Comments on: Vyvanse for ADD/ADHD: The Water Titration Recipe http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/ Dr. Charles Parker Reports on Core Brain and Body Evidence: Psychiatry and the Mind Evolve Mon, 22 Mar 2010 01:04:51 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: Dr Charles Parker http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/comment-page-1/#comment-3637 Dr Charles Parker Wed, 13 Jan 2010 00:59:41 +0000 http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/#comment-3637 Hey Jon, I simply don't use Vyvanse or any of the AMP products as a weight loss tool - not indicated and wouldn't work predictably over time, as most get over the appetite suppression at the outset. Now if you told me you had a significant low grade ADHD that became aggravated with SSRIs, [as we so often see, and have <a href="http://www.corepsychblog.com/2008/12/add-adhd-medications-amphetamines-2d6-drug-interaction-update/">repeatedly written about here]</a> then I would tell you to watch those signs of increased impulsivity secondary to the SSRI, including eating without thinking. Your dosing strategy will work with the plan outlined on this post - if you are really concerned go on down to 1/4 of the 20 mg with the water titration described herein - yes and 2.5 mg can be done as well, just seems like a bit too careful from my experience, unless you have an extended transit time and associated metabolic problems. cp Hey Jon,
I simply don’t use Vyvanse or any of the AMP products as a weight loss tool – not indicated and wouldn’t work predictably over time, as most get over the appetite suppression at the outset.

Now if you told me you had a significant low grade ADHD that became aggravated with SSRIs, [as we so often see, and have repeatedly written about here] then I would tell you to watch those signs of increased impulsivity secondary to the SSRI, including eating without thinking.

Your dosing strategy will work with the plan outlined on this post – if you are really concerned go on down to 1/4 of the 20 mg with the water titration described herein – yes and 2.5 mg can be done as well, just seems like a bit too careful from my experience, unless you have an extended transit time and associated metabolic problems.
cp

]]> By: Jon Clark http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/comment-page-1/#comment-3629 Jon Clark Tue, 12 Jan 2010 14:25:45 +0000 http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/#comment-3629 Greetings, I was prescribed Vyvanse to offset the weight gain from Lexapro. I'm a naturally nervous person by nature and have great fear that the medication may be too activating. I have 20mg capsules. Would it be appropriate to dilute this and start at perhaps 2.5mg and titrate according to side effects every three days? I am not keen on taking any type of medications and do consider myself sensitive to medications. Thanks so much in advance for any words of wisdom. 34yr male 5'11/240lbs Greetings,
I was prescribed Vyvanse to offset the weight gain from Lexapro.
I’m a naturally nervous person by nature and have great fear that the medication may be too activating.
I have 20mg capsules. Would it be appropriate to dilute this and start at perhaps 2.5mg and titrate according to side effects every three days? I am not keen on taking any type of medications and do consider myself sensitive to medications. Thanks so much in advance for any words of wisdom.
34yr male 5′11/240lbs

]]> By: Tweets that mention Vyvanse for ADD/ADHD: The Water Titration Recipe -- Topsy.com http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/comment-page-1/#comment-2839 Tweets that mention Vyvanse for ADD/ADHD: The Water Titration Recipe -- Topsy.com Thu, 19 Nov 2009 02:16:34 +0000 http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/#comment-2839 [...] This post was mentioned on Twitter by drcharlesparker, Lebby. Lebby said: RT Vyvanse for ADHD: The Water Titration Recipe http://bit.ly/4GGDq this one bears review as questions continue (via @drcharlesparker) [...] [...] This post was mentioned on Twitter by drcharlesparker, Lebby. Lebby said: RT Vyvanse for ADHD: The Water Titration Recipe http://bit.ly/4GGDq this one bears review as questions continue (via @drcharlesparker) [...]

