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Old 08-20-18, 09:20 PM
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Doc Says Tolerance Stops at Correct Dose

Hi all,

First post here, and I have a lot of questions. However, I won't shoot them out all at once - just one at a time. Was diagnosed with ADHD by the VA about a year ago when I retired from the military.

However, I didn't think much of it until I read up on it recently and realized how destructive it can be...and it has been for as long as I can remember, i.e., bonding issues, negativity, anger and irritability, horrible memory, disorganized, LOW ENERGY, poor self discipline, sleep problems, marital problems, impulsiveness, and the list goes on to include things like depression and anxiety.

Went to a psychiatrist a little over a month ago and she prescribed 20MG Vyvanse. Saw her again last week and she upped the dose to 30MG. I asked her how many times the dose would need to be increased and she explained that we would eventually find a dose where tolerance would no longer set in. But, I'm skeptical.

Curious as to some of your experiences regarding the subject.
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Old 08-21-18, 01:35 AM
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Re: Doc Says Tolerance Stops at Correct Dose

Doses really re awfully variable so the idea of increasing the dose until it either works well or causes to many side effects is perfectly rational.
These medications dont last long in our system- so if thing go badly- you stop them and restart them under your doctors supervision.
Have a good read of the medication insert so you know what to ecxpect.
Poor sleep, anxiety or tooth grinding are common side effects, as is a worsening bad temper.
If you are in doubt ask those around you.Sometimes it is hard to see what we look like from the inside.

Stimulants usually work very well for about 70%of us. Your doctor sounds very sensible.
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Old 08-21-18, 01:43 AM
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Re: Doc Says Tolerance Stops at Correct Dose

Once you and your doctor figure out the optimal dose, the chance of you developing tolerance to that dose is relatively low. It's certainly possible, but not something that you need to be overly worried about right now.
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Old 08-21-18, 04:42 AM
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Re: Doc Says Tolerance Stops at Correct Dose

I have been on amphetamines for about 14 years with a total of only 3 dose increases. I have been stable on the current dose for 4 years.
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Old 08-21-18, 11:35 PM
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Re: Doc Says Tolerance Stops at Correct Dose

Thanks for the info guys. It's good to know that I have a low chance of developing tolerance when we zero in on the correct dose. So far, 30MG is pretty intense. Often need to take very deep breaths and exhale slowly.

I've already experienced the afternoon crash and its associated anxiety, irritability and anger. I've also very recently tapered off of and discontinued Celexa and Wellbutrin after taking them for 12 years. So that is likely contributing as well.

I'm a single father of four boys ranging 9 to 4 years of age and on Sunday afternoon they were irritating the hell out of me. I was very short with them and shouted at them, which I don't like to do.

Yesterday and today I skipped my morning .5MG klonopin and combined it with my afternoon .5MG klonopin, and it did the trick. My anxiety and irritability were very low. However, I'll likely have to talk to my doctor about upping my klonopin dosage to 1.5MG per day so I can take .5MG in the morning and 1MG at 5PM.


Again, thanks for the information.
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Old 08-22-18, 06:49 AM
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Re: Doc Says Tolerance Stops at Correct Dose

If you're having an afternoon "crash" you and your doc might want to consider adding an afternoon booster dose of IR Adderall/Dexedrine.
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Old 08-22-18, 09:11 AM
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Re: Doc Says Tolerance Stops at Correct Dose

Yes it is true, otherwise stimulants wouldnt be life long treatment options. Unlike other controlled substances(benzos) , they stop building tolerance at a point , you don’t need detox process in order to make it work again.

I have been lied by a mentality which says that i only need my medication during studying, reading book etc.

Sarahsweets repeated many times here at different threads ADHD is 7/24 problem, we must be living highest life quality everyday and ADHD medicatiobs are designed for it
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Old 08-22-18, 01:08 PM
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Re: Doc Says Tolerance Stops at Correct Dose

Thank you for the responses. I'll speak to the doctor about it. Just concerned how a booster later in the day might affect bedtime and falling asleep.


Oddly enough, I was sleeping horribly prior to starting the Vyvanse...taking three hours to drift off, then waking at 4AM. But, after starting the Vyvanse I fall asleep within fifteen minutes and wake to the alarm clock.
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Old 08-31-18, 11:10 AM
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Re: Doc Says Tolerance Stops at Correct Dose

Does anyone have experience with Vyvanse just crapping out completely, and have you had success with any other medications as a replacement?

Currently upped Vyvanse from 30 mg to 40 mg and the jury is still out as to how it is helping. It worked fantastically for about 6+ years. I finally allowed myself some caffeine today (against doctor's wishes) this morning and feel much more energized and actually less anxious/angry.
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Old 09-02-18, 06:57 AM
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Re: Doc Says Tolerance Stops at Correct Dose

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Originally Posted by DanielGoldberg View Post
Does anyone have experience with Vyvanse just crapping out completely, and have you had success with any other medications as a replacement?

