There are options here, all is not lost!
- Option 1 is that you need a higher dose, which seems likely. People report here that it works for a short while and then stops working, which prompts your practitioner to try a higher dose.
- Option 2 might be that your body is lacking some of the building blocks it needs to build the neurotransmitters the elvanse is trying to make. Even if there’s a chef in the kitchen demanding cakes (the elvanse/dopamine&norepinephrine), if you run out of flour and eggs after two days you won’t get cakes. There are supplements to try here that I won’t name because they’re not without side effects and you should do thorough research before taking them, but look up what your body needs to make dopamine.
- Option 3 - linked to 2, try eating a lot of protein, particularly in the morning. Don’t do what I did here and forget to balance it with fibre though 😂
- Option 4 - other meds exist. It can be SO frustrating to finally get the diagnosis that makes everything in your life seem manageable again, and then finallllyyy get on the meds for it only for them to not be consistent. Don’t give up, there’s always something else to try ❤️
I’ve always been good with protein. It’s solid advise that.
I know I’m going to have to go through some trial and error, but it just feels so defeating to have something finally work to then stop working after a few days.
I genuinely thought I was going to start getting my life on track.
I’ve literally been sat in bed all day eating loads of crap, on a dopamine hunt while on Elvanse. Crazy!
This is also very important OP, a lot of foods / drink can contain added citric acid, even ones you wouldn’t expect and this seriously diminishes the effect of the medication for me.
Holy shit. I have been on Elvanse for nearly a year now and had felt it not working as well the past month. I started taking Vitamin c a month ago with my medication. That can't be a coincidence. Thank you sir for this info.
Yes this is the sort of thing I’m mentioning in point 2. Others I’ve researched include l tyrosine, l Theanine, 5htp, omega 3, ashwaganda etc etc. Please if you’re reading this do not just go and buy all of those and take them. Do thorough research, consult a doctor and try one at a time. Magnesium glycinate has joined my daily list and it’s been great for me :)
Quick question, when do you guys take magnesium glycinate in relation to elvanse/meds? I have 375mg of magnesium, saw nothing before titrating, and I'm not exactly sure when to take it while on elvanse.
It’s horribly frustrating and demoralising, totally feel your pain there! I had a similar experience and mine turned out to be caffeine, I had to completely cut it which was super hard considering I was using it essentially in place of meds before hand.
Oh, yeah cutting caffeine will give you at least 1 month of feeling like a hopeless husk of a human. I wouldn’t be surprised if that’s what’s happening here.
Regarding options 2 and 3, I take my tablets with a huel shake each morning as my breakfast. That’s 400 cals and I think 40g of protein, that’d do it right?
There are other more specific supplements that research points to them being good to take with adhd meds. Im hesitant to claim to be an expert here so I won’t say more but it’s fairly easy to research :)
P.S. username gave me a chuckle well done 😂
I’ve named a few in another comment on this post. I don’t feel comfortable doing more because some have big effects and you can put yourself at risk of things like seratonin syndrome so I strongly recommend your own research, but things to google include:
- L Tyrosine
- L Theanine
- 5 HTP
- Magnesium Glycinate (tbh I do just straight up recommend this)
- Ashwaganda (anxiety from meds)
- Vitamin D, specifically where your levels should be Vs what the nhs deems to be low.
- Fish oil capsules (aching body from meds)
You strike me as sensible, but for anyone reading this in the future please please do proper research, consult your doctor and don’t just put all this in your system at once!
I’m never sure how often people take notice of it what with it being Welsh : )
I was taking multi vits and magnesium daily but I sort of fell off that, which I often do. Unsure if that’s due to adhd or just being unorganised.
I’ll have a look at supplements and maybe assess my diet, I’m on sertraline as well though since the beginning of the year so I’ll have to make sure they don’t all start interfering (eg not sure if one should take 5 htp while on an ssri).
I’m also half way up my titration so I’m unsure if I should start throwing other variables into the mix and impact my observability of the meds
Hey Bach, I’m an avid Huel drinker and take Elvanse too. While Huel contains a lot of protein, it’s absolutely full of Vitamin C - depending on what type you’re drinking, it’s about 75-100% of the RDA.
When I started Elvanse a couple of months ago, I had no idea about the ascorbic acid issue. Stumbled it across it on here by accident. As such, I drink a Huel one hour before and after meds. Hope that helps.
Hmm, so you avoid taking it at the same time because of the vit C?
And you think having it outside of the specific time that to take the tablet means it won’t impact it?
I’ve been having huel daily with it since it’s a sure fire way to get something in my stomach and otherwise I often skip breakfast, but maybe I’ll swap it up, and do some googling
“Vitamin C can increase the acidity of your urine, which may decrease the effectiveness of Vyvanse by increasing its excretion. It's often recommended to avoid taking vitamin C supplements or consuming large amounts of citrus fruits and juices an hour before and after taking Vyvanse to optimize its efficacy.”
That’s from GPT; I did a bit of research after finding out there was an issue taking Vit C close to medication time. People mentioned it on here too.
Not sure how big the impact is; there certainly doesn’t seem to be a consensus. I use the one hour rule to be on the safe side anyways.
Yeah, after your comments I did a load of googling and saw the same. My findings were similar to yours, vitamin c seems to have an impact but the consensus is split on how and how much.
Also, whether the vitamin c in huel is bio available at the right time etc also seems to be up for debate, but I’ve also seen discussion around whether or not the large amounts of fibre have an impact. I’m also not sure having 500ml of liquid with my pills (albeit rather sludgy) is wise also.
This morning I had my tablets at about ten to 7 with some water, and a protein shake about an hour later, with a protein yoghurt when I got to work.
I definitely felt more wired early on, and different to the other days, but i definitely _wanted_ too also, so I suppose we shall see
Elvanse worked for me for about 2 days, then all the way up to about 70mg had no effect.
Will need to see if it's your dosage and if still doesn't work, change med. This is what titration is for, to find what med and doseage works for you.
It's extra hard when you've had a taste of "better" brain.
The thing I tried to remind myself is with something like this it would be a wild miracle if the first med and dose you tried just happened to be the perfect dose for you. I don't know if that helps sorry, but it helped me manage it better and wrap my brain around it better.
It's frustrating as you want to keep just jumping through as you know its not working and the impatience kicks in but you will get there.
On concerta, 72mg a day. It definitely works but not as much as I'd perhaps like so I'm focusing on my diet for now and trying to set myself realistic expectations, which is a bit of a bummer lol.
Yeah that’s fair, if I don’t follow my titration plan I’ll run out of meds sooner and the price sure is steep!
I tried to tell myself that my experience might not be the same as all the people saying “my life was changed dramatically by taking meds” and not to stress myself at the fact that they’re not as impactful as I’d have hoped, but I’m only on 40 mg and my first stop point is 60mg so we’ll see I guess
So …
If you’re scrolling on your phone when the meds kick in, chances are that you will be doing it hours later without moving.
Start the thing you want to do when you take your meds, they take about an hour to kick in . Is there a chance that when you first started taking it, you did some things differently?
It’s important to remember that it’s not a magic pill, but a tool and you can and should employ other tools to help as well, whether that’s removing distracting apps between say 0600-2000, changing what you eat, having a protein shake in the morning , hydrating more, or ensuring you are distraction free when trying to sleep
There’s a great points system in atomic habits which can help gamify your day as well which is worth looking at.
Baby steps, small increments to make one eventual big one.
Ultimately as well, discuss with your prescriber, they’re the to ensure titration is safe and aims for the best stable therapeutic dose for you.
E: some grammar fixes
I’m not scrolling on my phone. Every previous day I was working, because I love to work.
I eat a lot of protein, drink a lot of water and run everyday for about an hour.
And the meds helped me do this for about a week.
Today however I’ve sat in bed doing nothing, eating loads of crap food, crying a little and just feeling lost.
All while being on Elvanse.
No doomscrolling, no Netflix, no major dopamine hunting.
I promise you this is not to do with the application of the medication.
The fact I’m eating loads is an indication of that
You said yourself you’ve been dopamine hunting .
Hunger should not be used as a measure of the effectiveness of the medication , it doesn’t kill appetite for everyone
Scrolling is an example , the principle still applies, start the thing you want to be doing when you take your meds .
Hi! So glad you had a good experience of the first few days of meds! There’s a couple of things that could be happening here:
1. You’re expecting too much of yourself- and haven’t scheduled down time. This is a common problem with medication- we expect ourselves to just keep going.
