ADHD, Vyvanse and Ritalin 1 Year Later

HI all,

Per my post https://www.ozbargain.com.au/node/805436 12 months ago, a few people asked how it was all going - happy to give an update on this.

I've changed psychs for a range of reasons, mostly due to the previous psych's inability to do electronic scripts and having to pick them up from a different location, plus his obsession with my blood pressure, whilst my GP has no issue with my blood pressure at all. In fact I've been able to drop my blood pressure through a change in diet and daily doses of krill and fish oil.

New psych has suggested I test out the other medications so he's put me on Ritalin (2 to 3 times a day depending on needs for that day). Vyvanse bumped to 40mg.

Ritalin seems to have similar effects but gives more flexibility due to its shorter release. I've noticed a slightly different level of alertness, different impact on energy levels and slightly different impact on appetite. Not necessarily better or worse. The almost immediate hit of Ritalin is noticeable compared to the more gradual hit with Vyvanse. On Ritalin, I'm usually dropping motivation and energy by about 11.15AM (I usually start work at 7AM and take my meds at that time). I will then have a second dose around 11.30 to midday to power me through until around 3-ish. Sometimes I can push through and not need the third dose, depending on how much high-concentration/strategic work I have to do that afternoon or evening. Whereas Vyvanse is a more gradual increase in concentration/dopamine hit followed by a very gradual reduction in the afternoon.

I've been provided with scripts for both, so I can change between them from day to day until I can clearly articulate which one I believe is better. It's really hard to determine if one is better than the other.

I know people who have had bad reactions to Vyvanse who were then put onto Ritalin. Not the case in my situation. Overall, they both appear to be working although it's easy to take it for granted when you get "used" to them. I suspect my initial positive reaction to Ritalin was because its a different type of drug compared to Vyvanse, so initially it "feels" different but the brain settles into it. Vyvanse is a lisdexamfetamine whilst Ritalin is a methylphenidate. My psych stated that everyone is different and some respond better to one than the other.

Very hard to articulate the differences, but they both work. I'm spending more time seeing tasks through to completion in work scenarios and I am having more success in mapping/planning out projects into tasks so overall it's been positive. I'm generally sleeping better on Ritalin because I can control the dose more effectively, but Vyvanse is less hassle because it's one tablet a day. I still don't take the meds on weekends to give my brain a break, although there's been the odd weekend where I've taken Ritalin to help with certain high concentration tasks.

Anyway, just a quick update for those who were interested. If you suffer from the attention deficit part of ADHD like I do, it's worth spending the money to get diagnosed if you think it's been an issue for you. For me, it's been a positive change since diagnosis because I can concentrate better and accomplish tasks more effectively. None of these meds are miracles and they require you to implement your own mental changes to change your way of thinking, but I see them as tools to help me along life's way.

I think that psychological changes are important once the meds have been implemented, to change life-long habits and established ways of thinking - but one step at a time!

Comments

  • +1

    Manic wall of text from someone on stims, love to see it. (profanity) yeah.

  • plus his obsession with my blood pressure

    They might have OCD

  • +1

    Was this written post or pre Ritalin today?

    Jokes aside, nice to see an update and hear it’s working for you.

    Sometimes i wonder if medication would help me concen…

    • Oh look, a squirrel! That's what my wife would always say to me. Any time she'd try to have a serious conversation - "Now, shut out the squirrels, LISTEN TO ME and focus on me for just a moment, please!"

      That post was written about 5 or 6 hours after taking my Vyvanse for the day (40mg)

  • +1

    Glad you are doing well. Here, couldn't help myself. :)

    https://tinyurl.com/dmnskax8

    • Classic! So true. Even my psych agrees that there's way too much over-diagnosis. I've been dealing with this for life and have built up coping mechanisms around it and I'm a total medical cynic so for me to admit to having this issue in the first place was very, very difficult for me.

  • What was your blood pressure before and after diet change and krill/fish oil? Also, what sort of dietary changes did you do to reduce your blood pressure?

    • +1

      I did a 24 hour BP monitoring regime with the machine. Conclusion was that my BP was elevated both on and off meds.

      I stopped regularly checking after changing psychs about 3 or so months ago, but recently checked when I donated plasma/blood and it was down to 130/86 which I was happy about.

      Prior to this I could hit as high as 150/96 at its peak, usually mid-morning. Not to say that it still doesn't happen, but I can usually equate high BP to anxiety, not so much the meds as my 24 hour BP test proved that my BP was elevated both with and without the meds.

      Main changes I made were:
      - Krill oil, at least 1000 mg/day - although I varied this as I changed brands/Krill sources as I'm a cheapskate.
      - FIsh oil, at least 3000 mg/day - as above - I'd change the dose from time to time as I changed brands.

      • Cut back on snacking. The Ritalin and Vyvanse do impact my appetite so this wasn't generally an issue anyway.
      • No caffeine during the work day generally - although I may have a caffeinated diet soft drink with lunch and/or a proper coffee from time to time mid morning when in work meetings
      • Eating more fish, especially deep sea. Family aren't big fans of fish so I'd go with the fish option whenever eating out and/or at least twice a week as I work from home 2 or 3 days a week. Just got to watch the mercury.
      • Blueberries (frozen generally) every night instead of dessert - these supposedly help with BP although I'm not sure the evidence is 100% proven. Some doctors will tell you that they're a superfood.
      • Trying to eat more greens.
      • I love to smoke meat - I've had to cut back on that which was difficult but that may have helped somewhat.
      • Getting out of the house on weekends and doing things totally different to my day job seemed to help. Being highly introverted makes that a challenge but I do it anyway.
      • Incorporate more exercise into the day - I was a bit weak with that, but did my best! Mostly just walking, to get away from the desk as I tend to sit there and stay at my desk all day.
      • Re; desk - in the office we use sit/stand desks and I just found that standing more often helped when my mind was wandering - just the simple act of varying my ergonomics switched my brain into focus mode a little easier.
      • More breaks during the day. I have learnt that I cannot focus for more than say 30 minutes. So just more walking around - seems to help my brain settle a bit which probably helps the BP too.
      • Years ago I did Cognitive Behaviour Therapy with a psychologist and one of the main things I have tried to push myself on is acceptance and trying to worry less. Of course I'm still crap at that but I'm trying hard to push away the whole Imposter Syndrome issue with varying levels of success. I just think I'll be working on that for life, and I will always be dealing with it. Which has an indirect impact on BP.
      • +1

        Oh wow, thanks for explaining and sharing your experience. Well done on all of those changes, you’re really motivated! Keep it up!

  • +3

    I still don't take the meds on weekends to give my brain a break

    Remember that just because weekends belong to you rather than your employer it makes them no less valuable days. It may be that some things you do on the weekend can actually be a lot more consequential than things you do at work - family time, friend time, hobby time, whatever. Consider not always delegating med breaks to your time off work.

    • +1

      100%, great advice. Exactly - in fact my weekends are more valuable to me personally and yes, when I have difficult tasks/days on weekends I do use the meds when required. I should have worded my post to instead say "By default I don't do the meds on weekends, but if required, I take them"

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