Hi other brains,
I just signed up to look for advice on transitioning/switching from Medikinet (methylphenidate) to Elvanse (like Vyvanse, dexamphetamine), but I’ve been following Jessica’s videos for a long time. Thanks, Jessica & the YouTube commenting brains, for making me feel better over the years!
In short (yes this is a joke ): I was diagnosed at 37, waaaayyyy too late for my taste, but when I was a kid and dragged from doctor to doctor (but only one psychologist) for being overweight, ADHD was still something that girls didn’t get diagnosed for in Germany. I think at that time, non-super-hyperactive boys didn’t get diagnosed yet either, to be fair. Alas, how different my life could have been!
The actual diagnosis, after a decade of struggling to finish the last year of uni while working for student wages, and then allowing myself to go seek an ADHD diagnosis as a reward for handing in the masters thesis, was a huge relief. Suddenly everything made sense! Every. Thing.
Please proceed with care, the following might trigger for:
- binge eating
- uncompassionate thoughts towards self
- very light mention of suicidal thoughts (immediately reacted to and treated)
Five things make my symptoms better/worse, in order of importance: sleep, stimulant meds, exercise, B vitamins, omega 3.
I’ve had trouble with sleep for as long as I can remember. As an adult, policing the hours before sleep is the only thing that actually works (other than sleeping pills, of which I am deathly afraid so I never take them). Committing to police my evenings for “sleep hygiene” is incredibly exhausting. At the moment I’m not doing well in this area: my inner brat child keeps insisting that this is the only time during the day that I can do what I want!!! and if I want to binge carbs and binge Netflix then I’m allowed!! because I’ve been a extremely high-functioning human being ALL DAY already!!! … sigh.
“Exercise” in my case just means not sitting still all day, I don’t currently prioritise actually going to a gym. I should. You know how it goes.
(Travelling 4d a week for work doesn’t help with fitting in interesting sports, I love aquagym but it’s hard to get to classes.)
B Vitamins & Omega 3
My body seems to have an (undiagnosed) uptake difficulty for B vitamins. Way before my ADHD diagnosis I discovered by accident that my life is significantly easier when I take a cheap supermarket B-1/6/12 vitamin supplement. Maybe that’s just because B vitamin makes me less sleepy when I’m tired-as-usu, or it’s a placebo effect. I don’t care why, for me personally it’s been proven over and over again (when I forget to take them for a week) that when I don’t take the vitamin B, everything is harder.
Similar story with Omega 3, though less impactful. I know study results are contradictory, but there is a (very slight) improvement of my own ADHD symptoms if I take O3 supplements - so I do take them (if I remember to). Weirdly, O3 seems to have the better effects if I take it in the morning before any food.
Medikinet Adult (methylphenidate):
For the past four years, I’ve been on methylphenidate (Medikinet Adult) 25mg (10-15, my doc would prefer I take 20-10 but 10-15 works for me).
I have two problems with Medikinet:
- I loathe how dependent Medikinet makes me of food intake: it’s a slow release 3-4h type med whose release speed depends on stomach content.
- In general I think it could be more effective, but I don’t want to up my dose because too much mph, such as 10-20 or 20-10, makes me jittery and nervous.
Sometimes I take 10-15-5. That’s good, but taking the 5mg dose at work at around 4.30pm makes me feel like a drug addict, so I do it only if I have an important meeting at 5pm or later (i.e. maybe once every few months).
Very rarely, if I REALLY can’t sleep and have been awake for over an hour despite trying to sleep (rather than reading or watching Netflix), I take 5mg MPH, and then can sleep.
Ritalin Adult (methylphenidate):
To try to change away from the food-intake dependency, I tried Ritalin Adult two years ago for about three weeks (I think this corresponds to Ritalin XR). German Ritalin Adult has a different release mechanism, not dependent on food intake, which was brilliant!
It’s still MPH, same as Medikinet, so I was very surprised to find that I got quite depressed. I’m always depressed, sometimes barely so, sometimes very, so I know the signs of a really quite deep depression. As soon as I realised my thoughts were inching into vaguely suicidal thought territory, I switched back to Medikinet. The bad depressive symptoms cleared up within two days.
My psychiatrist said depression symptoms are not uncommon when switching from one to the other in either direction. But this experience made me even more wary of trying to switch away from Medikinet than I already was.
Today, after dithering and hemming and hawing (OH GOD THANKS TO WHOEVER designed this software in a way that accidentally hitting the delete button doesn’t actually delete a post draft as long as you don’t hit the delete button again!! I would have lost most of this post so far ARG). …
Elvanse Adult (Vyvanse, lisdexamphetamine dimesilate):
Today, after dithering and hemming and hawing, I took my first dose of Elvanse Adult 30mg instead of my mph (10+15mg). I got both from my psychiatrist, Elvanse to try out, Medikinet for backup. This was three weeks ago and I was too scared to try until now to try it.
Hence why I finally registered on this forum, to see if anyone had done this exact switch and could tell me how it went. (I found nothing, alas.)
So I’m making my own post now, saying hi, and trying to document how that meds switch goes for me.
My current thoughts:
What if the headache from not taking mph will be debilitating? What if I get headaches both from not taking my mph dose, AND from starting with a (apparently much lower) dose of 30mg Elvanse?
Why do I need to re-titrate from a lower dose? Why didn’t my psychiatrist give me more information?!
What if my cardiovascular system can’t take the dexamphetamine, even though it can tolerate the mph? I do have (genetic) trouble with my veins, I take blood thinners and have to wear compression stockings - did my psychiatrist remember that sufficiently when prescribing me Elvanse?
I asked my psychiatrist if I could go back and forth on the weekend, i.e. mph Mon-Fri and Elvanse for trial purposes on the weekend, he said yes, but I’m not sure he got my question.
Do I go back to mph on Monday? What if Elvanse makes me mess up at work? When I titrated MPH four years ago, it did cause problems at work. Now, I am in a difficult (= challenging, exhilarating) and stressful project situation, and I cannot mess up.
… okay breathe.
Currently, it’s been about an hour and a half since I took my first dose.
I have a light headache situated in my left forehead, but it’s not debilitating (yet), and could also just be a tension/stress headache.
I also feel slightly aggressive, more so than is warranted from a Saturday morning laying in bed, composing an intro to an ADHD forum - but that may just be the meds fully kicking in. I’ll keep an eye on it.
ETA: 4h after taking Elvanse, I still haven’t had breakfast (i.e. I still haven’t started eating every food available, as I would normally do on a Saturday morning). That side effect sure wasn’t exaggerated, I’m glad to report.
I’ll report back later (I hope. I mean, how many forums have you made one post on and never ever went back to? ;)).