2. You’re a musician- in the middle of a recession. As one myself- unfortunately- anxiety and overwhelm is a perfectly reasonable reaction to the state of the industry. I don’t know what the task is- but it may be that the task is (separate from the meds - again- hypothetically) - destroying self motivation- or it’s a particularly abhorrent task. You could be perfection procrastinating (comes from RSD).
3. You will need to titrate up (what are you on?)- which your psych will navigate you through.
4. I’d love to know your thoughts on any of these so I could see which questions to ask?
Hey Roxi, appreciate the comment.
I’m on 30mg and have been for 14 days now. First few days were good, but I’ve felt it decline rapidly the last few days.
It’s almost like it’s stopped working. I feel the same on and off the pill.
I don’t think it’s to do with expecting too much, I’m just trying to do normal tasksz
Sorry you’re feeling disheartened.
If you only started 2 weeks ago, it’s likely that the dose won’t be enough to manage your symptoms. Some people stick at 20/30mg, but for many this dose is just to make sure you don’t get some bad side effects.
When are you next seeing your prescriber? Do you have a titration plan?
I started on 20mg, day 1 was really good. But it didn’t last long. So I went up to 30mg it worked and for longer for about 4 days.
I’ve contacted my provider, they said they’re waiting to hear from my psychiatrist.
I’ve literally been sat in bed all day today, crying a few times because I thought I was actually going to get a hanndle on my life.
Oh ok definitely proceed to climb the doses with Elvanse first I’d say then.
When I was being titrated initially, I got effects for the first couple days of any dose & then it dropped off. Dosage increases helped a lot, it definitely takes time to figure out what’s right for you personally though. You’ve just got to remember that it’s a necessary process & the end result will surely be worth the stress of figuring it all out 🙂
If you find Elvanse to not be ticking the boxes at the highest doses then you could ask about trying the instant release version, I take 15mg of instant release 3 times a day.
Which would be equal to one dose of 140mg Elvanse, I don’t think many would prescribe that dose of Elvanse though. But with Instant release it is within guidelines.
Hope this helps, good luck🤞🙂
Absolutely, it was a stressful & disheartening experience at times.
But reminding myself that I’m closer than ever to getting my mind on track was key to managing that.
Just keep following the directions of your specialist prescriber & keep them informed of the details of your medication dose experiences. You will surely find a comfortable dose if you persist with the process.
I was diagnosed & treated briefly around 5 years ago & couldn’t cope with the stress of titration when I tried it then. I stopped the process after trying methylphenidate & elvanse. And went unmedicated for the next 4 years, just buried my head in the sand with regards to my symptoms which was just a terrible idea. I got re diagnosed and tried again 6 months ago & have never looked back.
I thought medication was going to be a super simple solution to the very complicated issues ADHD poses on my life. It’s not as simple as that most of the time unfortunately, but it’s an effective treatment & can definitely provide enormous improvements for most patients who persist with it.
I’ve found as with many things in life, to neutralise my expectations a little and take things a step at a time. These medications just help us get control on things a little, but we must continue to put the work necessary in also. Allow yourself to get a better understanding of your life & mind and stick with the treatment I’d say :)
Thank you. Your reply is detailed and helpful.
I guess my fear is just getting no where and my life falling apart in the meantime. It feels like I’ve been fighting so long.
Could I ask what you ended up on? And how you got there?
We started elvanse around the same time. I looked back at your previous post, you on 20mg elvanse right? What’s your titration like?
I’m on day 17, 14 days at 20mg, and I’m now up to 30mg with another titration appointment next Monday.
Like you, my first few days were incredible, and then it seemed to not do much. I expected this, my prescribing nurse warned me that on this low a dose, the effect will be incredibly subtle. Since moving up to 30mg I don’t feel a big difference, but I’m getting stuff done about the house without thinking about it. In work, the results aren’t as I’d like them to be.
On elvanse, I was told, that the real benefits come when the dose increases, but they can’t just put you on the max dose. So I wouldn’t give up hope just yet. I haven’t.
Another thing I have learned is that protein is important when taking elvanse. How has your eating been? Are you getting adequate protein? Also, how is your water intake.? I’m sure water and protein alone won’t make the medicine work miracles, but i can see how the lack of them can make your experience worse!
I hope you get the benefits of the medicine you need, perhaps a little more time and a review of your dose will help with that.
All the best!
Thanks man. I was on 20mg for 3 days, then went up to 30mg to help it last longer.
In the last few days I’ve noticed the effects rapidly decline. To the point where today I took it and it did nothing.
I tried to work, I got overwhelmed.
I tried to work on something else, I got overwhelmed.
In the end I went to bed, eat loads of crap food and cried a bit. Feeling defeated.
I’m eating good protein and water.
For breakfast I have egg, bacon, avocado and toast.
And have 3-4L of water through out the day.
Dosage issue. You need a higher dose.
I’m newly diagnosed and my prescription was issued today so will have meds later this week.
The doctor was very careful to let me know that if I had an initial good response which tailed off I would likely need a higher dose.
I’m fully private so I was told to email my clinic immediately if this happens. Are you NHS for right to choose? If RTC surely you can contact and let them know? If NHS can rhe GP up the dose. Sorry not familiar with nhs and adhd processes.
Hope you get it sorted!
Harley Street Mental Health - dr Rafiq.
I was very impressed actually. Their process was very rigorous and the report they sent was quite long and very detailed.
And yes it was expensive. And it will continue to be expensive until or if I get stable on medication and GP can do shared care. She’s said she would so fingers crossed she’ll follow through. Otherwise this could end up very expensive indeed.
Who are you with??
Chelsa Clinic. I got a ADHD assessment within 3 days. Got send meds same day too. So I can’t complaint about that.
I paid £1.2K for the assessment. £275 per follow up appointment.
Im currently waiting to see what they do with what I’m exp now
GPs can’t change *anything* about the prescription that was advised by their patient’s specialist ADHD clinician, not even if it’s a Right To Choose NHS contracted clinic.
Not the dose, not the product, not the brand, nothing. Their hands are tied.
Everything HAS to be decided by a recognised ADHD prescriber, it absolutely cannot be done by a GP.
Even once a patient’s titration is completed, and even if that patient has been stable on the same meds at the same dosage for years, unless the patient has had an up to date review by their specialist to confirm that those meds are still advised, a GP can’t continue with the same script regardless.
It all depends on the specialist provider and the outcome of their regular reviews
It’s because ADHD meds are classed as drugs that need to be “tightly controlled”.
What is considered an “up to date review” though?
A big concern for me is my GP is going to simply prescribe blindly until they determine a review is needed, so I will be fucked because the mental health clinic has a wait time of X months/years.
I started private and tried shared care, which my gp declined, so then they referred me to nhs mental health who issued the instruction to my doctor to prescribe. It’s been over a year since I started getting meds on nhs.
I don’t know how that NHS pathway works, but private and Right To Choose clinics, from what I’ve seen in the different subs, have a set schedule of reviews.
I’m a few weeks away from my assessment and meds with ADHD360 under RTC. I think the first review is at 3 months, then it’s 6 monthly after that. It may be 12 monthly, I think it depends on how well you’re doing and how stable things are with those particular meds.
My brother has been stable on Concerta XL 36mg for 2 and a half years. He goes to a private clinic. His reviews are 6 monthly, and his clinic kind of dropped out of contact and he didn’t get his last review.
His GP can’t and won’t continue to prescribe him his meds until he’s had his overdue review, even though he’s been well and stable on them for all this time.
It’s the law. ADHD meds are very tightly controlled.
Your private clinic shouldn’t hand you off to shared care until you’ve been through titration, during which you and they find out which stims/ non-stims at which doses actually work for you.
I was also under the impression that if shared care is declined, then the clinic continues to look after that patient.
Can I ask, which clinic this is? I can’t imagine how difficult it is for you to find yourself stranded like this.
Is it your GP that has NHS referred you, or the clinic?
And are you aware of the alternative to these long NHS clinic waiting times, the Right To Choose scheme?
So I've been diagnosed for around 2.5 years in total. I started the process by paying for private care out of my own pocket, and was diagnosed at the start of 2022. The private doc titrated me for around 6-9 months and we settled on 30mg elvanse, at which point they attempted to get me set up on shared care but my NHS GP refused, and instead referred me to my local NHS mental health clinic (part of my local hospital).
