CW: References to suicide.
I will try and keep this succinct.
I was diagnosed with ADHD-C in November 2022 and started on 20mg Elvanse/Vyvanse/Lisdexamfetamine. By Spring 2023 I’d worked my way up to 40mg. Two weeks ago, February 2024, I started on 50mg.
The 50mg has been a massive help to me. I’ve been much more productive and felt much more fulfilled. I stopped feeling suicidal. Around a week after upping the dose, I began noticing my heart racing and occasionally feeling tense or hyper-aware of parts of my body. The racing heart in particular is kind of irritating and I’d rather it stop. I’ve checked my blood pressure and it’s healthy.
I recall similar sensations for maybe around a month after I was first put on Lisdexamfetamine but I am not sure how long they lasted for. I don’t recall these sensations when I went from 30mg to 40mg.
I’m looking for some assurance that if I maintain a healthy lifestyle and check my BP regularly, that this will resolve itself in-time?
Relevant medical info:
- Cisgender man
- Late 20s
- approx. 90kg/198lb
- approx. 22% bf
EDIT: Updated with this morning’s BP reading.
119/79 80bpm
EDIT 2: I’m going to provide reasoning as to why I haven’t gone straight to my doctor about this. Firstly, the dose increase has been life-changing and I’d be so upset if I had to go back down. Secondly, I live in the post-satirical apocalypsescape formerly known as the United Kingdom and am therefore under the care of a private psychiatrist. Just to get on the phone with them would cost £100s and I’m relying on family assistance, which I feel guilty enough about spending. I could, within a few weeks, arrange to see my general practitioner for free but I don’t think they’d be able to suggest anything aside from reducing my meds. Thirdly, I have faint memories discussing palpitations with my psychiatrist last year and he said that as long as I was monitoring my BP they’d pass.
EDIT 3: I honestly appreciate the concern of all of those who have taken the time to post. I’ve decided to send a message to my psychiatrist explaining the situation.
EDIT 2024-03-21: Received an email from my psychiatrist stating that as long as they’re manageable and the dosage is helping, I’m safe to continue. They encouraged me to keep monitoring my blood pressure and heart rate. They suggested I be vigilant of chest pains or shortness of breath.
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Honestly you should talk with your doctor about it. Even if random fellas in internet tell you it’s/it’s not fine, discuss with a professional.
Taking medical advice from the internet can be meh at best, extremely dangerous at worst
That said, I remember having only extreme moodswitches as side-effect when starting on concerta when I was a kid. Took maybe couple weeks to “stabilize” (or I got used to it)
Thank you for your input. I’ve updated my original post with the reason I haven’t spoken to a doctor yet.
I can’t say for lisdexamphetamine itself, but with plain old methylphenidate (ritalin) I found everything was really quite quick to adapt. I take Concerta 18+27mg in the morning and Ritalin 20mg on afternoons when I need it, so a total of 65mg in a day. When I started I had no real side effects but I did have a whole bunch of trauma based issues because here, finally, was the cause of many of my problems and my parents had lied to me about my diagnosis for 13 years. That said, my psychiatrist was gradually increasing my dose and when we tried the 54mg Concerta and the 25mg Ritalin I knew on dose 1 of each I was over my limit. Sweating, rushing, agitation, and generally feeling awful, it was too high a dose.
That all said, completely unrelated to my meds I had a heart infection last year. A bacteria (streptoccocus sanguinis for the curious) ate a valve and my first symptom was a chest infection. I had fever for a couple of weeks, some gout symptoms, coughing, sweating, and eventually I had to drive to the emergency room. It took me 3 rest stops to walk the 100m from my car to the emergency room and I knew I was in trouble. They thought it may be Covid but no, I had bilateral pneumonia and when the doctor listened they thought I must have a bicuspid valve. It turned out most of the valve was eaten away and the little bits of valve left were flapping away, sounding like a bicuspid valve. Further scans figured out the issue and I had an emergency flight from my country town to a larger city to get an emergency valve replacement. Two days after surgery I was up and walking again with a lovely new scar and a prescription for warfarin and a beta blocker. So if you are feeling weirdness with your heart it is probably a good idea to get it checked if you can manage it. I am in Australia so none of that cost me a single dollar, but where you are it may be different.
Thanks for the detailed response. I’m sorry to hear you had to go through something so traumatic.
Nah, it was honestly a really cool experience. It was scary at times, yeah, but I absolutely love medical sciences and it was a fascinating experience. I had world class healthcare with experts and overall fantastic facilities and now I have made a really good recovery. Most people with two collapsed lungs and a sternotomy (I think that is the correct term for open heart surgery) have long term damage, but I work an intense physical job and feel better than I did for at least a few months, maybe a couple of years, before it all happened. Now I have to take some extra meds on an ongoing basis but as a bonus I sound like a cartoon bomb about to go off. Also my partner can hear my heart ticking from the other room, so that’s pretty cool.
