without the effexor. I also still want to see if I can try vyvanse. I had an rx for it, but I couldn't find a pharm. that had it and by my next visit, when I told my doc that, that's when he switched me to AXR.
Wellbutrin isn't a 24 hour anti-depressant either. I had to start taking a second dose of the SR in the afternoon or I couldn't get out of bed the next morning....
Why did your doc prescribe the Effexor? For ADHD? Or something co-morbid? How did it work before you added any stims? I have heard (read?) that Effexor CAN help with ADHD symptoms, but like Wellbutrin, I think it varies a lot from person to person. I suppose it COULD be working against your other meds, but I certainly could not say that for sure.
I would definitely ask your doc about trying Vyvanse. From what I read around here, it lasts 8-12 hours pretty darn consistently. Concerta lasts the whole day for me (meaning about 6-8 hours) but Focalin XR doesn't seem to make it through the afternoon. Concerta just isn't as gentle....it kicks in and feels like I got whacked upside the head. However, it was great for jet-lag and staying awake for 10-hour product training sessions!
Still seems screwy that your doc would say Vyvanse is no more potent than Concerta. Maybe he just hasn't had many patients on it to realize it does last much longer....?
Good luck!
[/QUOTE]
I just want you to know I am taking 9 different meds right now and just stopped my ADD med Provigil due to side effects. I am very med sensitive in some areas and not at all in others. I take enough to put out a horse at night but I still barely sleep till 3 am. That's with 3 tranquilizers, 2 muscle relaxers and 2 2 mg Klonopin for anxiety and a Lexapro. NO SLEEP. So there are some of us here that are very drug tolerant in certain areas. I get it.I've taken Strattera, Focalin XR and now taking Vyvanse. I was on a pretty high dose of Focalin XR about 30-45mgs a day and then it stopped working. We just recently switched to Vyvanse last month and I've been playing around with the dosage to get the right dose for me. I'm now taking 90mgs of it and that's pretty high for that med. (3- 30mgs caps in the am). The sleeping thing happened to me on this too, but once I stuck with it for 3 consecutive days, I was able to fall asleep with the help of 1mg Tenex and 2- 3mgs Melatonin.I don't know why your Dr. tried comparing Concerta with Vyvanse when Vyvanse is more comparable to Adderall XR than anything else. My Dr was going to prescribe Adderall XR to me, but because I had an issue with Focalin XR not lasting long enough he thought the Adderall XR would do the same thing length wise... so he chose to try the Vyvanse since it's supposed to last 12 hours. (and it does for me).
[QUOTE=soberxinsanity]Not that anyone missed my long rambles here, but I haven't had much time to do any posting...because I CANNOT GET ANYTHING DONE. I've been taking concerta 54 mg. for a couple months now, but last wed. doc changed me to adderall xr; he said it's more "potent". for the 99% of you that justifiably didn't read my ramblings from a few weeks ago, my doc rx'd vyvanse, but last visit changed his mind, saying that if concerta didn't work, he doesn't think vyvanse would be any better, as it "isn't any stronger than concerta".
Hmmmm. Each drug is different for each person. Hard to compare Concerta to Vyvanse since they are not the same drug.
Here's the deal: I was rx'd 10 mg ritalin even before the concerta, kinda as a trial (this was with my old doc), and my doc said I could use it as a booster, or take it on the weekends when I get up at 1PM
Well, I can't say the concerta did much, and neither did the 10 mg. ritalin. so today was my first day on AXR (FYI doc rx'd 30 mg. as my starting dose). I did go to bed at 2:45 last night, because I was up all night trying to finish my homework (which I still haven't finished...) and woke up at 8:45 for school. (took med around 8 AM). until about 11 I was kinda tired, but felt slightly more focused, slightly clamer mind. Afternoon was no diff. than it has been for past 2-3 mos., except up until now I am feeling hungrier than I have been on concerta..(I also took 10 mg. Adderall IR about 30 mins. ago).