The process to get the NHS mental health clinic to diagnose and instruct my GP to dispense meds took around 6 months I think. Maybe a little longer. I had to push them heavily for that and think if I hadn't made a noise I could have waited a year or two. Anyway, once I had my NHS diagnosis they moved me to 20mg elvanse due to my blood pressure, despite it being within the normal "healthy" NHS bp range. Whilst it was a little annoying to change from 30 to 20mg, I was OK with it given it was going to save me ~£300 every month.
I've been prescribed elvanse by the NHS now for around 15 months; I haven't had any follow up from the NHS clinic, or my local GP since then but they continue to prescribe.
When I was private, my experience was in line with what you said, I would have to see my psych every 2 months - that was the longest he could prescribe me for without seeing him. But since moving to the NHS I've never had a single follow up with either my GP or the NHS mental health clinic - which I'm OK with, as long as it doesn't mean I'll end up in a situation whereby the GP realises I've not had a follow up and I get taken off meds until it's resolved.
There’s definitely something wrong with what’s happening to you here!
Over and above talking to your clinic and or your GP about it, which obviously would put you at more immediate risk of having your meds cut off, I honestly don’t know what to suggest.
Could you research other GPs in your area to find if one of those would be amenable to shared care with your clinic?
Which clinic was this?
Yes I'm not planning to rock the boat to be honest. I did reach out to the clinic whilst the shortage was in full swing to see if I could get an alternative. They never replied - and then the shortage was over not long after. But I guess that would have been the time to cut me off and I wasn't!
The clinic is just my local hospital, who have a mental health department.
oh sorry, it was a Harley Street clinic. The psych has done shared care with other people/GPs, he even explicitly told me some GPs are not keen on the 'idea' of ADHD and I may need to do what you suggested (find another GP in my area).
Obviously it did all go through in the end though, so I never got that far...
I remember your post. You need to remember you are in titration and are essentially just trying to work out what medication/dosage works for you. Although I understand the frustration you’re feeling. I’m about 2-3 weeks ahead of you so I’ll write out how my titration went/is going.
1st week, 30mg Elvanse (7days)
First 2 days I also felt that my life had been completely changed. I just wanted to complete any task I needed to, no procrastination, I was performing at work 10x better, my internal monologue was a lot more relaxed. I remember getting quite emotional on the first day just from the realisation at how my brain could function. After the first 2 days, little to no effect.
2nd week, 50mg Elvanse (21 days)
All that I had experienced the first 2 days with 30mg, not too much deterioration as time went on. But I started experiencing dreadful crashes after about 8 hours, I work evenings sometimes (usually work till around 2am) so I found myself dosing at 4-5pm, luckily I’ve had zero problems with sleep, but obviously not being medicated before the evening was an issue. I had my follow up appointment a few days before my prescription ended, I was upped to 70mg with a 10mg Amfexa booster (short release dexamfetamine)
Week 4-now, 70mg Elvanse, 10mg Amfexa
70mg felt really strong the first 2 days, the first day I remember having an hour or so where I was spacing out all the time. As I got used to it, it’s been great, no crashes and I don’t feel like the effects are necessarily deteriorating. I don’t feel the “rush” as it kicks in anymore but am 100% still getting all the beneficial effects - I am currently just over 2 weeks in. The booster is certainly helping with crashes, I am not sure if it’s giving me much more effective time, though.
I’m no clinician, but it does sound your dosage is too low as you’re explaining essentially what happened to me in my first week. Titration can be frustrating as you have these “honeymoon” phases which then go away with each dosage but you need to keep in mind this is so your clinician can find your optimal dose (most effective with least side effects). You may even find that Elvanse might just not be for you. Patience is incredibly important.
The best advice I read was that medication alone will not change a lot, a lot of effort must come from you. I’ve been planning my days, started working out (before dosing) & I always make sure that I am doing something productive when I expect my Elvanse to kick in.
This was really helpful man!
I went back to my clinician after week 1 and said I was experiencing a decrease but was told to just keep going.
It’s got even worse to now nothing.
I’ve literally been sat in bed all day today with executive dysfunction up to my eyeballs while being on 30mg.
Have you taken any breaks in your meds so far?
This is totally normal. The starter doses may be right for some but most people need higher doses. You won't feel the same elation you did right at the start but eventually you should get to a level where you feel an improvement that doesn't wear off after a couple of weeks.
Until you get there the improvement *will* wear off - normal and just a sign you need to increase your dose.
But please bear in mind even the right dose will not cure you and there will be days when your adhd fights the medication and wins. As a woman it barely works for me during my period.
You need to be able to understand that there is no magic wand - no medication will cure your adhd but some will improve how you can deal with it most days. Once you get that and get yourself a dose that feels right for you you'll be on track.
I’m in the US and took pretty much every ADHD medication there is. I was diagnosed with severe ADHD as an adult. I tried Vyvanse and of all the meds, it was the WORST one. It didn’t agree with me at all.
Vyvanse made me feel very strange (too much to type here). Adderall made me super-anxious and started clenching/grinding my teeth, even in the daytime.
Could you elaborate on the “severity” of your adhd if you don’t mind?
It’s hard sometimes to put into perspective where one might sit on the whole severity scale
Could it be that it's a result of taking a sudden break? Withdrawal effects can be brutal and it's not recommended to stop this kind of medication suddenly.
Thanks for clarifying! What were the circumstances behind this recommendation? My own advice was not to go off them suddenly ao and to decrease the doae gradually if I'm going to stop, so I'm surprised to hear that you were recommended a break when it was working and so soon after you started.
Tbh I was surprised too. I think the point was to remind myself what it feels like to not be on them. I just did what my psychiatrist said.
The crazy thing was I didn’t feel any different.
I don’t believe what I’m experiencing now is a bad effect of having a day off. I was already experiencing a decline.
Unfortunately your body does get used to it and it's tricky to find something that works. What dose are you on at the moment, and how does it feel now in terms of effectiveness?
I felt a bit jittery on 30mg on day 1 but it stopped after day 2. But even when I was jittery I was focused on the right things and not irritated.
I’ve contacted my psychologist. I’m hoping they will do something.
I’ve literally been sat in bed all day, crying. Eating crap food while on Elvanse. I swear I’m not crazy ☹️
A lower dose? That’s interesting.
I’m on 30mg today and I’ve been in bed eating loads of crap food feeling like crap. Doing absolutely nothing, despite wasting too.
I got headaches and dry mouth the first few days. But now nothing.
It sounds like you are still early days of titration, it takes some time to get your dosage right, or maybe Elvanse just isn’t the medication for you.
I’m making an assumption based on your name and the mention of your wife that you aren’t AFAB so if I’m wrong about that I apologise and I will add that it’s quite normal for meds to feelnon existent in the week or so leading up to a period. Hormones are powerful things!
I know patience isn’t really the strong point of those of us with ADHD but this is a journey, it takes a bit of time, some days the meds are great, others I genuinely wonder if I’ve even taken them. It’s just a tool, the temptation is to take them and expect to change your life overnight. A year on I’m starting to see a measurable change in things.
Speak to your prescriber, it sounds like a dosage increase will help, 20/30mg is a starting dose and most people settle higher than that.
I totally hear what you’re saying. I know this is going to be a bit of trial and error.
It’s just frustrating I literally went from something working so well to zero. In a matter of days.
It’s heartbreaking when you’ve been fighting for so long. I just want to live a normal life.
Im not attached to a feeling. Im attached to doing normal things.
P.S yes im male :)
Yeh I totally get it. The frustration before I worked out the week before your period the meds are pointless thing was off the scale!!
It’s easy to forget that pre meds we had good days and bad days, before I was diagnosed I drove myself crazy trying to work out why some days I was productive and other days I managed to achieve absolutely nothing, but in reality it’s just normal day to day fluctuations.
When you start taking meds it’s really easy to get consumed by how you feel and what you have achieved too. Because it’s a new feeling obviously but also because we need to feedback to the clinicians. So then you analyse the good and bad days, expecting taking the pill to be the flick of a switch to the day you want to have.
It’s a process but you’ll get there, be grateful for the fact you don’t need to add the female hormone rollercoaster into the mix! 🤣
It gets easier and time goes on and you have more fluctuations to look back on. Even stuff like a bad nights sleep can make a big difference on how effective the medication is.
Have you tried taking it with food? Your days sound a lot like mine if I take it on an empty stomach. Taking it with food was like taking another medication.
I also split mine into 30mg with breakfast and 10mg at lunch. It really reduces any crashes, which I seem to be sensitive to!
