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MuddlingThru

Switch to Adderall XR from Vyvanse?

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Short story - MDD d/x'd 3 years ago with EDNOS (eating disorder not otherwise specified - i.e. I restrict, but I'm not thin, I used to purge, but not too much). I also self-harm and have situational anxiety and chronic insomnia. Current meds: 50 mg Pristiq, 450 mg Wellbutrin XR, 2 mg Klonopin (1 at 5:30p, 1 at 8:30p, occasionally 1 as needed), and 10mg Ambien. I've been on the klonopin/ambien combo for a long time and it works pretty well for my sleep. I've been through most of the SSRIs with limited success or horrible side effects, only to find out via a recent GeneSight test that I don't have the whatever/enzymes to process SSRIs (and SNRIs) correctly. Only Pristiq and Fetzima are in the "green column" for me.  Meds I've tried - Celexa (worked for a while and then nada), Lexapro (similar), Zoloft (horrible reactions), Paxil (little effect), Brintellix (not enough and bad side effects), Wellbutrin solo (worked for awhile, but then became not enough), Abilify (gained 20 lbs in one month with little effect), Risperadol (no impact), and I'm sure other combos I can't think of. 

We went up to 100mg of Pristiq but I felt like I was in a fugue and would lose all sense of time, so we backed it down. I'd like to go up to 600 on my Wellbutrin as it works well for me but my pdoc won't even though I've been purge-free for 13 months. My eating disorder is ok - my weight is stabilized and I'm not restricting or binging. I'm in therapy regularly and see my nutritionist every other week. But I am exhausted all of the time. It is difficult for me to get out of bed, it's impossible for me to do anything. I have no memory, and it is a struggle for me to think, let alone work (I'm a professor). With the Vyvanse, I'm sometimes able to get out of bed. I can feel my brain "knit" together and kick on, and even have started writing again. I still can't bring myself to get things done or to exercise or even get outside unless I must. 

The problem with the Vyvanse is that it wears off pretty quickly for me. If I take a dose at 6:30a, by 11:30p I'm scattered, can't think straight, and feel lost. I take a second dose at noon but it barely holds me to 4. Then my brain is gone. I am still exhausted, and then I can't really think at all in the late afternoon/evening. I'm completely distracted.

I have a call with my pdoc this week and I'm considering asking her to switch the vyvanse to adderall because it has an XR, and the up and down with vyvanse is shitty. I'm really reluctant to switch from the Pristiq since the worst of my depressive symptoms (hopelessness, sadness, flatness, isolation) are better. I like that the vyvanse cuts the cravings so I don't turn to sugar to try to help with the lack of energy because that worsens my ED. I can't take anything that will cause weight gain, or anything that increases appetite. I'm on a meal plan, I'm not losing weight, but I can't take aggravating my ED on top of the shit I'm dealing with.

Does Adderall XL last longer for depression-related ADD symptoms? Does it cause jitters or increased hunger? Anyone use it as an add-on to antidepressants? 

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I take Vyvanse for ADHD not depression symptoms, so my experiences may vary with what you will experience.

On 7/13/2016 at 4:04 PM, MuddlingThru said:

Does Adderall XL last longer for depression-related ADD symptoms? Does it cause jitters or increased hunger? Anyone use it as an add-on to antidepressants? 

I don't know how Adderall or Vyvanse act on the brain for people taking it for depression or how it differs from people with ADHD.

Chemically Adderall is a mix of D-Amphetamine and L-Amphetamine while Vyvanse is pure D-Amphetamines. Adderall being mixed salts with L-Amphetamines is what makes it act differently than Vyvanse. The bad part about Adderall XR in my experience is that it does cause jitters and can effect my anxiety, but the good part is that I could feel the kick soon after I took it.

IME Vyvanse works longer but steadies out throughout the day and Adderall XR works for 4 hours or so and I feel a crash. Both decrease my appetite. I've never used it as a anti-depressant add on.

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Thanks - my pdoc is considering evekeo as a "short-acting stimulant a few times/day." She didn't listen, I guess. I want to take one dose in the a.m. as the afternoon dose gets squirrely. Either I take it too late and I crash in between, I take it too early and I crash too early, or if it's a little late it bleeds into my evening anxiety.

Anyone try evekeo?

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