this post was submitted on 04 Sep 2024
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ADHD

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Medication lasting 8h, not 3 or 14? (self.adhd)
submitted 2 months ago* (last edited 2 months ago) by pantherina to c/adhd@lemmy.world
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Hey, first day with Elvanse!

Was pretty crazy, and tbh 30mg are also too much for me. I find it crazy that this is the standard dose people get.

I had 110+ BPM (If my Mi Band 8 is reliable), slight nausea, 0% appetite etc.

I used Modafinil before to cope with my (then unknown) ADHD and there I took ¼ pill, so also really little.

I prefer to be in control, and this was a lot!

The pills are not delayed (retarded??) and a possible consumption way is powdering over a Joghurt etc.

So I will firstly just try 10mg, maybe 15 or 20. I have a pretty good body awareness, that should be enough.

But still, that stuff lasts 14h+ ! That is intense, longer than a lot of other drugs, even LSD.

This also means that my evening today was kinda gone, because I was so exhausted, like in my brain, a pretty strange feeling.

The alternative, Medikinet, lasts 2-3h which is kind of a joke.

Is there something that lasts 8h? A whole work day would be way better.

Why are 3 comments deleted?

I didnt find anything in the modlog, while my other post was removed as it links to Mastodon.

I find this pretty bad, because deduplicating writing effort is not sustainable

Update: now at least 4 comments are deleted.

top 36 comments
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[–] Treczoks@lemmy.world 8 points 2 months ago (2 children)

The big problem with ADHD medication is that basically every patients reacts differently. There is no real general formula. With some patients, even small dose changes can make a vast difference.

Basically all you can do is try a medication/dose combo, observe and record what happens, maybe tune the dose slightly, and talk to the doc again if one medication does not work for you.

[–] pantherina 3 points 2 months ago (1 children)

Thanks yes I can imagine that.

I am generally very sensitive against drugs, noise, bad swimming water, ...

So I react way more than others.

Two issues here. It is no problem to just split a pill. I open it up in a good vessel, shake it a bit and eyeball ⅓ of it. No atom science.

And I would like to tell my doctor that I want to increase the dose, if I dilute anyways, I wouldnt need to go that often.

There is a 40mg 100 capsules package, which would last like a year for me!

But at the same time I would like to tell him that 30mg is not a safe dose, he should teach first time patients to open the capsule and dilute themselves. You can easily do that.

But then he might not prescribe me what I need, because some garbage argumentation that it is not safe to split yourself or whatever.

I might just try it, and explain my reasoning. He is kinda nice.

[–] Treczoks@lemmy.world 1 points 2 months ago (2 children)

But at the same time I would like to tell him that 30mg is not a safe dose,

Leave it to the medical people what a "safe dose" is. If the capsules have 40mg, they have achieved this value not by just eyeballing, but by amazingly intensive testing.

he should teach first time patients to open the capsule and dilute themselves. You can easily do that.

If you have doubts on or problems with the prescribed dosage, please discuss this with your doctor. It helps if you can give detailed information on the effects it has. I have to admit that I have no first-hand experience with ADHD medication, but I closely followed the struggles of my daughter to find the right medication, dosage, and application method, and it took her quite some trials and changes of medications to find what helps her best.

[–] pantherina 2 points 2 months ago

Yeah and the professional didnt tell me that I can ust open the capsule, mix the powder and take a third, then a half, then 2 thirds etc.

So having that data would be very valuable.

[–] pantherina 1 points 2 months ago

Your comment seems to have been deleted

[–] pantherina 1 points 2 months ago (1 children)

Your comment seems to have been deleted

[–] Treczoks@lemmy.world 1 points 2 months ago (1 children)

On lemmy.world, both comments are still there.

[–] pantherina 1 points 2 months ago

Strange... this may be a Jerboa issue

[–] CaptainPedantic@lemmy.world 8 points 2 months ago (3 children)

I've been on 70mg of Vyvanse (Elvanse) for a few years. It's just enough to get me through a 10 hour work day. Everyone's bodies react differently.

You'll get used to the medication, so a given dose will feel like it's doing less over time. If I don't take my meds for a few days, my pulse will be elevated when I start taking them again. After a few days of that, it's about 10 BPM higher than my non-medicated heart rate. I've found the first day of a new stimulate medication to be not at all representative of what long term use is like. After being on a few stimulant medications for a while, it eventually feels like I'm my normal self, just more focused.

Do not split the pills over food without talking to a pharmacist first. With stuff like Adderall XR, splitting the capsule can make the meds instant release. I'm not sure if Vyvanse is the same way or not. Either way, don't rely on an idiot on the Internet (me). Ask a professional.