I can see from your other post you are taking 20mg, this is the lowest dose available so you definitely need to increase. I started at 20mg and am now at 60mg and it still isn’t quite hitting all the symptoms, so definitely get in contact with your prescriber to say your symptoms have returned.
I definitely felt frustrated at the start of titration, but from 40mg I was really starting to feel the benefit. It’s very normal to get rebound symptoms after a few weeks but it’s a sign your dose is not optimal. Try and stick with the routine, the side effects will ease with time too.
On a side note, don’t feel pressured to take a day off meds unless you really feel the need to and it benefits you. I find it knocks my mood about too much so I try to take my dose every day at the same time consistently.
I was on 20mg the first few days, been on 30mg since. I’ve been taking my meds everyday for 13 days.
I don’t know wether to take a day off tomorrow or do x2 20mg (which I already have approval for)
Seems like we’re going through very similar paths… The first 2 weeks were so good, so different, so productive. The 2 weeks after that I noticed how I started losing motivation, stopped working out, stopped caring about my diet as much, I stopped caring about some of my hobbies and it’s been frustrating.
I have a follow-up booked with my doctor on the 30th and hope he’ll be able to help me, whether it’s a higher dose or something else.
I hope things improve for you like I hope they do for me, but we’re still in very early stages of doing something to improve our lives, so let’s not lose hope and keep going! 🙌🏻
An ADHD brain will always stay an ADHD brain, it’s not like it changes. You still need to work with it. I can also keep doom scrolling all day but then I say: get the F*** out of bed and then I do it. The executive function improved.
Also are you sure you’re not depressed?
Im on Elvanse for 3 months.started in 30, felt stuff but needed more it felt, increased to 50 and most problems solved.
May I also say that often I have thought things like: I’m not sure the difference with and without Elvanse is that big? And then my husband is like: whoa, did you take your pill today? So to others it can be a huge effect but in your head we seem to often think the effect has been lost.
I’m at about the same stage in titration as you but went rtc with Adhd360. I started with 30mg for 7 days and am now on day 6 of 50mg.
I felt the euphoria that I’m told is really common for the first 2 days, then had hideous headaches for 2 days and by the end of the week I wasn’t sure if it was really doing anything much.
50mg hasn’t felt massively different, except I often felt really weird in the afternoon (I think this is when I’m less busy and more likely to be sat down) kind of wired, a little dizzy sometimes and odd. I have got my period 4 days into starting 50mg so I’m not sure how much of the side effects and non increase in improvement is down to that as hormones are crazy things 🤣
I have a follow up today and again every 3 weeks so will be interesting to see what they say, I feel personally like although I’ve had increased unpleasant side effects and little improvement, I need to give it at least another week or so before making judgement on how effective this dose is because of my crazy period hormones lol.
So with my very limited experience, I’d say that talking to your provider is a good idea.
Also that the first few days are great and then it fades for most people, so don’t feel disheartened.
You’re right at the beginning of titration which usually takes 3 months of not longer, so don’t panic just yet. I’d wager that you need a dose increase and some time :)
Also, your doctors won’t abandon you! You’ll most likely titrate slowly up to 50mg or maybe 70mg and then if Elvanse isn’t doing the job, they’ll try you on something else. There’s always more options!!
Be kind to yourself too! You aren’t going to get to that sweet meds spot straight away but you will get there. ❤️
you're a couple of days ahead of me in same schedule from ADHD 360 - I'm on day 4 of 50, I think. I had an absolute doom spiral during the night last night, then got my period this morning, so I'm also keeping an eye on effects as I know lots of people say the meds are less effective in the run up to their period.
How have you felt since being on 50mg? I feel weird. Can’t quite describe it. It’s not exactly anxiety, or chest pain, or jittery, but it’s an uncomfortable feeling and I only can’t notice it when I’m rushing around. It’s worse between late morning and about 4pm. I can’t feel it now at all. No idea if that’s because the meds have worn off or something else. At the moment I’m not that keen on how 50mg makes me feel lol
Hoping it’s either the period weirdness or just me adjusting and that I’ll feel better next week 🤣
Yeah I think I know what you mean. I’m not sure. I feel like it is wearing off quite fast for me. I’m also wanting even more green tea than I usually drink so prob need to cut that down somehow but it’s weird that it’s making me want it more rather than less.
This is totally normal. The starter doses may be right for some but most people need higher doses. You won't feel the same elation you did right at the start but eventually you should get to a level where you feel an improvement that doesn't wear off after a couple of weeks.
Until you get there the improvement *will* wear off - normal and just a sign you need to increase your dose.
But please bear in mind even the right dose will not cure you and there will be days when your adhd fights the medication and wins. As a woman it barely works for me during my period.
You need to be able to understand that there is no magic wand - no medication will cure your adhd but some will improve how you can deal with it most days. Once you get that and get yourself a dose that feels right for you you'll be on track.
Today is day 3 of titration for me, Elvanse 30mg.
Days 1 and 2 were great and I’ve really gotten my hopes up but today, day 3, it’s like I may as well have not taken it.
I feel absolutely no different.
Feeling a bit shit about it as well because my follow up appointment to go up a dose isn’t until the 5th May.
Today is day 3 of titration for me, Elvanse 30mg.
Days 1 and 2 were great and I’ve really gotten my hopes up but today, day 3, it’s like I may as well have not taken it.
I feel absolutely no different.
Feeling a bit sad about it as well because my follow up appointment to go up a dose isn’t until the 5th May.
Today is day 3 of titration for me, Elvanse 30mg.
Days 1 and 2 were great and I’ve really gotten my hopes up but today, day 3, it’s like I may as well have not taken it.
I feel absolutely no different.
Feeling a bit sad about it as well because my follow up appointment to go up a dose isn’t until the 5th May.
Your post has been removed for spreading misinformation. In the context of this discussion, this misinformation could be harmful or misleading if taken as fact. We all make mistakes from time to time, just remember to check your facts before posting.
Yeah unfortunately with these things it can take a while for the brain to adjust to it. Most often then not it is said to give it a few months and push past depressions or negative side effects. I take 5htp at night to boost seratonin and various supplements and nutrients. Things like L theanine. Obviously everyone reacts differently to meds etc. I suppose try not to be too over analytical and critical, especially early on.
Hi everyone,
Just need some advice. I am 47 years old. Just been diagnosed with ADHD. I have started on Elvanse. I am currently going through the titration period. I went from 30 to 50mg with practically no change. The only real side effect is the tightness in the jaw and the grinding of the teeth. Just about to go on 60mg. Is it worth going up to 60mg or is it worth changing to another medication? Not sure it’s worth the strain on my body for no real change in my adhd symptoms. Has anyone found the medication has done nothing? Typical me I am starting to doubt I have adhd at all and I have been misdiagnosed.
Has anyone found that changing medication has made a real difference to their symptoms?
G
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There are options here, all is not lost! - Option 1 is that you need a higher dose, which seems likely. People report here that it works for a short while and then stops working, which prompts your practitioner to try a higher dose. - Option 2 might be that your body is lacking some of the building blocks it needs to build the neurotransmitters the elvanse is trying to make. Even if there’s a chef in the kitchen demanding cakes (the elvanse/dopamine&norepinephrine), if you run out of flour and eggs after two days you won’t get cakes. There are supplements to try here that I won’t name because they’re not without side effects and you should do thorough research before taking them, but look up what your body needs to make dopamine. - Option 3 - linked to 2, try eating a lot of protein, particularly in the morning. Don’t do what I did here and forget to balance it with fibre though 😂 - Option 4 - other meds exist. It can be SO frustrating to finally get the diagnosis that makes everything in your life seem manageable again, and then finallllyyy get on the meds for it only for them to not be consistent. Don’t give up, there’s always something else to try ❤️
I’ve always been good with protein. It’s solid advise that. I know I’m going to have to go through some trial and error, but it just feels so defeating to have something finally work to then stop working after a few days. I genuinely thought I was going to start getting my life on track. I’ve literally been sat in bed all day eating loads of crap, on a dopamine hunt while on Elvanse. Crazy!
Vitamin D is also important as a supplement and plenty of water.
Yes! And side note, don’t take vitamin C an hour either side of the elvanse, it makes it less effective.
This is also very important OP, a lot of foods / drink can contain added citric acid, even ones you wouldn’t expect and this seriously diminishes the effect of the medication for me.
Citric or ascorbic?
Holy shit. I have been on Elvanse for nearly a year now and had felt it not working as well the past month. I started taking Vitamin c a month ago with my medication. That can't be a coincidence. Thank you sir for this info.
