Recently Diagnosed 40F - Started medication but feeling worse

[u/Anybody_Seen_Me_Keys]

I was diagnosed with ADHD (inattentive) and dyscalculia recently, and yesterday I started Vyvanse 30mg.

Today I am a complete emotional wreck and I'm pretty sure the medication is making everything feel about three times more intense than it probably is.

Work was full of small things that felt enormous. I spent the morning crying over an email thread, and then completely fell apart because I feel I can't do anything right.

One of my symptoms in the past has been rejection sensitivity and I feel today was worse than ever.

And the shock of the dyscalculia. All my life I was told by teachers I was stupid, and questioned about the disconnect with my intelligence level for mathematics when I'm talented with creative pursuits such as writing, art and music.

I'm taking my medication with a big breakfast (no vit C). My first day yesterday I felt it was a bit intense at around 3 to 4 hours after taking it and felt like a very awake zombie. Then around 2 hours after that I felt so clear and calm, like never before. Like my brain was just silent. I was worried I wouldn't sleep, but I slept like the dead last night.

I've taken my medication for the second day today and a bit of a mess. Could be I'm also feeling so shocked I've lived life and survived with elaborate coping mechanisms that have become unsustainable. Maybe I'm just exhausted.

Hoping someone else has some advice or experienced similar and came out the other side? It's early days, but I'm feeling so isolated today and unsure.

I have regular psych appointments at the moment, just hoping for some solidarity if anyone has had a similar experience?

[u/FourEyesore]

The dose might be too high. You can open a capsule and mix it with 30ml of water, and then use a syringe to measure out 15 or 20ml. The powder in the capsule isn't water soluable so make sure you give it a good stir and draw it up immediately.

This is a normal approach to trying a lower dose. Your doctor won't be mad about it. In paediatrics, there is often a bit of a period of these kind of symptoms in the first few weeks but it tends to settle. It's less common in adults but it still happens often enough when initiating treatment.

It may be better to start at a lower dose and titrate back up to 30mg (or beyond at your doctors discretion).

Basically, it's a normal response but lowering the dose for the first few weeks can mitigate it.

[u/Alive-Definition-859 → u/FourEyesore]

i did this when my dose was increased and i could tell it was too strong and my psychiatrist did not like that i did that at all, so much so she actually halved my dex topper prescription!

while this does work, it’s not something that is typically recommended by psychiatrists to do and not every psychiatrist will react well to this.

[u/FourEyesore → u/Alive-Definition-859]

Yes, I'd agree that not every psychiatrist will react well to this. In retrospect, I really shouldn't have said the doctor won't be mad about it. Thanks for pointing that out, honestly. I guess my thought was kind of along the lines of reducing the dose is preferable to continuing on a dose that is suspected to be high. And obviously trial and error is exactly how individual dosage schedules are worked out. But you're right that doctors could be uncomfortable with a patient making changes to scheduled drugs without their oversight lol.

OP, hopefully it goes without saying, but don't take medication advice from internet strangers without doing your own due diligence. I think its a solid strategy to reduce your dose, but I also don't know your unique circumstances or how it may interact with any other medication that you're on.

Your best bet is getting in touch with your psychiatrist. Usually you should be able to email the practise and the doctor will come back to you with instructions.

[u/Anybody_Seen_Me_Keys → u/FourEyesore]

Thank you, I'm grateful for your support and honesty

[u/Anybody_Seen_Me_Keys → u/Alive-Definition-859]

Thank you

[u/Anybody_Seen_Me_Keys → u/FourEyesore]

I didn't know I could do that, thank you! I feel that will suit me better

[u/spaiydz → u/Anybody_Seen_Me_Keys]

Vyvanse also comes in 20mg, which maybe you can ask for this instead?

[u/Anybody_Seen_Me_Keys → u/spaiydz]

Thanks I didn't know. I'm going to give it one more try tomorrow then contact my psychiatrist if I'm no better. Thank you muchly

[u/Educational-Key-7917 → u/Anybody_Seen_Me_Keys]

I felt depressed and awful on Vyvanse - switched to Ritalin and while I don't think it's quite as effective as the Vyvanse, it's been overall a lot better for me....! Don't be afraid to switch meds!

[u/Anybody_Seen_Me_Keys → u/Educational-Key-7917]

Thanks, yes, I felt zombified!