Personally, I've found Adderall XR to work decently well for 6 to 8 hours. That's not enough for me, but it might be for you. A smaller dose of Elvanse is also a good idea. Personally, I'd go with changing dosage before changing meds. If the smaller dose is still not going well, try a different med. I tend to give myself a couple of weeks on the med before I think about changing it unless I have an extreme reaction. I only did one day of Ritalin because it made me extremely aggressive, for example.

Good luck.

[–] SwearingRobin@lemmy.world 3 points 2 months ago (1 children)

To add to the splitting thing, it says very specifically in my elvanse panphlet that you shouldn't split it. Even if it didn't I would be very difficult to split such a tiny dose of powder accurately, and getting a consistent dose everyday is important.

I take the same dose as you, and like you I felt it was a bit much on the first few days. Your body takes some time getting used to them, after two weeks 30 didn't feel like too much anymore. It feels just right, it raises my heartbeat a bit 2 hours after I take it, and a bit later it evens out.

[–] AddLemmus@lemmy.ml 1 points 2 months ago

The splitting advice is correct in theory; it can become instant-release and thus briefly stronger, even dangerous. But in this case I trust my belief over science that trying 1 % - 5 % first is always the safer option. Splitting a slow-release by 50 % - that might cause this problem, yes.

There is also the theoretical possibility that the active component(s) are not evenly distributed. Even a split marker is supposedly not safe, only instructions that say so. But - doubt

[–] pantherina 1 points 2 months ago (1 children)

Your comment seems to have been deleted

[–] CaptainPedantic@lemmy.world 1 points 2 months ago (1 children)

Strange. I can still see it. Even when not logged in.

[–] pantherina 1 points 2 months ago

Might be a weird Lemmy Federation issue

[–] pantherina 1 points 2 months ago

Thanks, yes there will be huge differences.

Funny, I didnt get a tolerance often, for example with Cannabis. I got one with Caffeine I think.

I think with cannabis was because I took so little.

I want to try the "as low as possible" way. And maybe also 10mg Elvanse in the morning, something shorter lasting in the afternoon.

I will wait a few days and see how that evolves, but that was so much I am sure I dont want that every day and also not sometimes.

Actually, on the packaging it says that you can open the capsule and digest with joghurt. Pretty strange method, but thats why I did it.

Maybe the fat helps with a slower release. I will see, today I experiment with 10mg sober, may kick a bit too hard.

Vyvanse seems to just be a chemical prodrug, so the capsule is less important than the actual compound, regarding the release delay. That is my interpretation, I may keep you updated.

Thanks a lot for all the tips! I will try a lower dose and also make pause days (apart from weekends).

I will try Adderal, if that is not good enough, if I can find the compound it includes (it is also just some form of Amphetamine, likely with less molecules attached so it goes faster).

[–] Jojowski@sopuli.xyz 6 points 2 months ago (2 children)

You can definitely split the Elvanse capsule for a smaller dose, it's safe and doesn't affect the drug itself. Where I live Elvanse is so expensive it would make sense to try and get as high dose as possible and just split it to smaller doses to save money. The price is like 95-135€ for 30 capsules... Also a good-to-know that doctors don't tell but should: 2 grams of vitamin C should get rid of most of the drug in your system in about an hour or so, take with plenty of water and prepare to piss a lot. For example if you have problems falling asleep or feel like it's lasting too long you could try if vitamin C helps. Also if you accidentally take too much. I wonder why the doctors don't often mention about this because taking vit-C supplements will lessen the effect of Elvanse.

And like the others said, it will take a while to get used to the drug. There's also the "wow-factor" in the beginning that might make the effect of the drug feel stronger. But it's a good idea to start with a smaller dose first. No need to force yourself and feel uncomfortable with too big a dose.

[–] pantherina 1 points 2 months ago (1 children)

Your comment seems to have been deleted

[–] AddLemmus@lemmy.ml 1 points 2 months ago

I can see it

[–] pantherina 1 points 2 months ago

Thanks for the Viramin tip!

It was definetly not a wow effect, that stuff was physical.

For me the cost is mostly way too much time (nearly a day just spent on getting a prescription). So with the 40mg 100x I could last at least 200 days!

[–] Gormadt@lemmy.blahaj.zone 5 points 2 months ago (2 children)

For me Straterra lasts about 10-12 hours which is just about perfect. Unfortunately though for me the longer I take it the shorter that time slot becomes until I up the dosage again.

I've been taking it for about 18 months and it's down to just about 8 hours for me now and for those 8 it's still okay on effectiveness though I feel it could be a bit higher.