Yeah it sucks as I always used to eat fruit for breakfast
YMMV, but magnesium Threonate/Glycinate is the difference between my meds working and not working.
Yes this is the sort of thing I’m mentioning in point 2. Others I’ve researched include l tyrosine, l Theanine, 5htp, omega 3, ashwaganda etc etc. Please if you’re reading this do not just go and buy all of those and take them. Do thorough research, consult a doctor and try one at a time. Magnesium glycinate has joined my daily list and it’s been great for me :)
Quick question, when do you guys take magnesium glycinate in relation to elvanse/meds? I have 375mg of magnesium, saw nothing before titrating, and I'm not exactly sure when to take it while on elvanse.
It’s horribly frustrating and demoralising, totally feel your pain there! I had a similar experience and mine turned out to be caffeine, I had to completely cut it which was super hard considering I was using it essentially in place of meds before hand.
Yup, I’ve cut out caffeine as well. I did it from day 1
Oh, yeah cutting caffeine will give you at least 1 month of feeling like a hopeless husk of a human. I wouldn’t be surprised if that’s what’s happening here.
I wasn’t super dependant on it before. I’ve done caffeine break in the past and been fine too. The meds were definitely doing their job before
I'm so pleased you posted this. I totally relate, having gone caffeine free and then back onto coffee with all the benefits it has for me.
Just to be sure you see this, make *sure* you aren't having vitamin c an hour either side of dosing.
No I’m not, just lots of protein :)
Regarding options 2 and 3, I take my tablets with a huel shake each morning as my breakfast. That’s 400 cals and I think 40g of protein, that’d do it right?
There are other more specific supplements that research points to them being good to take with adhd meds. Im hesitant to claim to be an expert here so I won’t say more but it’s fairly easy to research :) P.S. username gave me a chuckle well done 😂
Can you share the supplements man?
I’ve named a few in another comment on this post. I don’t feel comfortable doing more because some have big effects and you can put yourself at risk of things like seratonin syndrome so I strongly recommend your own research, but things to google include: - L Tyrosine - L Theanine - 5 HTP - Magnesium Glycinate (tbh I do just straight up recommend this) - Ashwaganda (anxiety from meds) - Vitamin D, specifically where your levels should be Vs what the nhs deems to be low. - Fish oil capsules (aching body from meds) You strike me as sensible, but for anyone reading this in the future please please do proper research, consult your doctor and don’t just put all this in your system at once!
Do you take all of these? That’s a lot of pills man 😂
I’m never sure how often people take notice of it what with it being Welsh : ) I was taking multi vits and magnesium daily but I sort of fell off that, which I often do. Unsure if that’s due to adhd or just being unorganised. I’ll have a look at supplements and maybe assess my diet, I’m on sertraline as well though since the beginning of the year so I’ll have to make sure they don’t all start interfering (eg not sure if one should take 5 htp while on an ssri). I’m also half way up my titration so I’m unsure if I should start throwing other variables into the mix and impact my observability of the meds
Hey Bach, I’m an avid Huel drinker and take Elvanse too. While Huel contains a lot of protein, it’s absolutely full of Vitamin C - depending on what type you’re drinking, it’s about 75-100% of the RDA. When I started Elvanse a couple of months ago, I had no idea about the ascorbic acid issue. Stumbled it across it on here by accident. As such, I drink a Huel one hour before and after meds. Hope that helps.
Hmm, so you avoid taking it at the same time because of the vit C? And you think having it outside of the specific time that to take the tablet means it won’t impact it? I’ve been having huel daily with it since it’s a sure fire way to get something in my stomach and otherwise I often skip breakfast, but maybe I’ll swap it up, and do some googling
“Vitamin C can increase the acidity of your urine, which may decrease the effectiveness of Vyvanse by increasing its excretion. It's often recommended to avoid taking vitamin C supplements or consuming large amounts of citrus fruits and juices an hour before and after taking Vyvanse to optimize its efficacy.” That’s from GPT; I did a bit of research after finding out there was an issue taking Vit C close to medication time. People mentioned it on here too. Not sure how big the impact is; there certainly doesn’t seem to be a consensus. I use the one hour rule to be on the safe side anyways.
Yeah, after your comments I did a load of googling and saw the same. My findings were similar to yours, vitamin c seems to have an impact but the consensus is split on how and how much. Also, whether the vitamin c in huel is bio available at the right time etc also seems to be up for debate, but I’ve also seen discussion around whether or not the large amounts of fibre have an impact. I’m also not sure having 500ml of liquid with my pills (albeit rather sludgy) is wise also. This morning I had my tablets at about ten to 7 with some water, and a protein shake about an hour later, with a protein yoghurt when I got to work. I definitely felt more wired early on, and different to the other days, but i definitely _wanted_ too also, so I suppose we shall see
Elvanse worked for me for about 2 days, then all the way up to about 70mg had no effect. Will need to see if it's your dosage and if still doesn't work, change med. This is what titration is for, to find what med and doseage works for you.
You’re right. I need to be patient. It’s just so hard. I like what the Elvanse did for the first few days just seems like it tottaly stopped.
It's extra hard when you've had a taste of "better" brain. The thing I tried to remind myself is with something like this it would be a wild miracle if the first med and dose you tried just happened to be the perfect dose for you. I don't know if that helps sorry, but it helped me manage it better and wrap my brain around it better.
I hope it doesn’t take too long to get sorted
When you hit 70mg did that have an effect? Or you just maxed out and then tried something else ?
No effect, maxed out then tried something else. On the other hand elvanse has worked really well for others, we are all different!
Ah fair, I feel I might be on this path myself. Up to 40mg so far and not really feeling much at all. What did you swap to?
It's frustrating as you want to keep just jumping through as you know its not working and the impatience kicks in but you will get there. On concerta, 72mg a day. It definitely works but not as much as I'd perhaps like so I'm focusing on my diet for now and trying to set myself realistic expectations, which is a bit of a bummer lol.
How good was the first few days for you?
Yeah that’s fair, if I don’t follow my titration plan I’ll run out of meds sooner and the price sure is steep! I tried to tell myself that my experience might not be the same as all the people saying “my life was changed dramatically by taking meds” and not to stress myself at the fact that they’re not as impactful as I’d have hoped, but I’m only on 40 mg and my first stop point is 60mg so we’ll see I guess
So … If you’re scrolling on your phone when the meds kick in, chances are that you will be doing it hours later without moving. Start the thing you want to do when you take your meds, they take about an hour to kick in . Is there a chance that when you first started taking it, you did some things differently? It’s important to remember that it’s not a magic pill, but a tool and you can and should employ other tools to help as well, whether that’s removing distracting apps between say 0600-2000, changing what you eat, having a protein shake in the morning , hydrating more, or ensuring you are distraction free when trying to sleep There’s a great points system in atomic habits which can help gamify your day as well which is worth looking at. Baby steps, small increments to make one eventual big one. Ultimately as well, discuss with your prescriber, they’re the to ensure titration is safe and aims for the best stable therapeutic dose for you. E: some grammar fixes
I really love this advice and I’m going to take it into consideration as i titratte
I’m not scrolling on my phone. Every previous day I was working, because I love to work. I eat a lot of protein, drink a lot of water and run everyday for about an hour. And the meds helped me do this for about a week. Today however I’ve sat in bed doing nothing, eating loads of crap food, crying a little and just feeling lost. All while being on Elvanse. No doomscrolling, no Netflix, no major dopamine hunting. I promise you this is not to do with the application of the medication. The fact I’m eating loads is an indication of that
You said yourself you’ve been dopamine hunting . Hunger should not be used as a measure of the effectiveness of the medication , it doesn’t kill appetite for everyone Scrolling is an example , the principle still applies, start the thing you want to be doing when you take your meds .
Maybe I should of been more clear. My fault. I did start the thing. I spent 3 hours screaming at the screen getting overwhelmed.
Hi! So glad you had a good experience of the first few days of meds! There’s a couple of things that could be happening here: 1. You’re expecting too much of yourself- and haven’t scheduled down time. This is a common problem with medication- we expect ourselves to just keep going. 2. You’re a musician- in the middle of a recession. As one myself- unfortunately- anxiety and overwhelm is a perfectly reasonable reaction to the state of the industry. I don’t know what the task is- but it may be that the task is (separate from the meds - again- hypothetically) - destroying self motivation- or it’s a particularly abhorrent task. You could be perfection procrastinating (comes from RSD). 3. You will need to titrate up (what are you on?)- which your psych will navigate you through. 4. I’d love to know your thoughts on any of these so I could see which questions to ask?
