Overlooked: Vyvanse has many interesting features for ADHD treatment – but this challenge is often missed.
Take a quick look at this video, will only take a few minutes, – but can help find the Top of the Window with Vyvanse – the ‘forgiving amphetamine.’ I reviewed the Vyvanse titration process [duration DOE] this previous video, so do check that one out, but watch for this uncommon and subtle presentation previously described in this article on the Top of The Therapeutic Window.
Top of the Window – Heavy Nuance
Check out this thought: The top can look like the bottom with Vyvanse, more than the other stimulants, – because it’s so forgiving.
Please take a look and tell me what you think, it can be quite obvious and quite subtle at the same time.
The key points here, just to review and amplify:
- Onset of action was appropriate in time at first, about 30-45 min after taking it
- Increased dose caused apparent improvement, but later the effect onset comes around 10 AM, – 3 hr after taking it
- Intensity high for about 4-6hr then drops off early afternoon
- They don’t feel the ‘jittery’ side effect one experiences on too much Adderall, but they feel very irritable, anger easily and can become suddenly quite depressed
- Others are burdened by their emotional travails when they never had this intense emotionality previously
- They aren’t eating correctly – often no breakfast
- They aren’t sleeping adequately
- They can’t focus, and feel that they need more stimulants and antidepressants
- Some wag calls them bipolar, serious, and – it becomes the diagnosis de jur
- They distance themselves from their progress and regress in their program, smoke, drink, etc.
- They can become suicidal over their dismay at the regression.
- SPECT Imaging does not show signs of ‘diffuse cortical hyperperfusion’ – [euphemistically yet emphatically labeled 'Ring of Fire' by Amen - a designation frowned upon by experienced nuclear medicine folk]- but rather signs of diffuse cortical hypoperfusion.
- This same observation applies to Adderall XR and Adderall IR, but is much easier to recognize.
Yes you can stop it altogether, abruptly if the presentation is more acute – but I find that simply cutting the dose in half can create a foundation for a careful recalibration – taking more time.
Drop us a comment if you do think of some more features on this puzzle.
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