]]> By: Dr Charles Parker http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/comment-page-1/#comment-224 Dr Charles Parker Wed, 14 Jan 2009 12:27:49 +0000 http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/#comment-224 Med Titration: If you simply Search Vyvanse on this series of posts you will find all the info you need, then if not go over to http://www.squidoo.com/vyvnase It is the best product out there, you simply have to know how to use it precisely, sign up for my new book for the details of why meds are so challenging. It isn't for everyone, but the numbers that can't take it are less than 5% if taken correctly. cp Med Titration:

If you simply Search Vyvanse on this series of posts you will find all the info you need, then if not go over to http://www.squidoo.com/vyvnase

It is the best product out there, you simply have to know how to use it precisely, sign up for my new book for the details of why meds are so challenging.

It isn’t for everyone, but the numbers that can’t take it are less than 5% if taken correctly.
cp

]]> By: Medication Titration http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/comment-page-1/#comment-225 Medication Titration Tue, 13 Jan 2009 07:56:22 +0000 http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/#comment-225 I've tried several different approaches to handle my ADHD in the past and keep running across different styles or methods of how to handle it. I went the medication route as well as the psychologist route and found both to be mildly effective. I'm very curious about the effects of Vyvanse now and whether or not the product is similar to adderall in nature or if its from a different part of the amphetamine family. I’ve tried several different approaches to handle my ADHD in the past and keep running across different styles or methods of how to handle it. I went the medication route as well as the psychologist route and found both to be mildly effective. I’m very curious about the effects of Vyvanse now and whether or not the product is similar to adderall in nature or if its from a different part of the amphetamine family.

]]> By: Dr Charles Parker http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/comment-page-1/#comment-226 Dr Charles Parker Thu, 18 Dec 2008 13:54:02 +0000 http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/#comment-226 Leighann, Glad it worked for you- If interested you may want to review the several full articles I have posted on med titration over here: http://ezinearticles.com/?expert_bio=Dr_Charles_Parker Bottom of the page, Have a great Holiday, cp Leighann,
Glad it worked for you-

If interested you may want to review the several full articles I have posted on med titration over here:

http://ezinearticles.com/?expert_bio=Dr_Charles_Parker

Bottom of the page,
Have a great Holiday,
cp

]]> By: Leighann Foley http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/comment-page-1/#comment-227 Leighann Foley Mon, 15 Dec 2008 06:58:08 +0000 http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/#comment-227 Thanks doc, all good. talked with my doc and he upped my dose of vyvanse to 120 mgs, tons better, thanks for the confident chat I needed to nip this in the arse. peace, leighanne Thanks doc, all good. talked with my doc and he upped my dose of vyvanse to 120 mgs, tons better, thanks for the confident chat I needed to nip this in the arse.
peace, leighanne

]]> By: Dr Charles Parker http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/comment-page-1/#comment-228 Dr Charles Parker Fri, 05 Dec 2008 13:48:04 +0000 http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/#comment-228 Leighann, With the dramatic changes everyday in everyone's life, a single day at school or work can become a turning point. Naturally I don't know the treatment options, but would encourage you to call around, ask for some help during your docs vacation - but do go back and give him a run at this new understanding. Finding your own dose is a two edged sword, yes it is correct, but medical folk prefer to manage controlled substances more closely and he could reasonably have a problem with the changes you have made. All that should be explored with him. The last chapter in my new book addresses the many problems with medical team communication - and offers some resolutions for challenges like this. I hope you do get the team play ironed out for the Holidays, cp Leighann,
With the dramatic changes everyday in everyone’s life, a single day at school or work can become a turning point. Naturally I don’t know the treatment options, but would encourage you to call around, ask for some help during your docs vacation – but do go back and give him a run at this new understanding.

Finding your own dose is a two edged sword, yes it is correct, but medical folk prefer to manage controlled substances more closely and he could reasonably have a problem with the changes you have made. All that should be explored with him.

The last chapter in my new book addresses the many problems with medical team communication – and offers some resolutions for challenges like this.

