Comments on: ADD/ADHD Treatments: Tips for Vyvanse

By: Dr Charles Parker

Dr Charles Parker — Sat, 24 Jul 2010 12:32:22 +0000

Vicky,
No more coffee and no more wine!…- just joking No problem with either. Only problem we see is going past 2 glasses of wine you can suddenly become unpredictably loose and abundantly intoxicated. Coffee is not a problem – my only suggestion to those in my office: Don’t drink a volume that sets you out the Top of the Therapeutic Window… additional stimulants might very well decrease the ability to concentrate. There are several other articles at that Top Post for your review on dosage matters.

You will do well – as just thinking about the details will preempt future difficulties.
cp

By: Vicky

Vicky — Thu, 22 Jul 2010 05:23:42 +0000

Hi,
I am a 41 yr old woman in decent health. I have been on Pristiq 50mg for the past six months and was just prescribed Vyvanse 30mg for my ADD symtoms. Was wondering about coffee consumption while on Vyvanse, since I drink 2 big mugs of coffee per day. In addition, I drink one glass (about 6 oz) of red wine after dinner every night. Wanted to know about the possible side effects of taking these 2 medications together along with this amount of coffee & wine daily. Please let me know & thanks so much for your help!

By: Dr Charles Parker

Dr Charles Parker — Mon, 05 Jul 2010 00:20:53 +0000

Hotaru,
Check out this article, similar to the previous question… I think you are on too much, the DOE in your case is telling the tale, and the late onset is the give away for the Top of the Window…

Talk to your doc about a decrease and see what happens.
cp

By: Dr Charles Parker

Dr Charles Parker — Mon, 05 Jul 2010 00:17:29 +0000

Steph,
Even tho the DOE works most of the time, I always reserve the right to be wrong.

If the person is not sleeping, paranoid and otherwise out the Top of the Window, I defer to clinical evidence, period. I agree completely with your doc, and suggest that if these are the side effects that the DOE is not quite measured correctly, and look at this point as well: take a look here at #4 on this Ezine Article.

Hope this helps,
cp

By: Hotaru

Hotaru — Sun, 04 Jul 2010 07:44:07 +0000

I notice it’s been a month or two since anyone has written on this specific blog, i hope I’m not bring up a post from the grave. but… I started vyvanse in march (i was on dexedrine from feb to march and because of a really bad memory issue we changed to vyvanse which I haven’t had any issues with my memory on vyvanse). I take 30mg once a day. (i tried taking it in the morning but because I think I was still so sleepy it had no effect (cause i wouldn’t notice any) but when i’m up for a few hours (11-1) I take it about 1:30 in the afternoon and it seems to kick in within 3 hours, then at the beginning it would last for a few hours.. take a break then start back up again for an hour.. now it just lasts for about 45mins to 2 hours.
I am wondering what i should do.. I guess my main question is.. what is the normal affect of vyvanse.. am I suposed to feel like I do for those few times during the day? or is that a sign of something else where I should be taken off of it? I get to feeling concentrative and where I do chores but when it wears off I’m just like “blah.. *sits down and does something that doesn’t take much focus*”

Thanks

By: Stephanie

Stephanie — Sat, 03 Jul 2010 15:13:04 +0000

Hello,
My 20-year old daughter was diagnosed with adhd a year ago. She has been on vyvanse for this past year – starting at 50 mg and then 70 mg for the past six months. The last two nights she had very frightening psychotic episodes -extreme paranoia. Both happened around the 11 hour DOE. In retrospect, she has been overanalyzing for the past few months. Her doctor just dropped her dose back to 50 mg. Any thoughts/suggestions??
Thank you.