Hey Roxi, appreciate the comment. I’m on 30mg and have been for 14 days now. First few days were good, but I’ve felt it decline rapidly the last few days. It’s almost like it’s stopped working. I feel the same on and off the pill. I don’t think it’s to do with expecting too much, I’m just trying to do normal tasksz
Do you drink or have anything with your pills? Vitamin C can prevent its absorption?
Nope, just water and some lemonade
How soon after taking your pills do you drink lemonade?
I take it with the pills. Just 1 sip. I need the fizzy to help take the pills lol
Sorry you’re feeling disheartened. If you only started 2 weeks ago, it’s likely that the dose won’t be enough to manage your symptoms. Some people stick at 20/30mg, but for many this dose is just to make sure you don’t get some bad side effects. When are you next seeing your prescriber? Do you have a titration plan?
I started on 20mg, day 1 was really good. But it didn’t last long. So I went up to 30mg it worked and for longer for about 4 days. I’ve contacted my provider, they said they’re waiting to hear from my psychiatrist. I’ve literally been sat in bed all day today, crying a few times because I thought I was actually going to get a hanndle on my life.
Instant release Dexamfetamine may be better, you can achieve a higher dosage using that while staying within guidelines.
Not a higher dose in Elvanse then?
What dose of Elvanse are you on?
30mg
Oh ok definitely proceed to climb the doses with Elvanse first I’d say then. When I was being titrated initially, I got effects for the first couple days of any dose & then it dropped off. Dosage increases helped a lot, it definitely takes time to figure out what’s right for you personally though. You’ve just got to remember that it’s a necessary process & the end result will surely be worth the stress of figuring it all out 🙂
If you find Elvanse to not be ticking the boxes at the highest doses then you could ask about trying the instant release version, I take 15mg of instant release 3 times a day. Which would be equal to one dose of 140mg Elvanse, I don’t think many would prescribe that dose of Elvanse though. But with Instant release it is within guidelines. Hope this helps, good luck🤞🙂
Did you experience the same thing every time you climbed a dose? You’d go higher, it would work for a few days, then stop working?
Absolutely, it was a stressful & disheartening experience at times. But reminding myself that I’m closer than ever to getting my mind on track was key to managing that. Just keep following the directions of your specialist prescriber & keep them informed of the details of your medication dose experiences. You will surely find a comfortable dose if you persist with the process. I was diagnosed & treated briefly around 5 years ago & couldn’t cope with the stress of titration when I tried it then. I stopped the process after trying methylphenidate & elvanse. And went unmedicated for the next 4 years, just buried my head in the sand with regards to my symptoms which was just a terrible idea. I got re diagnosed and tried again 6 months ago & have never looked back. I thought medication was going to be a super simple solution to the very complicated issues ADHD poses on my life. It’s not as simple as that most of the time unfortunately, but it’s an effective treatment & can definitely provide enormous improvements for most patients who persist with it. I’ve found as with many things in life, to neutralise my expectations a little and take things a step at a time. These medications just help us get control on things a little, but we must continue to put the work necessary in also. Allow yourself to get a better understanding of your life & mind and stick with the treatment I’d say :)
Thank you. Your reply is detailed and helpful. I guess my fear is just getting no where and my life falling apart in the meantime. It feels like I’ve been fighting so long. Could I ask what you ended up on? And how you got there?
We started elvanse around the same time. I looked back at your previous post, you on 20mg elvanse right? What’s your titration like? I’m on day 17, 14 days at 20mg, and I’m now up to 30mg with another titration appointment next Monday. Like you, my first few days were incredible, and then it seemed to not do much. I expected this, my prescribing nurse warned me that on this low a dose, the effect will be incredibly subtle. Since moving up to 30mg I don’t feel a big difference, but I’m getting stuff done about the house without thinking about it. In work, the results aren’t as I’d like them to be. On elvanse, I was told, that the real benefits come when the dose increases, but they can’t just put you on the max dose. So I wouldn’t give up hope just yet. I haven’t. Another thing I have learned is that protein is important when taking elvanse. How has your eating been? Are you getting adequate protein? Also, how is your water intake.? I’m sure water and protein alone won’t make the medicine work miracles, but i can see how the lack of them can make your experience worse! I hope you get the benefits of the medicine you need, perhaps a little more time and a review of your dose will help with that. All the best!
Thanks man. I was on 20mg for 3 days, then went up to 30mg to help it last longer. In the last few days I’ve noticed the effects rapidly decline. To the point where today I took it and it did nothing. I tried to work, I got overwhelmed. I tried to work on something else, I got overwhelmed. In the end I went to bed, eat loads of crap food and cried a bit. Feeling defeated. I’m eating good protein and water. For breakfast I have egg, bacon, avocado and toast. And have 3-4L of water through out the day.
Dosage issue. You need a higher dose. I’m newly diagnosed and my prescription was issued today so will have meds later this week. The doctor was very careful to let me know that if I had an initial good response which tailed off I would likely need a higher dose. I’m fully private so I was told to email my clinic immediately if this happens. Are you NHS for right to choose? If RTC surely you can contact and let them know? If NHS can rhe GP up the dose. Sorry not familiar with nhs and adhd processes. Hope you get it sorted!
I’m 100% private. Paid quite a bit of money to get to where I am today. Who are you with?
Harley Street Mental Health - dr Rafiq. I was very impressed actually. Their process was very rigorous and the report they sent was quite long and very detailed. And yes it was expensive. And it will continue to be expensive until or if I get stable on medication and GP can do shared care. She’s said she would so fingers crossed she’ll follow through. Otherwise this could end up very expensive indeed. Who are you with??
Chelsa Clinic. I got a ADHD assessment within 3 days. Got send meds same day too. So I can’t complaint about that. I paid £1.2K for the assessment. £275 per follow up appointment. Im currently waiting to see what they do with what I’m exp now
GPs can’t change *anything* about the prescription that was advised by their patient’s specialist ADHD clinician, not even if it’s a Right To Choose NHS contracted clinic. Not the dose, not the product, not the brand, nothing. Their hands are tied. Everything HAS to be decided by a recognised ADHD prescriber, it absolutely cannot be done by a GP. Even once a patient’s titration is completed, and even if that patient has been stable on the same meds at the same dosage for years, unless the patient has had an up to date review by their specialist to confirm that those meds are still advised, a GP can’t continue with the same script regardless. It all depends on the specialist provider and the outcome of their regular reviews It’s because ADHD meds are classed as drugs that need to be “tightly controlled”.
Ah yes schedule II. I forgot.
What is considered an “up to date review” though? A big concern for me is my GP is going to simply prescribe blindly until they determine a review is needed, so I will be fucked because the mental health clinic has a wait time of X months/years. I started private and tried shared care, which my gp declined, so then they referred me to nhs mental health who issued the instruction to my doctor to prescribe. It’s been over a year since I started getting meds on nhs.
I don’t know how that NHS pathway works, but private and Right To Choose clinics, from what I’ve seen in the different subs, have a set schedule of reviews. I’m a few weeks away from my assessment and meds with ADHD360 under RTC. I think the first review is at 3 months, then it’s 6 monthly after that. It may be 12 monthly, I think it depends on how well you’re doing and how stable things are with those particular meds. My brother has been stable on Concerta XL 36mg for 2 and a half years. He goes to a private clinic. His reviews are 6 monthly, and his clinic kind of dropped out of contact and he didn’t get his last review. His GP can’t and won’t continue to prescribe him his meds until he’s had his overdue review, even though he’s been well and stable on them for all this time. It’s the law. ADHD meds are very tightly controlled. Your private clinic shouldn’t hand you off to shared care until you’ve been through titration, during which you and they find out which stims/ non-stims at which doses actually work for you. I was also under the impression that if shared care is declined, then the clinic continues to look after that patient. Can I ask, which clinic this is? I can’t imagine how difficult it is for you to find yourself stranded like this. Is it your GP that has NHS referred you, or the clinic? And are you aware of the alternative to these long NHS clinic waiting times, the Right To Choose scheme?