I hope you do get the team play ironed out for the Holidays,
cp

]]> By: Leighann Foley http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/comment-page-1/#comment-229 Leighann Foley Fri, 05 Dec 2008 06:52:46 +0000 http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/#comment-229 Dear Dr cp, I would like to thank you for such a quick and thorough response. I had no idea I would get answers so fast. I planned on making an appointment with my dr. for tommorrow yet when I called I was notified he would be on vacation for another week or so. Since I feel as if work would be almost immposible without any meds, yes I ran out as of today from dosing one and a half, I'm wondering if going to an urgent care center would be an option? I realize you only answer questions pertaining to certain topics so I'm certain my question is a bit nuts, but since I feel half way there I thought I would give it a try. Once again I thank you, Leighann Foley Dear Dr cp,
I would like to thank you for such a quick and thorough response. I had no idea I would get answers so fast. I planned on making an appointment with my dr. for tommorrow yet when I called I was notified he would be on vacation for another week or so. Since I feel as if work would be almost immposible without any meds, yes I ran out as of today from dosing one and a half, I’m wondering if going to an urgent care center would be an option? I realize you only answer questions pertaining to certain topics so I’m certain my question is a bit nuts, but since I feel half way there I thought I would give it a try.
Once again I thank you,
Leighann Foley

]]> By: Dr Charles Parker http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/comment-page-1/#comment-230 Dr Charles Parker Fri, 05 Dec 2008 05:18:18 +0000 http://www.corepsychblog.com/2007/11/vyvanse-for-addadhd-the-water-titration-recipe/#comment-230 Leighann, From speaking with 100s of colleagues and watching the internet I can report that I have often heard much larger numbers than yours, - and while the package insert suggests top of 70, it's only because no formal research has been presented regarding safety etc - I am very careful over 100 mg, see below. If you do the AMP math and round off your Vyvanse to 100 = 2x50 = 40mg Adderall/day [according to the dosage equivalency of the Harvard study] you are well within standard of practice for safe AMP dosage of 1.5mg/kg tops for Adderall toxicity. Now, some will argue, quite reasonably, that all AMP are not specifically the same. No argument, but clinically they do appear to carry the same relevant dosage for the most part in the office as seen in the study. My recourse in the office: stay with very precise DOE, watch for adverse events, good breakfast, no more than 14 hr DOE, watch the top of the window, and then do the following: At higher doses [anything over 100mg] work hard at following up carefully with a complete metabolic review: hormones, liver function, etc as encouraged elsewhere in these posts. Consider comorbid conditions in detail. Your doc is the final path, - I suggest trying to work with him on the math above 1kg = 2.2lbs, therefore 145lbs= top dose of Adderall 98.863mg, far above the dosage 105 mg of Vyvanse. Again, I am clearly not recommending a top bar here, just doing the math, and do have very few [1-4] of my entire practice 120 mg or over. Identifying comorbid conditions will almost always lower the top dose requirement - evidence makes the difference. cp Leighann,
From speaking with 100s of colleagues and watching the internet I can report that I have often heard much larger numbers than yours, – and while the package insert suggests top of 70, it’s only because no formal research has been presented regarding safety etc – I am very careful over 100 mg, see below.

If you do the AMP math and round off your Vyvanse to 100 = 2×50 = 40mg Adderall/day [according to the dosage equivalency of the Harvard study] you are well within standard of practice for safe AMP dosage of 1.5mg/kg tops for Adderall toxicity.

Now, some will argue, quite reasonably, that all AMP are not specifically the same. No argument, but clinically they do appear to carry the same relevant dosage for the most part in the office as seen in the study.

My recourse in the office: stay with very precise DOE, watch for adverse events, good breakfast, no more than 14 hr DOE, watch the top of the window, and then do the following:

At higher doses [anything over 100mg] work hard at following up carefully with a complete metabolic review: hormones, liver function, etc as encouraged elsewhere in these posts. Consider comorbid conditions in detail.

Your doc is the final path, – I suggest trying to work with him on the math above 1kg = 2.2lbs, therefore 145lbs= top dose of Adderall 98.863mg, far above the dosage 105 mg of Vyvanse.

Again, I am clearly not recommending a top bar here, just doing the math, and do have very few [1-4] of my entire practice 120 mg or over. Identifying comorbid conditions will almost always lower the top dose requirement – evidence makes the difference.
cp

]]>