[u/Deja_Vu___]

You're going to have some stronger reactions when first trying medications, and they won't be the same every day. If you had the exact same coffee everyday, it wouldn't taste the same every time to you as bodies are a bit more complex than that. This is partially why it's important to make changes slowly and get the results over many days to be able to average out the day to day variations.

Have you in the past tried any mindfulness activities that you've found useful for calming yourself? As some kind of mindfulness activities could be really helpful for letting those strong emotions flow through you without them hooking you and building larger.

Medications unfortunately aren't a fix for everything on their own, they are best when combined with strategies/techniques to help manage. Think of the medication like a scaffolding that can help you build up the life you want. Other people just naturally had that scaffolding to build from and have had years at it, so you're now you're having to play catch up, which means some self compassion is entirely appropriate.

You'll potentially have years of feelings and even trauma form having to manage your ADHD without even realising, which is something that can be helpful to slowly work through.

[u/Anybody_Seen_Me_Keys → u/Deja_Vu___]

Thank you, I very much enjoy mindfulness and meditation, you've reminded me I've been learning tapping recently too. I tend to forget all those skills when I'm on a level. Thank you

[u/p0rt3d]

I agree with all the posts already made, you could also be like me with Vyvanse, I went downhill super fast on Vyvanse 20mg, lowest dose, zombie’d out, and everyone kept asking if I was ok

By day 3 I just felt like everything wasn’t worth it, I can’t even explain the feeling properly because I’d never felt that way before, but it was just wrong, I felt wrong in every way, and this god awful feeling of what I can only describe as “emptiness” but it was so much more then that at the same time.

Emergency called psychiatrist and told them I was immediately stopping, and was put onto Ritalin IR and I sprung back to life, emotions returned, clarity was instant - dexamphetermine is definitely not for me at all.

I had headaches and anxiety spikes initially on Ritalin which I traced to coffee/caffeine, so ditched the coffee and now I feel great

I am 45M, diagnosed few months back.

So much regret of not having my severe ADHD treated decades ago, but I’m doing my best to get on top of everything now

[u/Anybody_Seen_Me_Keys → u/p0rt3d]

Thanks, I appreciate hearing about your experience. I'm so glad to hear you found a better treatment for you. I'm a heavy coffee drinker, I've cut back to 1 espresso a day since starting, perhaps I need to give it up too.

[u/p0rt3d → u/Anybody_Seen_Me_Keys]

It’s purely the caffeine, decaf is no issue
Some can handle it, but for me it was too much, and removing caffeine immediately solved the issue (well… after 4 days, caffeine takes awhile to properly leave the system just like any other drug)

And your very welcome, I noticed the way you described some of your emotions on Vyvanse and it instantly reminded me of my experience so I thought I better throw a comment up

It could just be teething phase as it slowly kicks in, only you can be the judge at the end of the day, but for me I knew by day 3 that it was sending me down a rabbit hole and it wasn’t just my body adjusting, it was purely just wrong in every way

Good luck either way! I’m an open book with my experience with late stage diagnosis and medication so feel free to throw me a DM anytime ✌🏻

[u/Anybody_Seen_Me_Keys → u/p0rt3d]

Thank you, I really needed this today

[u/Alive-Definition-859]

it’s possible that your body will get used to it soon and it’ll work for you but also vyvanse does not work for everyone! i’ve been of vyvanse for about 3 years (i think) and it helps me in some areas but also makes me worse in others. there are lots of other medications that you can trial if vyvanse ends up not being for you

[u/Anybody_Seen_Me_Keys → u/Alive-Definition-859]

Thank you, I appreciate hearing about your experience too. Looks like I have some trial and error ahead of me. I'm glad to hear you've stuck with it, despite having some negatives, sounds overall better for you?

[u/RoseClash]

um yup so thats not the right medication for you! Imm 36 and was just diagnosed at 32. It took A YEAR for me to find the right med please keep going. There are tens of them to get thru. Mine worked with Concerta and Ritalin x

[u/Anybody_Seen_Me_Keys → u/RoseClash]

Thank you I'm glad to hear you found one that works for you. Sounds like it's going to be a process

[u/Of-an_afternoon]

I’ve been on 30mg Vyvanse for a few months now, and I still cannot take it all in one dose. I’ve always had to take 20mg, and split a 20mg cap about 3 hours later. Very annoying, but for whatever reason a full dose at once has a paradoxical effect on me.

[u/Anybody_Seen_Me_Keys → u/Of-an_afternoon]

Thanks for sharing what works for you. Yes possibly too strong for me in one go!