Currently upped Vyvanse from 30 mg to 40 mg and the jury is still out as to how it is helping. It worked fantastically for about 6+ years. I finally allowed myself some caffeine today (against doctor's wishes) this morning and feel much more energized and actually less anxious/angry.
Yes, eventually due to aging, metabolic changes, exterior events (like a stressful job or a divorce) and the like, medications can and do stop giving the same effects. I was never an asthmatic until age 36. I had started Vyvanse at age 33, it was fantastic from day one, once I began eating clean, exercising daily, and taking care of my life better all around. (I do find Vyvanse has always been a persnickety drug, not very consistent if you let any little thing slide- unlike how Adderall was to me.)

Since developing severe asthma (totally unrelated to Vyvanse, which has done nothing but help my life), I no longer receive the same beneficial effects. Although I'm a lifelong nonsmoker, nearly dying from asthma that had morphed into COPD Stage 3 levels made changes to my cognition and focus that no amount of stimulant medication seems to be able to touch now. My life circumstances have also taken a complete 180 in so many ways from five years ago (at age 33), that it's possible Vyvanse works less potently for me because my lifestyle and mindset changed so much since then. I am in the same boat that you are right now, regardless. Vyvanse isn't the first medication that has just simply stopped working as it once did for me.

Thyroid, brain and hormonal culprits can also be to blame sometimes. I think that this can be more pronounced in women more than men due to hormones and such, but it happens to many ADDers at some point. The brain and body can be far too complex to figure out why. If you feel low in energy, have trouble shaking off minor illnesses, feel tired all of the time, are burned out physically, it's worth having a doctor do blood work and such to determine any physical cause that might be adding to the problem.

Double-check and make sure that the same basic habits you had before (when Vyvanse was successful) - such as quality of food, hydration, exercise, and so on - are in place. If you've let some area of your life slide and have any unhealthy habits, it will definitely affect the quality of aid you receive from the medication. Check to make sure that you have not added or subtracted any supplements, medications or something like alcohol since your last go-around with the medication. If you've developed any other medical or mental health conditions, suffered an injury or serious illness, or got any new allergies to something you had no issue with before, those are likely to change how Vyvanse feels. Again, it is a highly complex and individualized issue.
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Old 09-02-18, 07:45 AM
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Re: Doc Says Tolerance Stops at Correct Dose

Quote:
Originally Posted by KodyBear View Post
Thanks for the info guys. It's good to know that I have a low chance of developing tolerance when we zero in on the correct dose. So far, 30MG is pretty intense. Often need to take very deep breaths and exhale slowly.

I've already experienced the afternoon crash and its associated anxiety, irritability and anger. I've also very recently tapered off of and discontinued Celexa and Wellbutrin after taking them for 12 years. So that is likely contributing as well.

I'm a single father of four boys ranging 9 to 4 years of age and on Sunday afternoon they were irritating the hell out of me. I was very short with them and shouted at them, which I don't like to do.

Yesterday and today I skipped my morning .5MG klonopin and combined it with my afternoon .5MG klonopin, and it did the trick. My anxiety and irritability were very low. However, I'll likely have to talk to my doctor about upping my klonopin dosage to 1.5MG per day so I can take .5MG in the morning and 1MG at 5PM.


Again, thanks for the information.

It might be worth your while trying training in therapeutic mindfulness meditation ( ie by a qualified therapist- psychologist, social worker etc).





In the longer term (at least 2 months of supervised training) this can have effects that are far more rapid in onset than a dose of almost any non injected medication. It is particularly helpful for irritability, and i have also found that since I learned it my dose of stimulants has been permanently lower.
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Old 09-02-18, 11:09 PM
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Re: Doc Says Tolerance Stops at Correct Dose

I just started vyvanse a few weeks ago. I haven't noticed any difference at all. Actually feel it makes my brain fog worse. I'm on 30mg right now. I tried adderall XR and IR and didn't enjoy it either. IR i felt a difference and was super awake, but it faded quickly. XR 20mg i felt a huge difference but it lasted all day. Literally up till 2am and beyond. I haven't really found any meds that work great. My doc is stumped too, and some make me worse which is odd. I feel more "up" on coffee most times. I've tried meds on empty stomach, meds on full stomach. Eat breakfast then take meds half hour later. Every suggestion i can think of.
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Old 09-03-18, 09:50 PM
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Re: Doc Says Tolerance Stops at Correct Dose

I don't know that this is anything other than an opinion

I tend to gain tolerance sometimes so ill stop taking

(and yes, I know the difference between, a high, drug working and so on)

more just to do with the person, everybodies different
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