Stimulants Question about my medications (Vyvanse & Valium) and dosage

[thatniceguy]

Note: I dont abuse drugs or plan to. I just thought this place would be the best place to ask about my medication as you all are knowledgeable.



I havent been diagnosed with anything but im pretty certain I have ADD/ADHD. Big focus issues. I get bored of tasks easily, cannot stay focused or work.

Althought my doctor hasnt diagnosed me yet because he doesnt like to diagnose/label people in such a short period of time, he has still given me medication to treat symptoms. I was prescribed by my doctor Vyvanse (60mg, once a day), I also have been prescribed Valium (Diazepam) 5mg 2x a day (once morning and once at night) for anxiety issues.

I've been on it for several months now...

Sometimes I don't take the diazepam and I am slowly getting off them anyway. Sometimes ill take just 1 5mg at night to sleep, sometimes none at all. I had anxiety issues before the diazepam but with the diazepam I have been able to mentally become comfortable in social situations to the point where I feel like I no longer need the diazepam.. so thats not my issue anymore and I plan on stopping it completely


But my Vyvanse however, I get 30 capsules of 60mg (1 months worth, i take one a day)

I take it in the morning (60mg) usually (before I was taking it only on the days where I had to work, rather than every day because I needed it to focus.. but now ive just been taking it every day), I usually wake up around 7 or 8 am... I take it, it kicks in around 9am... I feel happy, excited and focused. and it lasts until about 5 or 6pm.. I wish it lasted a bit longer, maybe till like 8pm... and I start to feel tired/depressed (the comedown, which is not that bad becuase I sleep around 8pm so I only experience it for an hour or 2)...

During these several months, nothing has changed. I always feel the same effects, which is good and what I want, so I havent really become 'tolerant' despite being on them for over 4 months.


Now heres my problem:


Ive travelled overseas... and they dont have 60mg capsules here.. only 30, 50 and 70...

so I just got myself a prescription of 30mg x 60 capsules (for 1 months worth, taking 2 a day to equal my 60mg)... this was an issue because 60 capsules of 30MG is almost 300$!!! and I cannot afford this every month, but I need this medication... but I bought it anyway.

HOWEVER, today I only took 1 30mg, rather than 2... so ive lowered my dosage to see what happens and how much of a difference it makes. So that way I can get 30 capsules rather than 60 capsules of 30mg a month so I could get it for half the price.


So my questions:

1. Will it be a big difference going from 60mg to 30mg a day? What can I expect? Will the comedown hit me earlier? Or should it be the same?

2. The price of 30mg x 60 capsules is 300$.... the price of 50mg x 30 capsules is 170$.... the price of 70mg x 30 capsules is 180$..... obviously the other two are cheaper... so next time I see my doctor i plan on changing the dose IF the 30mg is not as helpful as the 60mg dosage.

3. If I do end up changing my dosage (which is normally 60mg a day)... would going down to 50mg make much of a difference... or would u recommend I go up to 70mg a day especially since I want it to last an hour or two longer than it normally does?

4. If I take my diazepam 5mg with my Vyvanse... since Diazepam is a downer, will it take the "focus" effect of Vyvanse away, or will it just take the alert/awakeness effect of Vyvanse away?

 

[InterestingFACT]

Do you have a prior history of stimulant abuse?

I ask this because it doesn't make much sense for your doctor to start you at 60mg. For reference, I'm prescribed 50mg Vyvanse/daily, and I've been prescribed stimulants since I was a young child. It still works very well, and it's been more than a year since I switched to it from Focalin.

I feel your pain on the monetary front: I pay about 180 per script as well. Needless to say that it's impractical for you to continue this dosing 2x30mg. Raising the dose will probably increase the duration at least marginally due to Vyvanse's mechanism of metabolism. Likewise, you'll probably notice a significant reduction in duration when jumping down to 30mg.

In my opinion, 30mg will probably "feel" insufficient to you now after having been at the 60mg dose for a while, but sometimes the subjective "feel" of a drug has more to do with its modification of your mood than with its actual performance as a treatment for ADHD. Remember that the euphoric pushy urge to get stuff done that everyone gets early on isn't practical to maintain. Instead you should be shooting for an actual reduction in attention deficit (Which isn't the same as an increase in productivity). Whether 30mg will do that for you or not, there's only one way to find out.

On the topic of extending the duration, note that Vyvanse is enzymatically cleaved into d-amp with a 1 hour metabolic half-life, while d-amp itself has a halflife of 8-11 hours. This basically means that blood plasma concentration slowly builds from the time you take the pill to a peak somewhere between 4 and 7 hours later before dipping a little bit more rapidly (because no more lysdexamfetamine is being cleaved to slow the drop in plasma concentration).

However because the time release is enzymatic, you don't have to worry about accidentally breaking it by opening up the pill. The powder inside is water soluble, and you could consider splitting up your consumption of a 50mg or 70mg pill over the course of a couple hours. Just don't take it too late--keep in mind that you reach plasma peak multiple hours after consumption.

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In respect to comedown--you'll notice a milder comedown with a lower dosage, though it might happen sooner. That being said, I hardly notice the comedown at all on 50mg. If you're getting comedowns, it might indicate that your dosage is too high.