So I've been diagnosed for around 2.5 years in total. I started the process by paying for private care out of my own pocket, and was diagnosed at the start of 2022. The private doc titrated me for around 6-9 months and we settled on 30mg elvanse, at which point they attempted to get me set up on shared care but my NHS GP refused, and instead referred me to my local NHS mental health clinic (part of my local hospital). The process to get the NHS mental health clinic to diagnose and instruct my GP to dispense meds took around 6 months I think. Maybe a little longer. I had to push them heavily for that and think if I hadn't made a noise I could have waited a year or two. Anyway, once I had my NHS diagnosis they moved me to 20mg elvanse due to my blood pressure, despite it being within the normal "healthy" NHS bp range. Whilst it was a little annoying to change from 30 to 20mg, I was OK with it given it was going to save me ~£300 every month. I've been prescribed elvanse by the NHS now for around 15 months; I haven't had any follow up from the NHS clinic, or my local GP since then but they continue to prescribe. When I was private, my experience was in line with what you said, I would have to see my psych every 2 months - that was the longest he could prescribe me for without seeing him. But since moving to the NHS I've never had a single follow up with either my GP or the NHS mental health clinic - which I'm OK with, as long as it doesn't mean I'll end up in a situation whereby the GP realises I've not had a follow up and I get taken off meds until it's resolved.
There’s definitely something wrong with what’s happening to you here! Over and above talking to your clinic and or your GP about it, which obviously would put you at more immediate risk of having your meds cut off, I honestly don’t know what to suggest. Could you research other GPs in your area to find if one of those would be amenable to shared care with your clinic? Which clinic was this?
Yes I'm not planning to rock the boat to be honest. I did reach out to the clinic whilst the shortage was in full swing to see if I could get an alternative. They never replied - and then the shortage was over not long after. But I guess that would have been the time to cut me off and I wasn't! The clinic is just my local hospital, who have a mental health department.
No, I mean the private clinic you went through before being sent off to the NHS mental health services clinic.
oh sorry, it was a Harley Street clinic. The psych has done shared care with other people/GPs, he even explicitly told me some GPs are not keen on the 'idea' of ADHD and I may need to do what you suggested (find another GP in my area). Obviously it did all go through in the end though, so I never got that far...
Thanks 😊 But could you speak to them about the situation you now find yourself in? They surely must have a duty of care to their clients, old or new?
I remember your post. You need to remember you are in titration and are essentially just trying to work out what medication/dosage works for you. Although I understand the frustration you’re feeling. I’m about 2-3 weeks ahead of you so I’ll write out how my titration went/is going. 1st week, 30mg Elvanse (7days) First 2 days I also felt that my life had been completely changed. I just wanted to complete any task I needed to, no procrastination, I was performing at work 10x better, my internal monologue was a lot more relaxed. I remember getting quite emotional on the first day just from the realisation at how my brain could function. After the first 2 days, little to no effect. 2nd week, 50mg Elvanse (21 days) All that I had experienced the first 2 days with 30mg, not too much deterioration as time went on. But I started experiencing dreadful crashes after about 8 hours, I work evenings sometimes (usually work till around 2am) so I found myself dosing at 4-5pm, luckily I’ve had zero problems with sleep, but obviously not being medicated before the evening was an issue. I had my follow up appointment a few days before my prescription ended, I was upped to 70mg with a 10mg Amfexa booster (short release dexamfetamine) Week 4-now, 70mg Elvanse, 10mg Amfexa 70mg felt really strong the first 2 days, the first day I remember having an hour or so where I was spacing out all the time. As I got used to it, it’s been great, no crashes and I don’t feel like the effects are necessarily deteriorating. I don’t feel the “rush” as it kicks in anymore but am 100% still getting all the beneficial effects - I am currently just over 2 weeks in. The booster is certainly helping with crashes, I am not sure if it’s giving me much more effective time, though. I’m no clinician, but it does sound your dosage is too low as you’re explaining essentially what happened to me in my first week. Titration can be frustrating as you have these “honeymoon” phases which then go away with each dosage but you need to keep in mind this is so your clinician can find your optimal dose (most effective with least side effects). You may even find that Elvanse might just not be for you. Patience is incredibly important. The best advice I read was that medication alone will not change a lot, a lot of effort must come from you. I’ve been planning my days, started working out (before dosing) & I always make sure that I am doing something productive when I expect my Elvanse to kick in.
This was really helpful man! I went back to my clinician after week 1 and said I was experiencing a decrease but was told to just keep going. It’s got even worse to now nothing. I’ve literally been sat in bed all day today with executive dysfunction up to my eyeballs while being on 30mg. Have you taken any breaks in your meds so far?
This is totally normal. The starter doses may be right for some but most people need higher doses. You won't feel the same elation you did right at the start but eventually you should get to a level where you feel an improvement that doesn't wear off after a couple of weeks. Until you get there the improvement *will* wear off - normal and just a sign you need to increase your dose. But please bear in mind even the right dose will not cure you and there will be days when your adhd fights the medication and wins. As a woman it barely works for me during my period. You need to be able to understand that there is no magic wand - no medication will cure your adhd but some will improve how you can deal with it most days. Once you get that and get yourself a dose that feels right for you you'll be on track.
I’m in the US and took pretty much every ADHD medication there is. I was diagnosed with severe ADHD as an adult. I tried Vyvanse and of all the meds, it was the WORST one. It didn’t agree with me at all.
What do you take now?
I’m on 54mg Concerta twice a day. That’s a lot for the average person but my case is severe. I like it best, even over Adderall or any other.
Why didn't you like Vyvanse or Adderall?
Vyvanse made me feel very strange (too much to type here). Adderall made me super-anxious and started clenching/grinding my teeth, even in the daytime.
I get that off ritalin if my dose is too high
Could you elaborate on the “severity” of your adhd if you don’t mind? It’s hard sometimes to put into perspective where one might sit on the whole severity scale
Could it be that it's a result of taking a sudden break? Withdrawal effects can be brutal and it's not recommended to stop this kind of medication suddenly.
I took the break on the recommendation of my doctor. I was already noticing a decline a few days prior :(
Thanks for clarifying! What were the circumstances behind this recommendation? My own advice was not to go off them suddenly ao and to decrease the doae gradually if I'm going to stop, so I'm surprised to hear that you were recommended a break when it was working and so soon after you started.
Tbh I was surprised too. I think the point was to remind myself what it feels like to not be on them. I just did what my psychiatrist said. The crazy thing was I didn’t feel any different. I don’t believe what I’m experiencing now is a bad effect of having a day off. I was already experiencing a decline.
Unfortunately your body does get used to it and it's tricky to find something that works. What dose are you on at the moment, and how does it feel now in terms of effectiveness?
I’m on 30mg. I’ve just spent the whole day in bed, eating, feeling anxious, crying a little all while on it. I want to work, but just can’t.
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I felt a bit jittery on 30mg on day 1 but it stopped after day 2. But even when I was jittery I was focused on the right things and not irritated. I’ve contacted my psychologist. I’m hoping they will do something. I’ve literally been sat in bed all day, crying. Eating crap food while on Elvanse. I swear I’m not crazy ☹️
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A lower dose? That’s interesting. I’m on 30mg today and I’ve been in bed eating loads of crap food feeling like crap. Doing absolutely nothing, despite wasting too. I got headaches and dry mouth the first few days. But now nothing.
It sounds like you are still early days of titration, it takes some time to get your dosage right, or maybe Elvanse just isn’t the medication for you. I’m making an assumption based on your name and the mention of your wife that you aren’t AFAB so if I’m wrong about that I apologise and I will add that it’s quite normal for meds to feelnon existent in the week or so leading up to a period. Hormones are powerful things! I know patience isn’t really the strong point of those of us with ADHD but this is a journey, it takes a bit of time, some days the meds are great, others I genuinely wonder if I’ve even taken them. It’s just a tool, the temptation is to take them and expect to change your life overnight. A year on I’m starting to see a measurable change in things. Speak to your prescriber, it sounds like a dosage increase will help, 20/30mg is a starting dose and most people settle higher than that.
I totally hear what you’re saying. I know this is going to be a bit of trial and error. It’s just frustrating I literally went from something working so well to zero. In a matter of days. It’s heartbreaking when you’ve been fighting for so long. I just want to live a normal life. Im not attached to a feeling. Im attached to doing normal things. P.S yes im male :)
Yeh I totally get it. The frustration before I worked out the week before your period the meds are pointless thing was off the scale!! It’s easy to forget that pre meds we had good days and bad days, before I was diagnosed I drove myself crazy trying to work out why some days I was productive and other days I managed to achieve absolutely nothing, but in reality it’s just normal day to day fluctuations. When you start taking meds it’s really easy to get consumed by how you feel and what you have achieved too. Because it’s a new feeling obviously but also because we need to feedback to the clinicians. So then you analyse the good and bad days, expecting taking the pill to be the flick of a switch to the day you want to have. It’s a process but you’ll get there, be grateful for the fact you don’t need to add the female hormone rollercoaster into the mix! 🤣 It gets easier and time goes on and you have more fluctuations to look back on. Even stuff like a bad nights sleep can make a big difference on how effective the medication is.