Basically when I up my dosage it works great for awhile then kinda starts winding down a bit.

[–] pantherina 2 points 2 months ago (1 children)

Interesting! That is an atypical treatment, isnt it? It is a norepinephrine-reuptake-inhibitor, unlike others that act on Dopamine.

Why did you get this instead of the typically associated meds?

It could be interesting to switch (for people that really cant take pauses) between this and Amphetamines (acting on Dopamine) to avoid a tolerance.

Another person told me Adderal would last equally long, while that works on Dopamine.

[–] Gormadt@lemmy.blahaj.zone 1 points 2 months ago (2 children)

It's commonly prescribed for ADHD, my doctor wanted to try non-stimulant based meds first because of my extensive history of substance abuse and also because of my diagnosis with anxiety and PTSD.

It's worked pretty great for me so far.

[–] pantherina 1 points 2 months ago

Your comment seems to have been deleted

[–] pantherina 1 points 2 months ago

Interesting!

Anxiety is caused by Dopamine? I am not sure here, but would expect it to be bound to low Serotonine and high Adrenaline and Noradrenaline (aka. Norepinephrine).

Noradrenaline (aka. Norepinphrine) causes alertness and is associated with the "fight of flight response".

I have no idea why somebody would prescribe something for a person with 1. ADHD and 2. Anxiety issues.

But I assume the person may know better.

ADHD, to my knowledge, is mostly an issue of overactive pumps removing Dopamine from the synapse slit too quickly.

I used drinking Coffee, or Modafinil (which afaik also works on noradrenaline) as a substitute which tbh is pretty bad. I have the feeling that Amphetamines are better.

But I will have to see under exactly the same conditions. For example on Modafinil I could spend a day hyperactively doing random shit I shouldnt do. This might as well happen with Amphetamines, I will have to see that.

[–] pantherina 1 points 2 months ago (1 children)

Your comment seems to have been deleted

[–] Gormadt@lemmy.blahaj.zone 1 points 2 months ago (1 children)

I'm not seeing any recent activity mod activity towards me, and the comments still seem to be there from my alts.

It's odd that it looks deleted for you

[–] pantherina 2 points 2 months ago

Yup, pretty strange, only happens in this thread in this community

[–] Noodle07@lemmy.world 3 points 2 months ago (1 children)

My first time taking ritalin was WILD, then it really slowed down and my heart beat stopped being crazy so it could be just your body having to adapt to the medication

[–] pantherina 1 points 2 months ago (1 children)

So you just took the same dose the next day?

Your body doesnt get used to that, the only method it has for this is tolerance.

So if you just take big amounts every day, tolerance may make it seem as if it was less. Still you have possibly too much in your blood...

[–] Noodle07@lemmy.world 1 points 2 months ago (1 children)

Yup took the same dose 🤷 I have increased it twice ever since too

[–] pantherina 1 points 2 months ago

Yes because you build up a tolerance 😅 still, increasing the dose increases the stress on your body, what it needs to digest, and possibly more.

[–] AddLemmus@lemmy.ml 2 points 2 months ago (2 children)

Interesting, I'm also like that with many meds. Currently using Modafinil, and it's the same there. 1/4 or 1/2 was the right dose for me initially, now I can take a whole one. Supposed dose is two whole ones, always, from the start.

Many meds come with an insanely high dosage. The worst is Venlafaxine - the smallest dose give many people a terrifying inner pain that lasts for a long time, easily the worst day of your entire year. Against all recommendations, I now start with like 5 - 10 % of any new stuff, and only if that has no effect at all, I go for like 50 %. With Modafinil, that method proved already quite daring.

What's your experience with Modafinil? I find that it works pretty well, but I am working on getting alternatives to try soon.

[–] pantherina 2 points 2 months ago

Btw seems like your comment was deleted too.

[–] pantherina 2 points 2 months ago (1 children)

I will have to try Modafinil again, it might work similarly or worse.

I dont have experience (period) with Amphetamines and homeoffice / doing Uni stuff while some Github issues might also be important.

[–] AddLemmus@lemmy.ml 1 points 2 months ago (1 children)

Take into account that Modafinil is very unsafe in combination with many other drugs, such as all benzos. I don't know how much time you need to be safe, but I'd wait at least a whole day (48 hours after taking Modafinil) before using something that is definitely unsafe with it.

Did you also get it through a EU prescription from a semi-shady, but legal site?

[–] pantherina 2 points 2 months ago

Didnt know that! Will have to look for side effects with Amphetamines.

I got it from Sweden, so yeah.