No joke, I find your positive outlook incredibly admirable :)
Long may your good health continue.
I am currently on vyvanse myself, originally 40mg down to 20mg (at my request, was lasting too long affecting sleep). Something I’ve noticed about it in particular is making sure to eat and avoiding caffeine. I get the jitters and heart racing if I don’t eat enough, vyvanse also decreases my appetite a bunch and makes me thirsty (I suggest water as the drink of choice).
This is only anecdotal experience, I also talked to my doc about it and it is being monitored. so as others also suggested, talk to your doc about it too, it’s more important and cheaper long term to get it correct and handled now than not.
Thanks for your perspective. My morning coffee definitely agitates it but I’m pretty good at drinking lots of water.
Will update the post with my psychiatrists perspective, if I can without compromising my privacy.
Call your doctor.
Thank you for your input. I’ve updated my original post with the reason I haven’t done so yet.
Contact your GP, they should get you an appointment soon.
If they can’t call 111. 111 may be able to get you an appointment for an ECG from a hospital or urgent care. Or some other intervention.
NHS inform is a much better place to get information than an internet form. It’s probably the best place for medical advice on the internet for non-medical professionals. It also tells you appropriate actions for your symptoms - treat at home, speak to pharmacist, call GP, call 111, call 999.
I’ve contacted my psychiatrist.
I hope your doc gets back to you soon. I’ve been off my ADHD meds for close to a year and it’s been hell! So I can relate to your concerns re: suicidal thoughts.
My only other comment is to make sure the symptoms are just associated with the meds because I wouldn’t want some sort of heart condition to get missed.
Feel better!
Over the past few years, I have taken 60mg/day generic adderall IR to be functional at work. I don’t usually take any when I go on vacation or when I have time off work.
While the drug is effective, the only side effects that I have noticed are a sharp drop in my appetite and minor dry mouth. After the drug has been metabolized, I haven’t noticed any lingering effects.
I have had the best results with amphetamine-dextroamphetamine produced by Teva. My pharmacist once provided amphetamine-dextroamphetamine as a substitute for Amphetamine Salts Combo, and I learned that the salt-combo was not as effective, and the side effects were less tolerable. I asked my doctor to specify my preference when writing my prescription. There is some controversy about whether the manufacturer affects the effectiveness of the drug formulation, but I detect a clear difference in my performance.
Definitely talk to your doc. (My GP prescribes my meds; the psychologist diagnosed and wrote a letter).
I don’t really have noticeable side effects. When I first tried the stuff I started at 30mg then at 40mg I started seeing lots of bright spots and went back to 30. Freaky experience.
I’ve been on 30mg for years now. My heart doesn’t usually race but some days I get a little jittery. I don’t recall it being elevated back when I was using an exercise monitor. It probably doesn’t help that I drink a double shot latte every morning with my meds. My BP did not seem to be affected by the lisdex last time I tested it on and off the ADHD meds. (I am on BP meds too).
Worth mentioning, I am also on Effexor (venlafaxine) for depression and anxiety, which was diagnosed a decade before adhd-c. Prior to Effexor I was on Lexapro for a few years.
When I was testing dosage, my PA said to increase 10mg every few days until I noticed it helping, then increase until I noticed side effects and then we would go with 10mg below that. Or something like that. Which is how I ended up at 30mg.
I recall that I couldn’t tell at first how much 30 helped vs 40 but now that I have more experience with the medicine and self evaluating my symptoms. The difference between 30mg and none is now very obvious.
Although… I have been thinking about trying 40 again so I can re-evaluate, in case I get a bit more out of it without side effects this time. Maybe I will do that next time I’m up for a refill.
Thank you for your input. I hope you get what you’re after with tweaking your dosage.
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I’ll try and keep this in mind, thank you.
My experiences:
For Adderall:
- Takes 45-60m to kick in
- Lasts about 2-3h. Afterwards I feel down, sometimes tired. It’s a slow decline after.
- If I take l-theanine with it the after effects are anecdotally reduced
For Ritalin:
- Takes 45 or less to kick in
- Only lasts about 2h
- Sharp, sudden, decline of feeling down and exhausted. Not nice at all.
I mostly just use Adderall now, and I only take 5-10mg at a time. On days where I feel like I can “do”, I take none. I’ve noticed that the longer I take it without long breaks the higher my dosage needs to be.
I really should take extended release, but complications between it and pseudoephedrine stop me from being able to. And my sleep quality has been better since I started taking it PRN. Though my chores and other things definitely suffer for it.