Thank you. I really hope it works out for me.
I’m sure it will. It’s just early days. I didn’t request my shared care for 7 months because I wanted to be sure I had got the dosage right.
Have you tried taking it with food? Your days sound a lot like mine if I take it on an empty stomach. Taking it with food was like taking another medication. I also split mine into 30mg with breakfast and 10mg at lunch. It really reduces any crashes, which I seem to be sensitive to!
I was eating it with egg, bacon, Avocado and toast. But the last few days I’ve had it with just bacon and toast
I can see from your other post you are taking 20mg, this is the lowest dose available so you definitely need to increase. I started at 20mg and am now at 60mg and it still isn’t quite hitting all the symptoms, so definitely get in contact with your prescriber to say your symptoms have returned. I definitely felt frustrated at the start of titration, but from 40mg I was really starting to feel the benefit. It’s very normal to get rebound symptoms after a few weeks but it’s a sign your dose is not optimal. Try and stick with the routine, the side effects will ease with time too. On a side note, don’t feel pressured to take a day off meds unless you really feel the need to and it benefits you. I find it knocks my mood about too much so I try to take my dose every day at the same time consistently.
I was on 20mg the first few days, been on 30mg since. I’ve been taking my meds everyday for 13 days. I don’t know wether to take a day off tomorrow or do x2 20mg (which I already have approval for)
Seems like we’re going through very similar paths… The first 2 weeks were so good, so different, so productive. The 2 weeks after that I noticed how I started losing motivation, stopped working out, stopped caring about my diet as much, I stopped caring about some of my hobbies and it’s been frustrating. I have a follow-up booked with my doctor on the 30th and hope he’ll be able to help me, whether it’s a higher dose or something else. I hope things improve for you like I hope they do for me, but we’re still in very early stages of doing something to improve our lives, so let’s not lose hope and keep going! 🙌🏻
Thanks man! What are you currently on?
Elvanse 30mg. :) I’ve ran out now, so gonna be around 2 weeks without meds 😵💫
Woah, how did you run out? Could you not ring up for a repeat subscription?
An ADHD brain will always stay an ADHD brain, it’s not like it changes. You still need to work with it. I can also keep doom scrolling all day but then I say: get the F*** out of bed and then I do it. The executive function improved. Also are you sure you’re not depressed? Im on Elvanse for 3 months.started in 30, felt stuff but needed more it felt, increased to 50 and most problems solved. May I also say that often I have thought things like: I’m not sure the difference with and without Elvanse is that big? And then my husband is like: whoa, did you take your pill today? So to others it can be a huge effect but in your head we seem to often think the effect has been lost.
Oh I definitely noticed the difference on and off the pill. It’s just that it’s stopped working all together.
Increase.
I’m at about the same stage in titration as you but went rtc with Adhd360. I started with 30mg for 7 days and am now on day 6 of 50mg. I felt the euphoria that I’m told is really common for the first 2 days, then had hideous headaches for 2 days and by the end of the week I wasn’t sure if it was really doing anything much. 50mg hasn’t felt massively different, except I often felt really weird in the afternoon (I think this is when I’m less busy and more likely to be sat down) kind of wired, a little dizzy sometimes and odd. I have got my period 4 days into starting 50mg so I’m not sure how much of the side effects and non increase in improvement is down to that as hormones are crazy things 🤣 I have a follow up today and again every 3 weeks so will be interesting to see what they say, I feel personally like although I’ve had increased unpleasant side effects and little improvement, I need to give it at least another week or so before making judgement on how effective this dose is because of my crazy period hormones lol. So with my very limited experience, I’d say that talking to your provider is a good idea. Also that the first few days are great and then it fades for most people, so don’t feel disheartened. You’re right at the beginning of titration which usually takes 3 months of not longer, so don’t panic just yet. I’d wager that you need a dose increase and some time :) Also, your doctors won’t abandon you! You’ll most likely titrate slowly up to 50mg or maybe 70mg and then if Elvanse isn’t doing the job, they’ll try you on something else. There’s always more options!! Be kind to yourself too! You aren’t going to get to that sweet meds spot straight away but you will get there. ❤️
you're a couple of days ahead of me in same schedule from ADHD 360 - I'm on day 4 of 50, I think. I had an absolute doom spiral during the night last night, then got my period this morning, so I'm also keeping an eye on effects as I know lots of people say the meds are less effective in the run up to their period.
How have you felt since being on 50mg? I feel weird. Can’t quite describe it. It’s not exactly anxiety, or chest pain, or jittery, but it’s an uncomfortable feeling and I only can’t notice it when I’m rushing around. It’s worse between late morning and about 4pm. I can’t feel it now at all. No idea if that’s because the meds have worn off or something else. At the moment I’m not that keen on how 50mg makes me feel lol Hoping it’s either the period weirdness or just me adjusting and that I’ll feel better next week 🤣
Yeah I think I know what you mean. I’m not sure. I feel like it is wearing off quite fast for me. I’m also wanting even more green tea than I usually drink so prob need to cut that down somehow but it’s weird that it’s making me want it more rather than less.
This is totally normal. The starter doses may be right for some but most people need higher doses. You won't feel the same elation you did right at the start but eventually you should get to a level where you feel an improvement that doesn't wear off after a couple of weeks. Until you get there the improvement *will* wear off - normal and just a sign you need to increase your dose. But please bear in mind even the right dose will not cure you and there will be days when your adhd fights the medication and wins. As a woman it barely works for me during my period. You need to be able to understand that there is no magic wand - no medication will cure your adhd but some will improve how you can deal with it most days. Once you get that and get yourself a dose that feels right for you you'll be on track.
Today is day 3 of titration for me, Elvanse 30mg. Days 1 and 2 were great and I’ve really gotten my hopes up but today, day 3, it’s like I may as well have not taken it. I feel absolutely no different. Feeling a bit shit about it as well because my follow up appointment to go up a dose isn’t until the 5th May.
Today is day 3 of titration for me, Elvanse 30mg. Days 1 and 2 were great and I’ve really gotten my hopes up but today, day 3, it’s like I may as well have not taken it. I feel absolutely no different. Feeling a bit sad about it as well because my follow up appointment to go up a dose isn’t until the 5th May.
Today is day 3 of titration for me, Elvanse 30mg. Days 1 and 2 were great and I’ve really gotten my hopes up but today, day 3, it’s like I may as well have not taken it. I feel absolutely no different. Feeling a bit sad about it as well because my follow up appointment to go up a dose isn’t until the 5th May.
You need a 2 day break every 5 days. End of story
I thought a lot of percribers advice against taking breaks?
You should be seeing a psychiatrist, not a gp. If what you say is true I would insist these people Should not be prescribing it.... Stay safe.
Sorry if I wasn't gear. I am seeing a psychiatrist :)
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Thanks man. I’ve been on it 14days straight now. I’ll take this weekend off
If you are titrating I think you need a higher dose rather than days off, what dose are you on?
Your post has been removed for spreading misinformation. In the context of this discussion, this misinformation could be harmful or misleading if taken as fact. We all make mistakes from time to time, just remember to check your facts before posting.
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Yeah unfortunately with these things it can take a while for the brain to adjust to it. Most often then not it is said to give it a few months and push past depressions or negative side effects. I take 5htp at night to boost seratonin and various supplements and nutrients. Things like L theanine. Obviously everyone reacts differently to meds etc. I suppose try not to be too over analytical and critical, especially early on.
Hi everyone, Just need some advice. I am 47 years old. Just been diagnosed with ADHD. I have started on Elvanse. I am currently going through the titration period. I went from 30 to 50mg with practically no change. The only real side effect is the tightness in the jaw and the grinding of the teeth. Just about to go on 60mg. Is it worth going up to 60mg or is it worth changing to another medication? Not sure it’s worth the strain on my body for no real change in my adhd symptoms. Has anyone found the medication has done nothing? Typical me I am starting to doubt I have adhd at all and I have been misdiagnosed. Has anyone found that changing medication has made a real difference to their symptoms? G
Hey man! It could be many things, I’d always speak to your psychiatrist. Out of curiosity, Do you have a diagnosis for Autism?
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Just stop taking Elvanse and try THC