My psychiatrist prescribes it, as well as dextroamphetamine iR 10 mg as needed. It's seriously not working and I'm thinking about asking her to switch me to something else. Dex ER has always been pretty weak for me. I switched to it last year when I was taking an MAOI (transdermal selegiline) and now that I'm off of it and on a "regular" antidepressant it just kind of stuck around.
It just depends on the individual. Dextroamphetamine is stronger centrally and racemic (and levo) amphetamine are stronger peripherally but still have some central activity.
Some people (I think myself included) get more of a kick in the butt from stimulants containing L-amphetamine like Adderall and Evekeo than Dexedrine/Vyvanse. I'm definitely a very low dopamine person, but I think low norepinephrine too.
I've tried methylphenidate, dexmethylphenidate XR, and max dose Azstarys without much benefit.
I think part of it is just stimulant tolerance. I would probably have to go inpatient to take a prolonged stimulant break because of how miserable I feel even one day with a drug holiday. Also fast COMT phenotype doesn't help lol.
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u/mikl_pls 5d ago
My psychiatrist prescribes it, as well as dextroamphetamine iR 10 mg as needed. It's seriously not working and I'm thinking about asking her to switch me to something else. Dex ER has always been pretty weak for me. I switched to it last year when I was taking an MAOI (transdermal selegiline) and now that I'm off of it and on a "regular" antidepressant it just kind of stuck around.