By: Dr Charles Parker

Dr Charles Parker — Sun, 16 May 2010 17:02:10 +0000

Andy,
Sorry for the delay in getting back, been 2 days on the road, and playing catch up ball in the office, then had a dinner party last night. Answer on your other machine.
cp

By: Dr Charles Parker

Dr Charles Parker — Sun, 16 May 2010 16:54:37 +0000

San Diego,
My own rec on this question for photographers and college students is simple: Drop the dose down a click, probably to 40 mg 2x/day = 80 mg for a consistent run over 12 hr. If you go to straight 80 in the AM shouldn’t be too much for that first part of the run, or could be simply a 2x/day dose all the time. Be careful not to take the second dose too late [much after 12 noon] as it can kick you into the AM easily. Only a discussion with your doc reviewing the DOE very carefully on the lessor dosage, watching the DOE on both, and making changes accordingly.

To reassure your wife: I have worked this strategy quite frequently, college students really appreciate the extra hours, it is not a relapse trigger, and extends the day up to 16 hr for a guy trying to catch up from wasted time using. I do think, generally speaking, that the 70mg 2x/day will give you too much. I don’t like to see a buzz, especially with Vyvanse, but rather the extended ability to concentrate with extending the DOE in this way.

BTW: don’t recommend chasing it with a PM dose of IR Adderall – that one has the buzz with it, does work sometimes, but generally is more on the ‘relapsive’ side of matters than the Vyvanse twice/day. And, no the Vyvanse when dialed in correctly should last 7-7PM 12 hr as discussed here and elsewhere in the Precise Solutions White Paper.

You might need to simply go up on the AM dose to 80-90 to cover the 12 hr, and be done with the extras. Yes, this is beyond FDA recommendations, but is not relapsive as it covers the expected DOE more effectively.

Best, – it works if you work it-
cp

By: Andy Stock

Andy Stock — Tue, 11 May 2010 17:09:40 +0000

Hi Doc, I sent over a long question this morning but I sent from another computer so I don’t see it on here. I have a history with drug abuse a few years back. So I have my wife give me my medicine daily. This makes it easy. I am now taking the 70mg once per day. However, sometimes I work late into the evening, maybe once or twice per week. On those days is it okay to take extra Vyvanse? I thought about asking the Dr for some 30mg pills to take on those days but how would he write that? If I take some of my 70mg pills then I am going to run out before it is time to refill. Also, I sometimes feel somewhat shameful when asking my wife for the extra medicine. She is very patient about it as long as I am only doing it on days when I am working late. Sorry for the long post, I just want to make sure i understand this. Any information you can help me with to pass on to my wife is greatly appreciated. Thank you for all you do! BTW, do you have a Dr you recommend in the Southern California area? Is there any place to have SPECT scans done?

By: San Diego photographer

San Diego photographer — Tue, 11 May 2010 13:59:28 +0000

Thanks for the information. I have one more question. A little history. I have a history of drug abuse a few years ago, so I have my wife keep the Vyvanse and she gives me it daily to prevent any temptation to take extra when not needed. I’ve tried to manage it on my own and I catch myself taking extra when not necessary. However, i own a business and sometimes will work late into the evenings on nights when I don’t have kids. Sometimes my wife is okay giving me an extra pill on these days as long as it isn’t every night. Here is my question. I recently changed to the 70mg pill once per day…so I not sure about taking a whole extra 70 mg. Should I take half dose? Also, if i take extra I will run out early. Should I ask my Dr for some 30 mg pills to have for these days? How would he write that because i don’t need it daily. i take my 70mg in the morning when i wake up, which should last until about 3 or 4, right. On the days i work late I would usually work until 7pm or sometimes as late as 10pm. I feel bad asking for extra on those days because my wife has concerns that i am abusing it. Do you have any advice on how to approach that? Should I just suck it up and not worry about the additional medication on the days i am working late? Is it all in my head that i need the extra to work in the evenings? Sorry for the long post but this is a HUGE issue with my wife and i and I sometimes feel shame for asking for extra based upon my history of abuse. My wife is very patient with it but i know it creates stress for her. How do i make her understand that it is sometimes needed? Thanks so much for all you do! – Andy Stock