Ugh. What a difference a few days makes. A few hours, actually, since things kind of fell apart on Sunday night, less than 12 hours after the last post.
I'd noticed a bit of irritability in the evenings on the Spansules during the week. I didn't take it too seriously, as short-term side effects are not unusual after changing doses or medications. I'd also noticed, with a little more alarm, some difficulty maintaining an erection around the same time. Again, I was willing to wait it out and see if there was really a long-term pattern.
Well, those things came together to make one big unacceptable problem on Sunday. Suffice it to say that my grumpy, anxious self made a nice wreck out of the end of the day. I had a horrible night, and I spent the morning lying in bed contemplating my own worthlessness until I couldn't delay getting up any longer.
Luckily, I did manage to get up and take my dose. An hour later, back in my right mind, I called my doctor and said I had to back off to 30mg of Vyvanse. That's the last problem-free dose I was on, and I have to get back to problem-free before I can seriously consider another experiment. I accept that this is a fundamentally experimental process, I really do. I just refuse to jump from problem to problem. I have to make sure I have a stable baseline of experience to compare with.
My doctor suggested that amphetamine may just not be my drug (his turn of phrase), and that we should consider trying methylphenidate (Ritalin) or atomoxetine (Strattera). I'm not ruling that out, but I don't think I should jump there from a crisis if I can avoid it.
In any case, it is clear that Spansules were definitely not my thing. Not only did I have negative side-effects, I didn't feel like I was getting the level of positive effects that I experienced on 30mg or 40mg of Vyvanse. This is surprising, since 20mg of Spansules is pharmacologically equivalent to 50mg of Vyvanse. I guess more amphetamine is not what I need.
So, back to 30mg Vyvanse for me. In addition to the 30mg of Vyvanse, though, I also have a bunch of 5mg dexamphetamine sulphate tablets. My deal with my doctor is that I'm going to try splitting those into 2.5mg halves and spreading 2 and then maybe 3 of them over my work day. My hope is that the smooth base of medication from the Vyvanse will prevent an evening "crash" without causing insomnia, and the tablets will let me play around with a bit of a higher dose during the day.
The best I've felt this whole time was when I was on 40mg of Vyvanse with a 5mg dexadrine tab at noon, but even on 40mg I remember feeling like I was sleeping a little too lightly and wasn't tired enough in the mornings. I think it is worth trying 30mg of Vyvanse as the base and seeing if I can't get back to the same level of positive effects by augmenting with the 5mg tabs.
I have to keep remembering that my goal is to get just enough help to be happy. I can't shoot for feeling awesomely focused all the time, or I'm likely to end up chasing that goal into riskier meds and doses than I'm really comfortable with. I'm getting a sense now, though, for how this process can take you in that direction. It is so tempting to just try a little more medication. Then when you get the negative symptoms, you get the offer to fix it with another medication, or a different medication. Going back to less seems like a step backwards, a concession, a defeat.
Well, I don't see it that way. Going back to a known good state is the only way to recover the stability necessary to make a good decision on your next steps. Maybe I'm just lucky that my unmedicated state was already not too shabby. If I was coming to meds with my life falling apart, I can see how it would be a much harder decision to back off in that direction again.
Showing posts with label spansules. Show all posts
Showing posts with label spansules. Show all posts
Wednesday, December 8, 2010
Sunday, December 5, 2010
20mg Dexedrine Spansules...
Wow, the last couple of weeks have been a blur. 50mg Vyvanse worked fine without the 5mg Dexedrine, except for one thing: I couldn't sleep through the night. I could get to sleep well enough, but I would wake up several times during the night. Each time it would take a long time to get back to sleep.
Most telling of all, for me, was that I couldn't even manage to get a half-hour of sleep at the end of the night, around the time I usually get up. This is also the time I usually take my dose. I was too alert to sleep even 24 hours after taking the Vyvanse, even after barely sleeping that night. It was clear to me then that the Vyvanse must be sticking around in my system for way too long. In retrospect, this fit with my experience on Vyvanse from the very beginning. When I started on 30mg, exactly the same thing happened. I'd sleep for maybe 4 hours, and then pop out of bed effortlessly.
My doctor doesn't have any particular explanation for this. It is possible he thinks I'm just imagining the whole thing. I couldn't find much information on why it might be happening, other than some stuff about acidic diets speeding up the metabolism/elimination process, and basic or acid-neutralizing diets doing the opposite. My diet happens to not include many acidic items, so maybe that is it.
I got fed up with not sleeping on a Friday when I would not have an opportunity to talk to my doctor, so I just dropped down to a left-over 40mg Vyvanse for that day, and then went to 30mg for the weekend. No problems sleeping at all on the 30mg. Felt a little blurry around the edges dropping down to 30 that quickly, but nothing serious.
On Monday my doctor recommended trying Dexedrine Spansules as they are not supposed to last as long as Vyvanse. The mechanism for releasing the drug over time is also less complicated than Vyvanse, so it is less likely that something odd about my metabolism would cause it to last longer than usual. So far this has worked out well. I am not having difficulty sleeping, and I wake up in the morning feeling more like my usual non-medicated self; that is, I don't want to get out of bed.
I think I've been on the meds long enough to say that they are having a positive effect for sure. I think that the Spansules are not quite as potent as the Vyvanse was yet, so I may have to go up to 30mg. We'll see. My experience on Vyvanse indicates that I may have been receiving a higher, longer dose of medicine than most people would on the same intake, so it may take a larger-than-expected dose of Spansules to produce an equivalent positive effect.
Most telling of all, for me, was that I couldn't even manage to get a half-hour of sleep at the end of the night, around the time I usually get up. This is also the time I usually take my dose. I was too alert to sleep even 24 hours after taking the Vyvanse, even after barely sleeping that night. It was clear to me then that the Vyvanse must be sticking around in my system for way too long. In retrospect, this fit with my experience on Vyvanse from the very beginning. When I started on 30mg, exactly the same thing happened. I'd sleep for maybe 4 hours, and then pop out of bed effortlessly.
My doctor doesn't have any particular explanation for this. It is possible he thinks I'm just imagining the whole thing. I couldn't find much information on why it might be happening, other than some stuff about acidic diets speeding up the metabolism/elimination process, and basic or acid-neutralizing diets doing the opposite. My diet happens to not include many acidic items, so maybe that is it.
I got fed up with not sleeping on a Friday when I would not have an opportunity to talk to my doctor, so I just dropped down to a left-over 40mg Vyvanse for that day, and then went to 30mg for the weekend. No problems sleeping at all on the 30mg. Felt a little blurry around the edges dropping down to 30 that quickly, but nothing serious.
On Monday my doctor recommended trying Dexedrine Spansules as they are not supposed to last as long as Vyvanse. The mechanism for releasing the drug over time is also less complicated than Vyvanse, so it is less likely that something odd about my metabolism would cause it to last longer than usual. So far this has worked out well. I am not having difficulty sleeping, and I wake up in the morning feeling more like my usual non-medicated self; that is, I don't want to get out of bed.
I think I've been on the meds long enough to say that they are having a positive effect for sure. I think that the Spansules are not quite as potent as the Vyvanse was yet, so I may have to go up to 30mg. We'll see. My experience on Vyvanse indicates that I may have been receiving a higher, longer dose of medicine than most people would on the same intake, so it may take a larger-than-expected dose of Spansules to produce an equivalent positive effect.
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