Seriously, how high do I have to go to have a normal concentration level? Correction, this is now the 4th med that I seem to have very high tolerance for. So far, this is how it's been for me with every med (in addition to the 3 mg. melatonin I took two sep. nights, but stopped at that b/c I got nothing out of it). Something's gotta work (I hope!)
Well, I take a fairly high dose of stims myself. I also take Wellbutrin 300mg AND Prozac 40mg. I started out trying the short-acting Ritalin 5mg and played with the dose until I found something that worked. Then switched to 15mg Focalin XR so I could take one dose a day. After 3 days, it didn't do anything so I tried Concerta 54mg. That worked fine for me, but I liked the smooth-ness of Focalin more (Concerta was definitely more "potent" for me) so I asked to try a higher dose of that. I am trying 20mg Focalin now. So far, so good, but I do find that I tend to keep going higher and higher on the dose spectrum as time goes on. This is the highest milligram strength so if I need to increase it I will have to take multiple dosages (i.e. 10mg capsule plus a 15mg one) and I don't know whether my insurance will give me grief. I'll cross that bridge when I come to it. Because the methylphenidate family works well for me, I don't want to switch over to the amphetamines until it is really necessary.
Dosing is initially based on weight, but is very individual. Some people only need teeny doses and some (like us) need higher ones. I would have thought for sure that taking Wellbutrin would have meant I would only need a small dose of a stimulant but that does not seem to be the case.
As far as what dose is sufficient for "normal" concentration - it will vary and so does the definition of "normal". I feel like I am getting sufficient benefit if the medication gives me the ability to quiet my mind when it gets too loud and the ability to stop and come back to what I need to focus on when it starts to wander away. In a lot of cases, I think this is as good as it gets. Now I am trying to learn how to do these things consistently since I am used to just letting my mind run over me because I could never control it.
I am also practicing meditation to help with concentration and believe it or not - some video games help with this as well. I have been spending time playing "Wii Play" mini-games and really pushing my focus. It has helped me. You would just need to be careful to not waste the day doing it.... 
Good luck!
[/QUOTE]
[QUOTE=soberxinsanity]I forgot to mention I'm also taking effexor xr 150 mg. every morning...is it possible that can affect the stims also?[/QUOTE]just out of curiosity how is the efexor-xr going for you? any side effects?
now the answer to your question no as far as I know as I was told I might need to take dexamphetamine as well as the exfexor-xr so guess it's fine.
I forgot to mention I'm also taking effexor xr 150 mg. every morning...is it possible that can affect the stims also?Honestly, you need to see a new Psych. Not that anyone missed my long rambles here, but I haven't had much time to do any posting...because I CANNOT GET ANYTHING DONE. I've been taking concerta 54 mg. for a couple months now, but last wed. doc changed me to adderall xr; he said it's more "potent". for the 99% of you that justifiably didn't read my ramblings from a few weeks ago, my doc rx'd vyvanse, but last visit changed his mind, saying that if concerta didn't work, he doesn't think vyvanse would be any better, as it "isn't any stronger than concerta".
Here's the deal: I was rx'd 10 mg ritalin even before the concerta, kinda as a trial (this was with my old doc), and my doc said I could use it as a booster, or take it on the weekends when I get up at 1PM
Well, I can't say the concerta did much, and neither did the 10 mg. ritalin. so today was my first day on AXR (FYI doc rx'd 30 mg. as my starting dose). I did go to bed at 2:45 last night, because I was up all night trying to finish my homework (which I still haven't finished...) and woke up at 8:45 for school. (took med around 8 AM). until about 11 I was kinda tired, but felt slightly more focused, slightly clamer mind. Afternoon was no diff. than it has been for past 2-3 mos., except up until now I am feeling hungrier than I have been on concerta..(I also took 10 mg. Adderall IR about 30 mins. ago).
Seriously, how high do I have to go to have a normal concentration level? Correction, this is now the 4th med that I seem to have very high tolerance for. So far, this is how it's been for me with every med (in addition to the 3 mg. melatonin I took two sep. nights, but stopped at that b/c I got nothing out of it). Something's gotta work (I hope!)soberxinsanity39395.68I don't know if that can happen anytime soon though...what's wrong with the one I have?